CAR T cell engineering impacts antigen-independent activation and co-inhibition

Viral vectors have successfully modified T cells to express chimeric antigen receptors (CAR), leading to clinical approvals. However, their high cost and regulatory challenges hinder rapid and broad clinical translation. Here, we demonstrate that our lentivirally (LV) manufactured R110-CAR T cells, targeting a leukemia neoepitope, can also be engineered using non-viral Sleeping Beauty (SB) transposition with minimal-sized DNA vectors. Flow cytometry and single-cell sequencing was used to compare the two production modes using healthy donor and CLL patient-derived T cells and a CD19-CAR T cell control. SB products were shifted towards CD8 ⁺ subsets with expression of activation/co-inhibition markers (CD69, LAG-3, TIM-3) despite their naïve-like phenotype and lack of antigenic challenge. The CAR binding moiety modulated these patterns with R110-CAR T cells showing more aberrant phenotypes. Moreover, SB engineering resulted in inflammatory signatures along with RIG-I-like and TOLL-like nucleotide sensing potentially resulting from the transfection procedure. Patient-derived products showed significantly fewer CAR-expressing cells, reduced proliferation clusters, and lower T cell diversity, particularly with SB manufacturing, pointing at potential challenges with this method when engineering CLL T cells. Together, our data suggest that the engineering mode may substantially influence T cell properties and that these are further modulated by the CAR binding moiety and the type of T cell donor.