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CAR T cell therapy has revolutionized the treatment of B cell leukemia, lymphoma, and multiple myeloma1,2. CAR T cells are also being investigated for solid tumor malignancies3. However, recurrent mechanisms for failure of CAR T cell therapy have been identified, including poor expression or loss of the CAR target antigen molecule, development of T cell dysfunction (exhaustion), active immune suppression by the tumor microenvironment, and limited T cell trafficking to and persistence in the tumor microenvironment3,4,5,6. While individual engineering solutions have been devised to attempt to overcome each of these CAR T cell resistance mechanisms3, introducing multiple engineered functions into a cell therapy product to simultaneously overcome multiple resistance mechanisms is challenging due to the limited genetic packaging capacity of retroviral and lentiviral vector systems7.
To overcome limitations in vector packaging capacity, co-transduction of T cells with multiple vectors has been used increasingly. Vector co-transduction has been used to study logic-gated and drug-regulated T cell engineering strategies in pre-clinical studies8,9,10 and in a recent clinical trial evaluating CD19/CD22 dual-CAR T cells to overcome vector packaging limitations11. However, co-transduction generates mixed cell products containing combinations of single- and dual-transduced T cells, which may impair functionality of the product if it depends on components encoded by both vectors and may also lead to competition between single-transduced T cells12.
To overcome these challenges, we have developed a methodology called Zip-sort, which uses heterodimerizing leucine zippers - each expressed from one of two co-transduced vectors - to direct single-step immunomagnetic purification of dual-transduced cells13. In this protocol, we describe methods for constructing retroviral vectors incorporating our Zip-sort methodology, retroviral supernatant production and concentration, T cell activation and co-transduction, and immunomagnetic purification of dual-transduced cells (Zip-sort).