Engineering allorejection-resistant adaptive NK cell therapies — ASN Events

Engineering allorejection-resistant adaptive NK cell therapies (#192)

Karen E Martin 1 2 , Silje Zandstra Krokeide 1 2 , Lamberto Torralba-Raga 1 2 , Julia Zeun 1 2 , Merete Thune Wiiger 1 2 , Johanna Olweus 1 2 , Ebba Sohlberg 2 3 , Karl-Johan Malmberg 1 2 3
  1. Department of Cancer Immunology, Oslo University Hospital, Oslo, Norway
  2. Precision Immunotherapy Alliance, Oslo, Norway
  3. Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden

Allogeneic cellular immunotherapies have the potential to revolutionize cancer treatment due to their cost-effectiveness, scalability, and on-demand availability. However, the immunogenicity and limited persistence of allogeneic cells remain significant obstacles to achieving sustained, robust antitumor responses with these therapies. A common strategy to address immunogenicity has been genetic knockout of HLA molecules, which efficiently abrogates T cell-mediated rejection in the recipient, but triggers rejection by natural killer (NK) cells via missing-self recognition. Our lab has previously demonstrated that knocking out key adhesion ligands within the immune synapse, specifically ICAM-1 and CD58, broadly protects allogeneic iPSC-derived NK cells from host NK cell-mediated rejection and increases persistence in vivo. Here, we developed a one-shot approach for adhesion ligand knockdown combined with CD19-targeted chimeric antigen receptor (CAR19) expression by incorporating microRNA-based shRNAs targeting ICAM-1 and CD58 into a CAR plasmid. The shRNA sequences and construct design were optimized for simultaneous knockdown and CAR19 expression as assessed by flow cytometry-based screens. Functional experiments showed that engineering NK cells with these one-shot constructs mitigated their rejection by host NK cells and T cells as shown by flow cytometry-based killing assays. Additionally, NK cell killing of CD19+ tumors was enhanced by the expression of CAR19, together demonstrating the ability to multiplex shRNA-based protein knockdown and drive functional CAR expression, all off a single promoter. This approach was evaluated in our primary adaptive NK cell therapy platform (ADAPT-NK), which is poised to enter clinical trials, thereby making significant progress towards the development of highly potent, immune-evasive ADAPT-NK cells for use as an off-the-shelf cancer immunotherapy.