Journal for ImmunoTherapy of Cancer

BackgroundPancreatic ductal adenocarcinoma (PDAC) is the paradigmatic immunotherapy-refractory cancer, with a 5-year survival of approximately 12% and minimal benefit from immune checkpoint blockade (ICB). The dominant mechanistic explanation classifies PDAC as a T cell-excluded "cold" tumor, implying that no functional anti-tumor T cells are available for checkpoint release. Whether this Block-strategy view is correct has not been re-examined under integrated evasion-framework analysis. MethodsWe applied a previously developed 16-module immune evasion framework to TCGA-PAAD (n=183), integrated with hub-cytokine analysis (IL-10/TGF-{beta}), Kv1.3-immune channelome data, and clinical trial mapping (12,007 trials). Single-cell validation used two independent PDAC cohorts retrieved through TISCH2: PAAD_CRA001160 (Peng 2019, 35 samples [24 PDAC + 11 adjacent normal], 57,443 cells) and PAAD_GSE154778 (Lin 2020, 16 samples, 14,953 cells), examined for CD8A, TOX, PRF1, KCNA3, and FAP expression by cell type. ResultsPDAC scored highest in CAF Wall (z=0.768) and Platelet Cloak (z=0.663) modules; strategy classification yielded Brake -- not Block -- driven by a positive KCNA3-survival relationship (HR=0.649, 95% CI 0.43-0.97, p=0.037). Single-cell qualitative analysis of TISCH2 violin plots showed that CD8 exhausted T cells (CD8Tex) carried (i) high CD8A, (ii) the highest TOX expression among annotated cell types, (iii) preserved PRF1, and (iv) high KCNA3 expression. FAP was strongly localized to fibroblasts (peak [~]3.0 vs. <0.5 elsewhere). The pattern was reproduced in the second cohort. The optimal three-module attack (MHC restoration + CAF disruption + VEGF blockade) suppressed 10 of 16 evasion modules in silico (62.5%); zero of 370 PDAC immunotherapy trials test this combination. ConclusionsPDAC may not be T cell-cold but T cell-trapped: CD8 T cells with intact Kv1.3 channels appear immobilized behind a FAP-positive cancer-associated fibroblast wall. ICB monotherapy is mechanistically insufficient because the brake is engaged on T cells that cannot reach the tumor. The framework predicts that triple-targeted intervention -- checkpoint release + CAF wall disruption + vascular normalization -- is the minimum effective strategy. This is a hypothesis-generating computational analysis; prospective experimental and clinical validation are required.

Interleukin-2 (IL-2) remains an attractive cytokine for enhancing antigen-specific CD8 T cell responses in cancer immunotherapy, but systemic toxicity hinders its broad clinical application. To address this, various IL-2-based therapeutics have been engineered with altered IL-2 receptor bias or targeted delivery to tumors, the tumor microenvironment, or immune cell populations. Ideally, IL-2 signals should be selectively delivered to antigen-specific CD8 T cells, boosting their responses and promoting effector differentiation while sparing non-targeted populations. Immuno-STATTM (Selective Targeting and Alteration of T cells) is a fusion protein platform comprising a bivalent peptide-MHC class I complex and an affinity-attenuated IL-2 mutein that co-stimulates TCR and IL-2 signaling in epitope-specific CD8 T cells. Here, we investigated whether a DbGP33-41-targeted Immuno-STAT enhances DbGP33-specific CD8 T cell responses in a mouse model of chronic lymphocytic choriomeningitis virus (LCMV) infection. Immuno-STAT treatment selectively expanded DbGP33-specific CD8 T cells with an effector-like phenotype. Non-targeted DbGP276-specific CD8 T cells showed little to no expansion in response to DbGP33-41-targeted Immuno-STAT therapy, underscoring the selectivity of this approach. However, minor changes in phenotypic markers, including increased expression of CD25 and CX3CR1, were observed in non-targeted CD8 T cells, likely reflecting bystander IL-2 signaling. Combining Immuno-STAT with PD-1 blockade augmented DbGP33-specific CD8 T cell responses more effectively than PD-1 blockade alone, with minor effects on the non-targeted DbGP276-specific population. These findings inform the clinical development of Immuno-STAT and other IL-2 therapeutics and highlight the value of coordinated TCR and IL-2 stimulation during chronic antigen exposure, alone or in combination with PD-1 blockade. IMPORTANCEInterleukin-2 (IL-2) is a key cytokine for promoting effector differentiation of antigen-specific CD8 T cells and remains an attractive agent in cancer immunotherapy, but systemic toxicity limits its clinical use. This study addresses a central challenge in IL-2-based immunotherapy: delivering IL-2 to cognate antigen-specific CD8 T cells while minimizing activation of non-targeted populations. Using a mouse model of chronic lymphocytic choriomeningitis virus (LCMV) infection, we show that the Immuno-STAT (Selective Targeting and Alteration of T cells) platform selectively expands targeted virus-specific CD8 T cells and enhances their function while limiting effects on non-targeted populations. We also show that combining Immuno-STAT with PD-1 blockade further enhances targeted virus-specific CD8 T cell responses during chronic LCMV infection. These findings provide mechanistic and preclinical support for integrating T cell receptor (TCR) specificity with IL-2 signaling to advance cancer immunotherapy and guide next-generation IL-2 therapeutics for cancer and chronic infection.

Protein tyrosine phosphatase non-receptor 11 (PTPN11/SHP2) is a critical upstream mediator of RAS-MAPK signaling and a central node in adaptive resistance mechanisms evolving with RAS and MEK/ERK inhibition. Accordingly, clinical trials are currently evaluating allosteric SHP2 inhibitors in vertical RAS pathway combination therapies for various KRAS-mutant malignancies, including pancreatic ductal adenocarcinoma (PDAC). Here, we aimed to delineate the immunomodulatory effects of SHP2-based vertical RAS pathway inhibition in notoriously immunotherapy-refractory PDAC, spanning from early treatment response to invariably evolving adaptive resistance. Employing human and murine PTPN11 knockout and wild-type PDAC cell lines, an autochthonous murine PDAC model (KPC), and patient-derived PDAC organoids, we find that short term dual MEK/SHP2 inhibition induces increased T cell infiltration and a reduction in immunosuppressive M2-like macrophages. However, these effects are accompanied by a decrease in mature dendritic cells and a concomitant expansion of monocytic myeloid-derived suppressor cells, indicative of a mixed immunological response with both immune-activating and immune-suppressing features. These changes are associated with tumor cell-intrinsic upregulation of CXCR3 ligands and TGF-{beta}, as well as increased expression of checkpoint ligands for TIGIT and TIM-3 across molecular subtypes and species. With prolonged treatment and transition to an adaptive resistant tumor cell state, the initial immune-sensitizing effects are lost and the immune-suppressive features prevail. M2-like macrophages re-accumulate, dendritic cell maturation remains impaired, TGF-{beta} expression persists, and TIGIT and TIM-3 ligand expression is further enhanced. Notably, dual SHP2/RAS inhibition recapitulates the observed induction of TGF-{beta} and checkpoint ligands. Collectively, these findings identify a dynamic but ultimately immunosuppressive remodeling of the tumor microenvironment in response to SHP2-based vertical RAS pathway inhibition in PDAC and provide a rationale for combinatorial immunotherapy strategies. In particular, concurrent targeting of TGF-{beta}, combined TIGIT/TIM-3 checkpoint blockade, and likely CD40 agonism may help sustain early immune activation while counteracting emerging suppressive features, thereby improving the durability of tumor control.

BackgroundAntibody-mediated blockade of innate receptor-MHC-I interactions represents a promising strategy to enhance anti-tumor immunity, particularly against metastatic cancers resistant to conventional checkpoint inhibitors. In this study, we investigated the effects of the pan anti-MHC-I monoclonal antibody M1/42, which targets MHC-I interactions with Ly49, selectively expressed on murine NK cell subsets. MethodsWe administered M1/42 to mice and assayed the proliferation and activation immune cells. Anti-tumor activity of growth and metastasis of checkpoint inhibitor-resistant pancreatic ductal adenocarcoma (PDAC) and B16F10 melanoma were assessed, complemented by extensive cellular phenotypic and RNA expression analysis. Binding and cryo-electron microscopic (cryo-EM) and X-ray crystallographic structural studies of M1/42 complexed with the mouse MHC-I molecule, H2-Dd, examined the Ab interaction site in comparison with those of Ly49 inhibitory receptors. ResultsM1/42 administration in mice robustly unleashed the proliferation and activation of natural killer (NK) cells, memory CD4+ and CD8+ T cells, dendritic cells, and macrophages in both lymphoid and non-lymphoid tissues, independent of Fc{gamma} receptors. M1/42 significantly restricted the growth and metastasis of checkpoint inhibitor-resistant pancreatic ductal adenocarcinoma (PDAC) and B16F10 melanoma in the liver and lungs, accompanied by increased tumor infiltration of effector CD8+ T cells, reduction of T regulatory cells, and a pro-inflammatory cytokine milieu. The anti-tumor effects of M1/42 depend on NK cells and are associated with upregulation of genes involved in antigen processing, interferon gamma responsiveness, and Th1 cytokine production, while downregulating inhibitory PD1/11 signaling. Structural analysis indicated that the effect of M1/42 on Ly49/MHC-I interactions was not due to direct steric competition. ConclusionsCollectively, these findings demonstrate that M1/42 unleashes coordinated innate and adaptive immune responses, overcoming tumor-induced immunosuppression and resistance to checkpoint blockade. This approach represents a paradigm shift in cancer immunotherapy, offering potential for more effective treatment of metastatic cancers that evade immune surveillance through MHC-I modulation. KEY MESSAGESO_ST_ABSWhat is already known on this topicC_ST_ABSA pan anti-mouse MHC-I mAb (M1/42) blocks interaction with several NK inhibitory receptors (Ly49A or Ly49C) resulting in NK cell activation and anti-viral and anti-tumor responses in vitro and in vivo. Other pan anti-human MHC-I mAbs (DX17 and W6/32) function similarly, blocking LILRB inhibitory receptor interaction of myeloid cells and NK cells. These stimulate human immune cells in humanized mouse models. What this study addsThis study analyzes the effects of the pan anti-mouse MHC-I mAb on NK and myeloid cell activation in detail, in the absence of T or B cells, and independent of FcR interaction. Additionally we analyze several mouse models of metastatic tumor progression, indicative of the progressive activation not only of the innate immune response, but also adaptive responses. The molecular mechanism of the mAb blocking of inhibitory receptors is revealed by cryo-EM and X-ray structures of M1/42 Fab/MHC-I (H2-Dd) complexes. How this study might affect research, practice, or policyElucidation of the details of the inhibitory effects of the mouse pan anti-mouse MHC-I mAb provides not only a more advanced understanding of the murine model system, but suggests additional functional avenues to be explored using the parallel an anti-human MHC-I mAbs.

Irreversible electroporation (IRE) has shown promise for treating pancreatic ductal adenocarcinoma (PDAC), but whether IRE can induce an abscopal effect is not established. We demonstrated that the combination of IRE and anti-PD-1 antibody could trigger robust abscopal effects in preclinical models of metastatic PDAC. Data from multiple in vivo models, RNA-seq, scRNA-seq, and spatial immunofluorescence provide compelling evidence that IRE induced mitochondrial dysfunction and cellular stress, which triggered activation of the cGAS-STING pathway and subsequent systemic antitumor effects. IRE also led to inflammatory response characterized by tumor infiltration of myeloid cells and their polarization toward M1 state, turning immunologically "cold" tumors into "hot" tumors. Moreover, the presence of T cell/B cell clusters in tumors from mice treated with IRE plus PD-1 and the lack of antitumor efficacy in B cell knockout mice bearing orthotopic murine PDAC tumors indicate that B cells play an important role in IRE-mediated systemic antitumor immunity. SignificanceThis study shows that IRE plus a checkpoint inhibitor represents a promising therapeutic strategy for PDAC and supports advancing this treatment toward clinical translation. Our data also support potential combination strategies with immunomodulatory agents that can recruit and reprogram B cells to support T cell activation and cytotoxic effector functions.

Importance: While gut dysbiosis is known to impair response to immune checkpoint inhibitors (ICIs), the relative clinical impact of antibiotic timing (pre- vs. post-ICI initiation) remains unclear. Objective: To evaluate whether antibiotic timing differentially influences overall survival (OS) in a large, multi-institutional pan-cancer cohort. Design, Setting, and Participants: This retrospective cohort study utilized deidentified electronic health record data from six academic medical centers within the University of California Health system. We included 21,108 adults with any malignancy who received PD-1, PD-L1, or CTLA-4 inhibitors between January 2014 and December 2024. Exposures: Antibiotic exposure windows were categorized as pre-only (-60 to -1 days), post-only (+1 to +60 days), both windows, or none. Main Outcomes and Measures: The primary outcome was overall survival (OS) calculated from the first ICI dose. Multivariable Cox proportional hazards models adjusted for demographics, tumor type, line of therapy, and baseline health indicators (albumin, NLR, and recent hospitalization). Results: Among 21,108 patients, 17.3% had pre-only exposure, 13.3% had post-only exposure, and 60.6% had no exposure. In the multivariable model, post-only exposure (HR, 1.27; 95% CI, 1.20-1.35) and combined pre- and post- exposure (HR, 1.31; 95% CI, 1.23-1.40) were significantly associated with higher mortality. Pre-only exposure was not significantly associated with OS (HR, 1.04; 95% CI, 0.99-1.10). Subgroup analyses by tumor type showed consistent trends across major malignancies, including head and neck (Post HR, 1.46) and renal cell carcinoma (Post HR, 1.26). Conclusions and Relevance: In contrast to some smaller studies, this large-scale analysis indicates that antibiotic exposure after ICI initiation carries a greater risk than exposure prior to treatment. These findings highlight the need for rigorous antibiotic stewardship strategies specifically during the early phases of immunotherapy treatment.

Immune checkpoint inhibition (ICI) is clinically active against multiple cancers, including urothelial cancer at the non-muscle invasive, muscle-invasive, and metastatic stages. Despite this, large numbers of patients experience disease progression and relapse after treatment with ICI-containing regimens. Tumor antigen-specific T cells are critical to ICI response, however few studies have evaluated the breadth and magnitude of tumor antigen-specific T cell responses with ICI therapy. In this study, we mapped the tumor antigen immunodominance hierarchy in the BBN963 model of murine basal-like bladder cancer for endogenous tumor neoantigens expressed physiologically. We used a high-throughput matrixed ELISpot assay to detect CD8+ T cell responses to predicted BBN963 tumor antigens derived from multiple mutational genomic sources. We found CD8+ T cell responses were directed against a subset of tumor antigens forming a stable and reproducible immunodominance hierarchy across individual mice. Treatment with anti-PD-1 or anti-CTLA-4 did not substantially reshape this hierarchy or broadly shift dominant responses to previously defined subdominant epitopes. Predicted peptide MHC binding stability and affinity was associated with antigen immunogenicity. Cancer-testis antigens, endogenous retroviral antigens, and SNV-derived tumor antigens that were immunogenic were found across tumor subclones. By diversifying the immunogenic antigen repertoire beyond SNVs, we achieved nearly 100% tumor subclone coverage, suggesting that broader antigen selection could help immunotherapy target more tumor subclones. In conclusion, this study supports the stability of the immunodominance hierarchy under ICI therapy and a role for broadening antigen discovery to multiple expressional sources in immunotherapy design.

BackgroundTumour-associated macrophages (TAMs) play critical roles within the tumour microenvironment regulating immune evasion and therapeutic response. Previously, we have shown that the combination of Checkpoint kinase 1 inhibitor (CHK1i) with a subclinical dose of hydroxyurea (LDHU) reprograms the tumour immune microenvironment to a pro-inflammatory status. MethodsWe investigated a tumour-restricted Fcgr4 (Cd16.2) expressing macrophage population in multiple murine tumour models and the impact of CHK1i+LDHU on this population, using conventional and imaging flow cytometry as well as single-cell sequencing. ResultsTranscriptional profiling using CITE-seq and single-cell RNA sequencing reveals that Fcgr4 TAMs closely resemble Fcgr4- TAMs but display modest enrichment of interferon-associated and inflammatory gene programs, consistent with a functionally biased state rather than a distinct lineage. Importantly, we show that a highly tumour selective CHK1i+LDHU therapy shifts TAMs toward a more inflammatory phenotype while preserving dominant immunosuppressive features. Depletion of CSF1R macrophages enhanced CD8 T cell activation without influencing tumour growth but significantly augmented therapeutic efficacy of CHK1i+LDHU. ConclusionTogether, these findings define a novel TAM population and establish how targeted therapy reshapes, but does not fully overcome, TAM-mediated immune regulation.

PURPOSE: Newly-diagnosed glioblastoma (nGBM) is a devastating tumor with median survival of only 14-18 months despite aggressive standard of care (SOC). Dendritic cell (DC) homologous antigenic double-loading provides a powerful pattern-based signal that initiates cDC1-like skewing of monocytic precursors, inducing downstream development of CD8+ memory effectors. Here we report phase I results for DOC1021 (dubodencel), a novel DC vaccine regimen integrated with SOC. METHODS: In this dose-escalating study, DC prepared from mobilized peripheral blood were doubly loaded with autologous tumor lysate and amplified tumor mRNA and administered bilaterally near the deep cervical node chains in three biweekly courses given with weekly peg-IFN after conclusion of chemoradiation. Four dose levels from 3.5x106 to 3.6x107 total cells were tested. Patients with subtotal resection or tumor progression prior to vaccination were not excluded. RESULTS: Eighteen patients (median age 61 years (range 47-73), 94% MGMT unmethylated, 25% subtotal/partial resected) completed vaccination (16 nGBM, 2 recurrent) with no dose-limiting toxicities. Attributable AE were mostly mild and flu-like or injection-site reactions. Twelve-month OS among the newly-diagnosed cohort was 88% compared to an expected ~60% for SOC alone. Patients who received observation rather than reoperation in response to worsening MRI contrast-enhancement demonstrated gradual lesional resolution and improved OS. Immunophenotyping revealed post-vaccination elevations in CD4 and CD8 memory T-cells in peripheral blood, and spatial transcriptomic analysis revealed foci of activated inflammatory complexes at the primary tumor site. CONCLUSIONS: DOC1021 was safe, feasibly integrated within SOC, and associated with more favorable outcomes in this challenging patient population. Patients who received observation rather than reoperation for worsening MRI contrast-enhancement exhibited superior survival, suggesting an immune-reactive tumor microenvironment manifesting as pseudo-progression. These data supported initiation of a randomized Phase II trial (NCT06805305) for nGBM.

CAR-T immunotherapy has achieved remarkable efficacy in hematologic malignancies. However, the widespread clinical adoption of autologous CAR-T products remains constrained by high costs, lengthy manufacturing process, and limited accessibility. Universal or off the shelf CAR-T (UCAR-T) cells derived from healthy donors offer a promising alternative, enabling immediate treatment at a lower cost. However, the allogeneic nature of UCAR-T cells triggers immune rejection by the host immune system after infusion, thereby compromising their persistence and therapeutic efficacy. Current strategies to circumvent this rejection focus on disrupting HLA class I expression. Although this modification allows UCAR-T cells to successfully evade T cell mediated elimination, the loss of HLA class I molecules renders them vulnerable to attack by host natural killer (NK) cells. In contrast to previous approaches that attempt to retain certain non-classical HLA molecules (such as HLA-E or HLA-G) to inhibit NK cells, we directly focused on editing the ligands that mediate NK cell rejection. Through transcriptomic and in vitro validation analyses, we found that UL16 binding proteins (ULBP) 2/5/6 were substantially upregulated in UCAR-T cells compared with nontransduced donor T cells. Elevated ULBP expression effectively activates the NKG2D receptor on allogeneic NK cells and leads to killing of UCAR-T cells, thereby impairing UCAR-T function. To test whether abrogating this NK activating signal could improve UCAR-T persistence and antitumor efficacy, we generated ULBP knockout UCAR-T cells using CRISPR-Cas9 editing. Deletion of ULBP2/5/6 significantly reduced NK cell mediated killing in vitro without affecting CAR expression or T cell effector function. Compared with wild type UCAR-T cells, ULBP deficient UCAR-T cells exhibited enhanced tumor killing efficacy in the presence of NK cells. Collectively, our findings identify ULBP upregulation as one of the mechanisms underlying NK cell mediated rejection of HLA deficient UCAR-T cells. Targeted ablation of ULBP molecules provides a novel strategy to confer resistance to host NK cells, thereby improving the therapeutic potential of universal CAR T products.

CD47 is a "dont eat me" signal that suppresses macrophage-mediated phagocytosis. Its upregulation in lung and other cancers facilitates tumour immune escape, making CD47 a promising immunotherapeutic target. Studies have demonstrated anti-tumour efficacy of CD47 blockade in preclinical lung cancer models, but monoclonal antibodies targeting CD47 have had limited efficacy as monotherapy in solid tumour patients to date. This discrepancy may in part reflect the use of human tumour xenografts in mice that do not have fully-functioning immune systems in preclinical efficacy studies. Thus, understanding tumour responses to CD47 inhibition using immune competent lung cancer models is needed to inform strategies to harness its therapeutic potential. Here, we characterized the effects of CD47 knockout (KO) on tumour growth and immune responses in two syngeneic, orthotopic murine lung cancer models, LLC-Luc (LLC) and CMT167 (CMT). As expected, CD47 KO impaired the fitness of LLC and CMT cells in vivo. Mice with CD47-deficient tumours exhibited prolonged survival and increased infiltration of anti-tumour leukocytes. However, although CD47 KO impaired lung tumour growth in syngeneic mice, KO tumours were ultimately lethal. Immunophenotyping revealed an increased prevalence of PD-L1+ cells in CD47-deficient tumours, nominating PD-L1-mediated suppression of tumour immunity as an acquired mechanism of resistance to CD47 blockade. Concordantly, dual inhibition of CD47 and PD-L1 extended the survival of CMT tumour-bearing mice compared to inhibition of either alone. These findings suggest that PD-L1 blockade could be leveraged to overcome resistance and potentiate the efficacy of CD47-targeted immunotherapy in lung cancer.

Defining the genetic and cellular programs that allow solid tumours to evade immune control requires preclinical models that preserve the complexity of the human tumour immune microenvironment. Most available systems capture only part of this biology. Organoid cultures and ex vivo tumour fragments can retain patient-derived tumour architecture and associated immune cells, but immune populations are typically maintained only for short periods. These models also cannot capture antitumour immune responses in the physiological setting of a living organism. Patient-derived xenografts propagated in humanized mice offer a potential path to overcome these limitations by combining patient-derived tumour tissue with a reconstituted human immune system. However, few studies have systematically tested whether these models reproduce the diverse immune cell phenotypes present in the parental tumours from which they are derived. This has limited their use for studying tumour-intrinsic mechanisms that shape immune composition and promote immune evasion. To address this gap, we profiled tumour-infiltrating, splenic, and bone marrow immune cells from ovarian, head and neck, and renal PDX models propagated in CD34+ hematopoietic stem cell (HSC)-derived huNOG-EXL mice expressing human IL-3 and GM-CSF. By comparing tumours grown across distinct HSC donor backgrounds with their matched primary tumour samples, we found that tumour-intrinsic factors are a dominant determinant of immune composition in humanized PDX tumours. Across models, these immune infiltrates generally resembled those of the corresponding parental tumours. These findings support humanized PDX models as a platform for functionally interrogating tumour-intrinsic drivers of immune composition and immune evasion in solid tumours.

Chimeric antigen receptor (CAR) T-cell therapy has shown limited efficacy in solid tumors, in part due to variability in autologous T cells derived from heavily pretreated patients with advanced disease. To address these constraints, we developed an off-the-shelf allogeneic CAR-T platform using CRISPR-Cas9-mediated genome editing in T cells from healthy donors to enable targeted CAR insertion at the TRAC locus with concurrent disruption of B2M. Using adeno-associated virus (AAV) delivery, we designed CAR-T cells targeting glypican-2 (GPC2) and glypican-3 (GPC3), emerging antigens expressed in pediatric and adult solid tumors. Genome-edited allogeneic CAR-T cells exhibited potent, antigen-specific cytotoxicity across multiple tumor models. GPC2-directed allogeneic CAR-T cells demonstrated enhanced or comparable activity relative to conventional lentiviral CAR-T cells in neuroblastoma models and mediated tumor regression with prolonged survival in preclinical models. Notably, repeated dosing augmented antitumor efficacy without evidence of toxicity, supporting multi-dose regimens for solid tumors. Similarly, GPC3-targeted allogeneic CAR-T cells based on a single-domain antibody showed robust activity against hepatocellular carcinoma cells in vitro and in vivo. These findings establish a scalable, genome-engineered allogeneic CAR-T strategy with strong therapeutic potential and support the clinical development of off-the-shelf cell therapies for pediatric and adult solid tumors.

Adoptive cell therapy (ACT) of tumor-specific T cells can improve survival in a subset of cancer patients. Current ACT approaches may be limited by using highly differentiated T cells which can be inhibited by an immunosuppressive tumor microenvironment (TME). Here, we developed an approach to optimize ACT and used spatial transcriptomics to show how stem-like and effector CD8+ T cells differentially mediate tumor control following vaccination. Spatial transcriptomic profiling of the TME showed that ACT with stem-like T cells followed by intravenous vaccination prevented immune exclusion, increased infiltration of pro-inflammatory macrophages, and reprogrammed tumor cells to upregulate Type I and Type II IFN signaling and apoptotic gene programs. The protective transcriptomic signature of the TME in this ACT model contained overlapping biomarkers with patients who responded to ACT therapy. This approach demonstrates synergy between transferred stem-like T cells and intravenous vaccination to transcriptionally remodel the TME and enhance tumor control.

While prostate cancer (PC) is defined as immunologically cold, limiting the efficacy of immune checkpoint inhibitors, therapeutic vaccination targeting tumor-associated antigens represents an attractive strategy to promote disease control in low volume metastatic patients. The UV1 cancer vaccine is based on immunization with tripeptide fragments from human telomerase reverse transcriptase (hTERT) and a phase II clinical trial demonstrated induction of robust T cell response in men with de novo metastatic castration-sensitive prostate cancer (mCSPC). Comparison with long-term survival data of non-metastatic CSPC patients as reference showed that despite metastatic disease at diagnosis, UV1-treated patients who mounted an early vaccine-induced immune response achieved progression-free and overall survival comparable to non-metastatic patients. We examined biological determinants of clinical benefit following UV1 vaccination including tumor transcriptome and T cell receptor (TCR) profiling from circulating and tissue resident T-cells of the 22 men enrolled. Analysis of diagnostic and post-UV1 treatment biopsies revealed that low baseline exhaustion of T cells and higher CD8+ T cell abundance are associated with early immune response to the vaccine and longer survival. Moreover, we identified specific TCR motifs relative to early responders, that can indicate potential benefit from UV1 vaccination. These findings indicate that baseline intratumoral T cell exhaustion state and repertoire shape responsiveness to hTERT vaccination and long-term outcome. Overall, our study underlines how baseline immune profiling may be used as a companion biomarker to predict mCSPC patients most likely to benefit from therapeutic vaccination.

Background: CD8+ tumor-infiltrating lymphocytes (TILs) are established prognostic markers in colorectal cancer, yet the clinical significance of CD103+CD8+ tissue-resident memory-like (TRM-like) T cells in locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (NACRT) remains unknown. Methods: We quantified CD8+ and CD103+CD8+ T-cell densities in stromal and intratumoral compartments of post-NACRT resection specimens from 40 LARC patients using Cu-Cyto, a deep learning-based imaging cytometry platform. Associations with survival, pathological response, and adjuvant chemotherapy (AC) were examined. Treatment-induced T-cell dynamics were assessed in paired pretreatment biopsies and post-NACRT resections (n = 9). Results: High stromal CD103+CD8+ density independently predicted better 5-year RFS (67.4% vs. 12.1%, p < 0.001) and OS (80.0% vs. 26.6%, p = 0.016); intratumoral density showed no prognostic significance. Pathological response correlated with stromal CD8+ but not CD103+CD8+ density. Paired analysis revealed a selective non-expansion of the CD103+ subset: stromal CD8+ T cells increased significantly after NACRT while CD103+CD8+ density remained unchanged. AC may preferentially benefit patients with low stromal CD103+CD8+ density. Conclusions: Stromal CD103+CD8+ T-cell density is a robust independent prognostic biomarker in rectal cancer after NACRT that appears to reflect pre-existing rather than treatment-induced immunity. Given its stability across NACRT, pretreatment biopsy assessment may provide equivalent prognostic information, with potential implications for patient stratification before treatment initiation.

Antigen escape is the dominant mechanism of therapeutic failure in chimeric antigen receptor (CAR) T cell and NK cell therapy, occurring in 30-60% of patients treated with single-target constructs. Existing discovery pipelines select epitopes and binders primarily on affinity metrics, neglecting evolutionary pressures that drive antigen editing, downregulation, isoform shifts, and glycosylation remodelling under sustained immunological selection. Here we describe Discovery 4.0, a five-layer computational engine developed at Pioneera Biosciences that encodes antigen escape resistance as a first-class engineering objective. Applied to four clinically validated hematologic antigens--CD19, CD20, CD22, and BCMA--Discovery 4.0 screened 20,000 synthetic binders in silico, designed 300+ CAR constructs, and validated [~]100 in co-incubation assays. The leading tri-specific construct achieved a 98.1% reduction in antigen escape relative to the best monospecific control, with an effective escape probability of 0.09%. Discovery 4.0 provides a generalizable, platform-scale framework for escape-resistant immunotherapy design applicable across oncological and autoimmune indications.

Colorectal cancer (CRC) displays inter-patient heterogeneity in molecular tumor features and immune cell composition, which influence therapy response. Humanized immune system (HIS) mouse models offer a promising in vivo model to study human tumor-immune interactions, yet their ability to recapitulate the CRC tumor immune microenvironment at single-cell resolution remains incompletely defined. Here, we performed single-cell RNA sequencing of systemic and tumor-infiltrating human immune cells in HIS mice bearing human CRC tumors and benchmarked these data against reference datasets of healthy human spleens and primary CRC tumors. Major immune lineages and transcriptional programs characteristic of the human systemic immune compartment were identified, and HIS mouse tumors developed complex, human-like immune infiltrates. Tumor-infiltrating immune cells comprised diverse T cell, myeloid, natural killer, and B cell populations, including exhausted T cell states marked by expression of PDCD1, TIGIT, HAVCR2, LAG3, and CTLA4. We further demonstrate CRC consensus molecular subtype-associated spatial differences in immune infiltration. Collectively, our findings support the use of HIS mice as a relevant model for studying CRC immune landscapes and preclinical evaluation of immunomodulatory therapies.

In recent years, immunotherapy of patients with higher-risk non-muscle invasive bladder cancer (NMIBC) in North America has relied on the use of the TICE strain of BCG. However, limitations in the supply chain have warranted investigation of the therapeutic benefit of other strains of BCG, such as BCG-Russia. Trained immunity, a form of innate immune memory, is now widely believed to be an important component of the therapeutic benefit of BCG. Therefore, in the present study we compared the effects of BCG-TICE and BCG-Russia on the acquisition of trained immunity and related secondary immune responses. C57BL/6 mice received a single intravenous injection of BCG-Russia or BCG-TICE. Four weeks later, bone marrow was collected for flow cytometric analysis of hematopoietic stem and progenitor cell (HSPC) populations, generation of bone marrow-derived macrophages, functional assessment of trained immunity, and transcriptomic profiling. Compared with BCG-Russia, BCG-TICE elicited stronger levels of trained immunity, characterized by higher production of several proinflammatory cytokines upon secondary activation. BCG promoted the expansion of HSPCs independent of strain. BCG-TICE was linked to upregulation of key inflammation-related genes and enrichment of functionally relevant pathways. The results of this study reveal strain-dependent differences in the ability of BCG to induce innate immune memory and inflammatory pathways that could ultimately determine efficacy of immunotherapy of patients with NMIBC.

Neoantigens are cancer-specific antigens arising from genomic alterations. Single Amino Acid Variants (SAAVs) represent a primary class of these neoantigens. To evaluate the therapeutic potential of Neurofibromin 1 (NF1)-derived SAAVs - given that NF1 is frequently mutated in malignant brain tumors - we prioritized the 40 NF1 SAAVs determined to be HLA-A*02:01 binders using computational prediction coupled with experimental validation. To validate these predicted neoepitopes, we employed a two-tiered experimental approach in HLA-A*02:01 homozygous U87-MG cells. We first synthesized minigene constructs encoding the predicted neoepitopes, introduced them via lentiviral transfection and confirmed their expression by mass spectrometry (MS). Subsequently, we performed endogenous validation using pan-HLA immunoprecipitation mass spectrometry (IP-MS), confirming 4 (10 neoepitopes) of the 40 candidate SAAVs. We observed a discrepancy between in silico predictions and the observed sequences. Our endogenous peptidomics further revealed conserved peptide motifs and demonstrated that peptide selection for HLA presentation is transient. While our study substantiates the therapeutic feasibility of T-cell immunotherapies targeting NF1 mutations, these results underscore a limitation in current computational prediction. Our study highlights the necessity of experimental validation to refine neoantigen prioritization strategies.