Systems serology of responses against tumor antigens in ovarian cancer reveal disrupted Fc-mediated immunity

High-grade serous ovarian cancer (HGSOC) represents 75% of ovarian cancer cases and 80% of deaths, with most patients relapsing despite initial treatment response. The limited effectiveness of immunotherapies in HGSOC indicates urgent need for novel therapeutic approaches. HGSOC patients produce tumor-binding autoantibodies (TBAs) with high tumor selectivity. Since effective antibody-mediated tumor cell killing requires Fc domain interactions with immune cells, we hypothesized that, although TBAs recognize tumor cells, they might still poorly elicit cell killing responses. Using a systems serology approach, we profiled TBA subclass and biophysical interactions with Fc receptors in HGSOC, comparing them to antiviral antibody responses. TBAs were consistently identified within ascites and serum and were heterogeneous in subclass composition. However, TBAs consistently lacked the capacity to bind Fc{gamma}RIIIa despite abundant interaction with Fc{gamma}RIIa and poorly elicited antibody-dependent cellular cytotoxicity, suggesting their Fc features prevent cell killing responses. Restoring Fc{gamma}RIIIa interaction may be a promising therapeutic approach in HGSOC. HighlightsO_LITBAs in ovarian carcinoma patients consistently lack interaction with Fc{gamma}RIIIa C_LIO_LIAscites- and serum-derived TBAs have heterogeneous subclass composition C_LIO_LISystems analysis shows complex serologic differences between TBAs and antiviral responses C_LIO_LIPatient-expressed TBAs demonstrate little antibody-dependent cellular cytotoxicity C_LI