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T cells play a key role in cell-mediated immunity, and strategies to genetically modify T cells, including chimeric antigen receptor (CAR) T cell therapy and T cell receptor (TCR) T cell therapy, have achieved substantial advances in the treatment of malignant tumors. In clinical trials, CAR-T cell and TCR-T cell therapies have produced encouraging clinical outcomes, thereby demonstrating their therapeutic potential in mitigating tumor development. This article summarizes the current applications of CAR-T cell and TCR-T cell therapies in clinical trials worldwide. It is predicted that genetically engineered T cell immunotherapies will become safe, well-tolerated, and effective therapeutics and bring hope to cancer patients.

Adoptive cell therapy (ACT) is a kind of immunotherapy in which T cells are genetically modified to express a chimeric antigen receptor (CAR) or T cell receptor (TCR), and ACT has made a great difference in treating multiple types of tumors. ACT is not perfect, and it can be followed by severe side effects, which hampers the application of ACT in clinical trials. One of the most promising methods to minimize side effects is to endow adoptive T cells with the ability to target neoantigens, which are specific to tumor cells. With the development of antigen screening technologies, more methods can be applied to discover neoantigens in cancer cells, such as whole-exome sequencing combined with mass spectrometry, neoantigen screening through an inventory-shared neoantigen peptide library, and neoantigen discovery via trogocytosis. In this review, we focus on the side effects of existing antigens and their solutions, illustrate the strategies of finding neoantigens in CAR-T and TCR-T therapies through methods reported by other researchers, and summarize the clinical behavior of these neoantigens.

To address immune escape, multi-specific CAR-T-cell strategies use natural ligands that specifically bind multiple receptors on malignant cells. In this context, we propose a split CAR design comprising a universal receptor expressed on T cells and ligand-based switch molecules, which preserves the natural trimeric structure of ligands like APRIL and BAFF. Following optimization of the hinges and switch labeling sites, the split-design CAR-T cells ensure the native conformation of ligands, facilitating the optimal formation of immune synapses between target cancer cells and CAR-T cells. Our CAR-T-cell strategy demonstrates antitumor activities against various B-cell malignancy models in female mice, potentially preventing immune escape following conventional CAR-T-cell therapies in the case of antigen loss or switching. This ligand-based split CAR design introduces an idea for optimizing CAR recognition, enhancing efficacy and potentially improving safety in clinical translation, and may be broadly applicable to cellular therapies based on natural receptors or ligands. A switchable CAR-T cell platform comprises a universal receptor expressed on T cells and tumor-targeting adapter molecules. Here the authors propose an APRIL- and BAFF-based switchable CAR strategy for ligand-mediated CAR-T-cell activation, showing anti-tumor activity in models of B-cell malignancies.

Background Immunotherapeutic approaches designed to augment T and B cell mediated killing of tumor cells has met with clinical success in recent years suggesting tremendous potential for treatment in a broad spectrum of tumor types. After complex recognition of target cells by T and B cells, delivery of the serine protease granzyme B (GrB) to tumor cells comprises the cytotoxic insult resulting in a well-characterized, multimodal apoptotic cascade. Methods We designed a recombinant fusion construct, GrB-Fc-4D5, composed of a humanized anti-HER2 scFv fused to active GrB for recognition of tumor cells and internal delivery of GrB, simulating T and B cell therapy. We assessed the construct’s antigen-binding specificity and GrB enzymatic activity, as well as in vitro cytotoxicity and internalization into target and control cells. We also assessed pharmacokinetic and toxicology parameters in vivo. Results GrB-Fc-4D5 was highly cytotoxic to Her2 positive cells such as SKBR3, MCF7 and MDA-MB-231 with IC 50 values of 56, 99 and 27 nM, respectively, and against a panel of HER2+ cell lines regardless of endogenous expression levels of the PI-9 inhibitor. Contemporaneous studies with Kadcyla demonstrated similar levels of in vitro activity against virtually all cells tested. GrB-Fc-4D5 internalized rapidly into target SKOV3 cells within 1 h of exposure rapidly delivering GrB to the cytoplasmic compartment. In keeping with its relatively high molecular weight (160 kDa), the construct demonstrated a terminal-phase serum half-life in mice of 39.2 h. Toxicity studies conducted on BALB/c mice demonstrated no statistically significant changes in SGPT, SGOT or serum LDH. Histopathologic analysis of tissues from treated mice demonstrated no drug-related changes in any tissues examined. Conclusion GrB-Fc-4D5 shows excellent, specific cytotoxicity and demonstrates no significant toxicity in normal, antigen-negative murine models. This construct constitutes a novel approach against HER2-expressing tumors and is an excellent candidate for further development.

Intravenous immunoglobulin (IVIG), first developed for the treatment of patients with antibody deficiencies, is now widely used in clinical practice, especially in hematological and immune system diseases, and its application in hematological oncology chemotherapy, cellular immunotherapy and hematopoietic stem cell transplantation (HSCT) is becoming more and more common. The Chinese Collaborative Group for Infection Immunology and Microecology Research Translation Collaborative Group organized relevant experts to discuss and propose the “Chinese expert consensus on the application of intravenous immunoglobulin in hematological diseases,” which was formulated based on the progress of research on the application of IVIG in blood diseases, and provides a basis for the standardization of the use of IVIG in hematologic disorders.

Unnatural amino acids (UAAs) have gained significant attention in protein engineering and drug development owing to their ability to introduce new chemical functionalities to proteins. In eukaryotes, genetic code expansion (GCE) enables the incorporation of UAAs and facilitates posttranscriptional modification (PTM), which is not feasible in prokaryotic systems. GCE is also a powerful tool for cell or animal imaging, the monitoring of protein interactions in target cells, drug development, and switch regulation. Therefore, there is keen interest in utilizing GCE in eukaryotic systems. This review provides an overview of the application of GCE in eukaryotic systems and discusses current challenges that need to be addressed.

Traditional cancer vaccines that utilize peptides or proteins often exhibit limited efficacy as a result of mutations in cancer antigenic epitopes, also known as antigenic drift, which reduce the ability of traditional vaccines to target tumor antigens and elicit robust immune response. To address these challenges, we propose an innovative and universal strategy for dendritic cell (DC)-targeted neoepitope delivery via proximity-induced conjugation (PIC). This approach enables the site-specific crosslink of a broad spectrum of neoepitopes tailored to diverse cancer types, thereby increasing both vaccine flexibility and applicability. The PIC method involves the use of recombinant Fc-affinity peptides that are modified with two distinct unnatural amino acids: the photoreactive amino acid p-benzoyl-L-phenylalanine (pBPA) and the bioorthogonal reactive amino acid 4-fluorophenyl carbamate lysine (FPheK). These modified peptides allow for the precise conjugation of neoepitopes through ultraviolet (UV) irradiation or mild incubation, thereby achieving controlled antigen coupling. Through optimization of this strategy, we observed a substantial increase in DCs mediated antigen uptake and processing, leading to enhanced T cell activation, a robust cytotoxic immune response, and significant improvements in antitumor efficacy. Moreover, the DC-targeted vaccine exhibited promising synergistic effects with an immune checkpoint inhibitor (ICI), resulting in a marked reduction in tumor growth and prolonged survival in preclinical models. These findings underscore the potential of the PIC-based DC-targeted vaccine system to augment the immunogenicity, versatility, and therapeutic efficacy of cancer vaccines. This strategy offers a compelling solution to the challenges posed by antigenic drift and mutation, thereby improving clinical outcomes across a broad range of cancers.

Advancements in protein engineering have driven the continuous optimization of T-cell engagers (TCEs), resulting in remarkable clinical outcomes in the treatment of B-cell malignancies. Moreover, developing tri- or multispecific TCEs has emerged as a promising strategy to address the challenges of tumor heterogeneity and antigen escape. However, considerable obstacles remain, primarily in format design. In this study, we engineered BAFF-based TCEs with various formats that incorporate anti-CD3 Fab or IgG domains fused with BAFF ligands to target BAFF receptors (BAFFR, BCMA, and TACI). These constructs varied in valency and the presence or absence of long-acting elements such as Fc domains or the albumin binding domain consensus sequence (ABDCon). Although the inclusion of an Fc domain did not enhance sustained tumor eradication, variations in valency and spatial configuration profoundly influenced cytotoxicity. We identified TriBAFF/CD3/ABDCon as the optimal trifunctional construct, featuring an anti-CD3 Fab backbone with BAFF and ABDCon fused to the C-termini of the heavy and light chains. This design facilitates optimal immune synapse formation between the target cells and T cells and effectively controls tumor burdens in various B-cell malignancy models with good tolerability. Notably, TriBAFF/CD3/ABDCon outperformed conventional therapies, including blinatumomab and BAFF-based CAR-T cells, in models of heterogeneous leukemia and aggressive lymphoma. These findings underscore the potential of using natural ligands as antibody-targeting modules and provide valuable insights into the design of the next generation of multispecific TCEs, which hold promise for improving treatment outcomes in a wide range of malignancies and beyond.

Recombinant subunit vaccines leveraging pathogen-derived components are pivotal for disease prevention. Nonetheless, application of these vaccines still faces challenges such as low immunogenicity and a short half-life. Additionally, selecting appropriate antigens presents a significant barrier in recombinant vaccine design. Here, we applied a novel approach to address these challenges by developing recombinant vaccines targeting LMP2A. We employed epitope prediction and splicing to create epitope enrichment regions (EERs) in conjunction with the TLR4 agonist hEDA to enhance immunogenicity and the immunoglobulin G1 (IgG1) Fc fragment to prolong persistence. This multifaceted strategy enhances antigen uptake by antigen-presenting cells, eliciting major histocompatibility complex (MHC) allele-dependent T-cell responses against targeted epitopes. Compared with split-component candidates, these innovatively designed vaccines demonstrate superiority in inducing the development of IFN-γ antigen-specific T cells, along with elevated humoral and cellular immune responses, and exhibit significantly enhanced antitumor efficacy in both preventive and therapeutic models. Furthermore, optimized vaccine treatment synergistically inhibits tumor growth when combined with the administration of immune checkpoint inhibitors, leading to significantly prolonged survival. This novel design strategy offers advances for the development of multifunctional recombinant vaccines and represents a promising platform for cancer immunotherapy and applications in other diseases.

Therapeutic antibody conjugates allow for the specific delivery of cytotoxic agents or immune cells to tumors, thus enhancing the antitumor activity of these agents and minimizing adverse systemic effects. Most current antibody conjugates are prepared by nonspecific modification of antibody cysteine or lysine residues, inevitably resulting in the generation of heterogeneous conjugates with limited therapeutic efficacies. Traditional strategies to prepare homogeneous antibody conjugates require antibody engineering or chemical/enzymatic treatments, processes that often affect antibody folding and stability, as well as yield and cost. Developing a simple and cost-effective way to precisely couple functional payloads to native antibodies is of great importance. We describe a simple proximity-induced antibody conjugation method (pClick) that enables the synthesis of homogeneous antibody conjugates from native antibodies without requiring additional antibody engineering or post-synthesis treatments. A proximity-activated crosslinker is introduced into a chemically synthesized affinity peptide modified with a bioorthogonal handle. Upon binding to a specific antibody site, the affinity peptide covalently attaches to the antibody via spontaneous crosslinking, yielding an antibody molecule ready for bioorthogonal conjugation with payloads. We have prepared well-defined antibody-drug conjugates and bispecific small molecule-antibody conjugates using pClick technology. The resulting conjugates exhibit excellent cytotoxic activity against cancer cells and, in the case of bispecific conjugates, superb antitumor activity in mouse xenograft models. Our pClick technology enables efficient, simple, and site-specific conjugation of various moieties to the existing native antibodies. This technology does not require antibody engineering or additional UV/chemical/enzymatic treatments, therefore providing a general, convenient strategy for developing novel antibody conjugates.