Abstract 332: Chimeric fusion receptors provide a CD3-mediated activation signal to off-the-shelf iPSC-derived TCR-less CAR-T cells for enhanced efficacy

T cells require a combination of signals to properly activate and exhibit their full potential; signal 1 from the T cell receptor (TCR), signal 2 from costimulatory receptors and signal 3 from cytokine receptors can shape the function of T cells. Second generation chimeric antigen receptor (CAR) T-cells targeting CD19 have shown success in hematologic malignancies, in part because signals 1 and 2 are provided by the CAR endodomain. As previously reported, we have developed an off-the-shelf iPSC-derived CAR19 T (CAR19-iT) cell product where the CAR is inserted into the T cell receptor alpha constant (TRAC) locus for enhanced efficacy and disruption of surface TCR expression. While the TCR-less CAR19-iT cells are ideal for allogeneic CAR-T cell therapies, as a consequence, they lack CD3 surface expression and the means by which to mediate CD3 signaling. To further improve CAR-iT cell performance and facilitate combinatorial strategies with T cell engagers such as bispecific T cell engagers (BiTEs), we designed chimeric fusion receptors (CFRs) comprising an ectodomain of CD3 or CD28, a transmembrane domain of CD28, and various endodomains that provide combinations of signals 1, 2, and 3. In addition to providing co-stimulatory signaling, the CFR designs can be controlled via agonistic antibodies or BiTEs to initiate signal transduction for precision control of the cell product. Furthermore, a series of CFRs with various CD3 endodomains were also developed to augment costimulatory signaling and the ER retention and endocytosis motifs found in CD3 endodomains were mutated to prevent downregulation of the CFRs from the cell surface of TCR-less cells. Selected CFRs were engineered into TRAC knockout Jurkat cells expressing a luciferase based NFAT reporter gene. After 48 hours, surface expression of the CFRs was confirmed by flow cytometry. Signal transduction via the CFRs was evaluated following exposure to agonistic antibodies or BiTEs. Measurement of the luciferase activity showed comparable levels to activated wildtype reporter cells. After construct validation, the CFRs were introduced into TCR-less CAR19-iT cells and co-cultured overnight with Nalm6 target cells in the presence of agonistic antibodies. Compared to control CAR19-iT cells, the armed CFR-CAR19 iT cells demonstrated superior killing of target cells. These results support the notion that enhancing signal 1 can increase CAR-T cell efficacy with current studies underway to investigate CFRs with endodomains that provide additional signal 2 or 3. We expect these constructs to further enhance CAR-iT cell persistence and engagement with BiTEs for activation and multi-antigen targeting. Collectively, the data suggest that TRC-less CAR-iT cells can be further armed with CFRs containing appropriate endodomains to provide superior antitumor function in a regulated manner. Citation Format: Eigen Peralta, Dan Lu, Mark Landon, Helen Chu, Shohreh Sikaroodi, Emily Carron, Natalie Navarrete, Alec Witty, Tom Lee, Anhco Nguyen, Bahram Valamehr. Chimeric fusion receptors provide a CD3-mediated activation signal to off-the-shelf iPSC-derived TCR-less CAR-T cells for enhanced efficacy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 332.