B7-H3–Targeting Chimeric Antigen Receptors Epstein-Barr Virus–specific T Cells Provides a Tumor Agnostic Off-The-Shelf Therapy Against B7-H3–positive Solid Tumors

Abstract

Encouraged by our observations of pronounced B7-H3 protein over-expression in many human solid tumors compared to healthy tissues, we focused on targeting B7-H3 with CAR T cells. We utilized a nanobody as the t B7-H3 targeting domain in our CAR construct to circumvent the stability issues associated with scFv-based domains. In efforts to expand patient access to CAR T cell therapy, we engineered our nanobody-based CAR into human Epstein-Barr Virus Specific T Cells (EBVSTs), offering a readily available off-the-shelf treatment. B7H3.CAR-armored EBVSTs demonstrated potent in vitro and in vivo activities against multiple B7-H3-positive human tumor cell lines and patient-derived xenograft models. Murine T cells expressing a murine equivalent of our B7H3.CAR exhibited no life-threatening toxicities in immunocompetent mice bearing syngeneic tumors. Further in vitro evaluation revealed that while human T, B and NK cells were unaffected by B7H3.CAR EBVSTs, monocytes were targeted due to upregulation of B7-H3. Such targeting of myeloid cells, which are key mediators of cytokine release syndrome (CRS), contributed to a low incidence of CRS in humanized mice after B7H3.CAR EBVST treatment. Notably, we showed that B7H3.CAR EBVSTs can target B7-H3 expressing myeloid-derived suppressor cells (MDSCs), thereby mitigating MDSC-driven immune suppression. In summary, our data demonstrate that our nanobody-based B7H3.CAR EBVSTs are effective as an off-the-shelf therapy for B7-H3 positive solid tumors. These cells also offer an avenue to modulate the immunosuppressive tumor microenvironment, highlighting their promising clinical potential in targeting solid tumors.