Abstract 4095: Targeting alternative classes of tumor antigens to improve immunotherapy for microsatellite stable, mismatch repair-proficient colorectal cancer

Abstract Background: The clinical outcomes of immunotherapy for microsatellite stable (MSS) colorectal cancer (CRC) remains unsatisfactory. The development of more effective immunotherapies is hampered by limited knowledge of the appropriate target antigens, also considering the low burden of mutations generating neoantigens of these tumors. Alternative classes of MSS CRC antigens may provide actionable epitopes. Methods: We have characterized the immunopeptidome of 2 MSS CRC cell lines derived from the primary tumor (SW480) and a metastatic lymph node (SW620) of the same patient. Given the low mutational burden of MSS, we focused on peptides belonging to alternative sources of HLA-A*02 epitopes, such as proteasomal cis-spliced peptides derived from cancer testis antigens and linear epitopes derived from Human Endogenous Retroviruses (HERVs), which are frequently reactivated in CRC. Peptide immunogenicity was functionally validated based on their ability to expand HLA-A*02+ donor T cells (>3) specifically killing targets cells presenting the relevant peptides or HLA-matched CRC cell lines. In vivo epitope immunogenicity was verified by analyzing polyfunctional responses of human CD8+ T cells obtained from NSG-A2 mice humanized with A*02+ donor PBMCs and immunized with epitope-loaded nano-emulsions selectively targeting human Clec9A+ dendritic cells. Therapeutic exploitation of the novel epitopes was investigated by adoptive transfer of epitope-specific T cells in NSG-A2 mice injected with SW620 cells. Epitope-specific T cell responses were investigated in PBMCs from 10 MSS CRC patients and 7 donors. Results: Among >50,000 HLA-bound peptides identified by in depth immunopeptidomics analysis, 11 cis-spliced peptides and 5 HERV peptides were functionally validated as immunogenic. Epitope-specific T cells showed specific cytotoxic activity against SW480 and SW620 CRC cells. Globally, cis-spliced peptides were more immunogenic in vitro than HERV-derived peptides. The immunogenicity of both groups of peptides was confirmed in vivo in humanized mice. Adoptively transferred HERV or cis-spliced epitope specific T cells significantly inhibited the growth of SW620 cells in vivo, with cis-spliced epitope-specific T cells being more effective. Therapeutic efficacy of Clec9A-targeting vaccines exploiting these epitopes is currently under investigation. T cell responses specific for cis-spliced and HERV epitopes were detected in PBMCs from 3/4 MSS CRC HLA-A*02+ patients but in none of 4 HLA-A*02- MSS CRC patients or 7 healthy donors (4 HLA-A*02+ and 3 HLA-A*02-). Conclusions: We have identified and validated a new class of immunogenic HLA-A*02 epitopes derived from alternative classes of MSS CRC antigens. We also provide the proof of principle supporting their therapeutic exploitation to improve the management of these poorly immunogenic tumors. Citation Format: Riccardo Dolcetti, Bijun Zeng, Jingran Ye, Tima Shamekhi, Madeleine Harpur, Davide Moi, Sara Roth, Rob Ramsay, Divya Duscharla, Antony W. Purcell, Pouya Faridi, Roberta Mazzieri. Targeting alternative classes of tumor antigens to improve immunotherapy for microsatellite stable, mismatch repair-proficient colorectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4095.