Chimeric antigen receptor T cell (CAR-T) therapy has shown remarkable efficacy against B cell malignancies, offering hope to patients with limited treatment options. However, extending this therapy to myeloid malignancies and solid tumors has proven challenging due to co-expression of targetable antigens on hematopoietic progenitors and healthy tissues. In this context, γδ T cells show promise, as they can directly identify and eliminate malignant cells via recognition of multiple tumor-associated stress antigens rarely expressed on normal tissues. We leveraged the tumor-sensing capabilities of γδ T cells with enhanced tumor localization by employing a non-signaling CAR (nsCAR) that excludes the CD3ζ domain, facilitating targeted tumor cell killing while sparing healthy tissues. We designed second-generation lentiviral constructs for anti-CD33-scfv for in vitro evaluation against acute myeloid leukemia (AML) lines HL-60, KG-1a, and MOLM-13 and the chronic myeloid leukemia (CML) line K-562 Additionally, we tested CD33/CD123 dual-targeting nsCAR constructs (ns-dCAR) to determine if the addition of CD123 targeting enhanced the therapeutic index. We also tested whether a secreted IL-15 (sIL-15) would enhance CAR-T cell fitness. We observed significant upregulation of CD69 in Jurkat cells transduced with signaling CARs in co-culture with KG-1a cells but not in those with nsCAR constructs. We also noticed a time-dependent reduction (43%) in the CD3ζ+ CD33CAR+ population over a 7-day extended coculture while the nsCAR+ Jurkat population remained stable, suggesting potential mitigation of activation-induced cell death (AICD). Expanded and activated γδ T cells from healthy donors were then transduced with nsCAR lentiviral vectors. The ns33CAR+ γδ T cells exhibited enhanced killing capability against HL-60 (up to 1.3x) and K-562 (up to 1.6x) compared to unmodified γδ T cells (UTD) in a 24-hour cytotoxicity assay. Incorporation of sIL-15 into the nsCD33 CAR construct also increased killing across all 4 cell lines (up to 1.8x for HL-60, up to 2.6x for KG-1a, up to 2.0x for MOLM-13 and up to 2.0x for K-562). Minimal cytotoxicity (<10%) was observed for nsCARs or UTDs against normal CD33+/CD123+ cells from healthy donor PBMC or CD34+ HPSCs. The ns-dCAR constructs did not improve in vitro AML killing compared to ns33CAR alone, although ns-dCARs generally exhibited lower transduction efficiency. In summary, our findings suggest that combining nsCAR constructs with γδ T cells may widen the therapeutic window to expand the reach of CAR-T therapy to cancers with limited target antigen expression on critical healthy tissues. Further optimization to improve integration and incorporation of membrane-bound IL-15 co-expression holds the potential to enhance both the efficacy and safety profiles of next-generation adoptive cell therapies against a broader spectrum of cancers.

Citation Format: Lei Ding, Yanjie Li, Jiexue Li, Mariska Ter Haak, Lawrence Lamb. Gamma-delta (γδ) CAR-T cells lacking the CD3ζ signaling domain enhance targeted killing of AML cells and preserve healthy tissues [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 5227.