AbstractThe prognostic benefit of immune checkpoint inhibitors (CPIs) is mainly restricted to specific cancers, such as melanoma and lung adenocarcinoma. For patients with cancers which are noninflamed (“cold”), or CPI-resistant, therapeutic options are currently limited. Recently, the US FDA approved the first bispecific molecule targeting a tumor peptide MHC. This highlights the potential of targeting MHC-presented tumor antigens to empower T cells to specifically recognize and eliminate solid tumors. While there is a growing number of agents targeting pMHCs, most of them are restricted to HLA-A*02. There is an urgent need to identify effective pMHC targeted therapies for solid tumors, especially on other alleles to increase the proportion of eligible patients.Kita-Kyushu lung cancer antigen-1 (KK-LC-1/CT83) peptide presented on HLA-A*01 is a promising tumor target as its expression is restricted to tumors and it is broadly expressed in many cancers including gastric, lung, breast, and cervical cancer. However, targeting the KK-LC-1/HLA-A*01 complex is challenging due to the high levels of similar off-target peptides presented in healthy tissues. Through in silico analysis we identified peptides within the human genome that share a high sequence identity to the target. These peptides were found in a database containing >1 million mass spectrometry (MS)-identified peptides presented by healthy tissues, cancer cell lines, and tumor tissue samples. A peptide derived from 6-pyruvoyltetrahydropterin synthase (PTS) was found to be abundantly presented in healthy tissues. MS confirmed that this peptide occurs at extremely high natural levels (620 - 3500 copies per cell) on HLA-A*01 cell lines and healthy tissue.Here, we describe a set of pMHC T-cell engager (TCE) antibodies with high specificity towards HLA-A*01 restricted KK-LC-1 epitope. ScFv phage display libraries were rigorously screened for binding to the pMHC target and counter-screened against predicted off-target peptides including PTS. Specific scFv hits were reformatted into TCEs using an anti-CD3 Fab effector arm. The TCEs showed efficient killing of KK-LC-1/HLA-A*01-positive human cell lines NCI-H1703 and EKVX in co-cultures with human PBMCs, while KK-LC-1-negative/HLA-A*01-positive cell lines SK-MEL-30 and PC-3 (known to present the risk peptides on the surface) were minimally affected. TCE-dependent T cell activation measured by IFNγ was significantly higher in presence of TAP-deficient, (empty) HLA-A*01-expressing T2 cells pulsed with the target peptide compared to the risk peptides. Alanine scans of isolated binders confirmed that at least 6 amino acids of the KK-LC-1 peptide are required for binding. Overall, the data show that these antibodies have promising anti-tumor activity and specificity for KK-LC-1/HLA-A*01 positive tumors. Future activities will focus on lead optimization for therapeutic development.Citation Format: Fabian Scheifele, Stephanie Jungmichel, Nagjie Alijaj, Athanasia Dasargyri, Romina Doerig, Philip Knobel, Hannes Merten, Philipp Richle, Thomas Schleier, Anna Sobieraj, Alessio Vantellini, Tim Fugmann, Rom Leidner, Swethajit Biswas, Leonardo Borras. Novel antibodies against a KK-LC-1-derived peptide presented on HLA-A*01 on tumor cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB442.