Endogenous CD4+ T Cells Recognize Neoantigens in Lung Cancer Patients, Including Recurrent Oncogenic KRAS and ERBB2 (Her2) Driver Mutations

JR Veatch, BL Jesernig, J Kargl, M Fitzgibbon… - Cancer immunology …, 2019 - AACR
JR Veatch, BL Jesernig, J Kargl, M Fitzgibbon, SM Lee, C Baik, R Martins, AMG Houghton…
Cancer immunology research, 2019AACR
T cells specific for neoantigens encoded by mutated genes in cancers are increasingly
recognized as mediators of tumor destruction after immune-checkpoint inhibitor therapy or
adoptive cell transfer. Much of the focus has been on identifying epitopes presented to CD8+
T cells by class I MHC. However, CD4+ class II MHC-restricted T cells have been shown to
have an important role in antitumor immunity. Unfortunately, the vast majority of neoantigens
recognized by CD8+ or CD4+ T cells in cancer patients result from random mutations and …
Abstract
T cells specific for neoantigens encoded by mutated genes in cancers are increasingly recognized as mediators of tumor destruction after immune-checkpoint inhibitor therapy or adoptive cell transfer. Much of the focus has been on identifying epitopes presented to CD8+ T cells by class I MHC. However, CD4+ class II MHC-restricted T cells have been shown to have an important role in antitumor immunity. Unfortunately, the vast majority of neoantigens recognized by CD8+ or CD4+ T cells in cancer patients result from random mutations and are patient-specific. Here, we screened the blood of 5 non–small cell lung cancer (NSCLC) patients for T-cell responses to candidate mutation-encoded neoepitopes. T-cell responses were detected to 8.8% of screened antigens, with 1 to 7 antigens identified per patient. A majority of responses were to random, patient-specific mutations. However, CD4+ T cells that recognized the recurrent KRASG12V and the ERBB2 (Her2) internal tandem duplication (ITD) oncogenic driver mutations, but not the corresponding wild-type sequences, were identified in two patients. Two different T-cell receptors (TCR) specific for KRASG12V and one T-cell receptor specific for Her2-ITD were isolated and conferred antigen specificity when transfected into T cells. Deep sequencing identified the Her2-ITD–specific TCR in the tumor but not nonadjacent lung. Our results showed that CD4+ T-cell responses to neoantigens, including recurrent driver mutations, can be derived from the blood of NSCLC patients. These data support the use of adoptive transfer or vaccination to augment CD4+ neoantigen-specific T cells and elucidate their role in human antitumor immunity.
AACR