T cell circuits that sense antigen density with an ultrasensitive threshold

Abstract

Designing smarter anticancer T cells Biological signaling systems can exhibit a large, nonlinear—or “ultrasensitive”—response, which would be useful to engineer into therapeutic T cells to allow for better discrimination between cancer cells and normal tissues. Hernandez-Lopez et al. modified human T cells using a two-step mechanism that allowed them to kill cells expressing large amounts of cancer marker protein but not cells expressing a small amount of the same protein. A first synthetic receptor recognized the antigen with low affinity. That receptor signaled to increase expression of a chimeric antigen receptor (CAR) with high affinity for the same antigen. The circuit proved effective in cell culture and mouse cancer models, offering hope of extending the CAR T cell strategy against solid tumors. Science, this issue p. 1166 An engineered signaling circuit allows discrimination of cells overexpressing a cancer marker. Overexpressed tumor-associated antigens [for example, epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2)] are attractive targets for therapeutic T cells, but toxic “off-tumor” cross-reaction with normal tissues that express low levels of target antigen can occur with chimeric antigen receptor (CAR)–T cells. Inspired by natural ultrasensitive response circuits, we engineered a two-step positive-feedback circuit that allows human cytotoxic T cells to discriminate targets on the basis of a sigmoidal antigen-density threshold. In this circuit, a low-affinity synthetic Notch receptor for HER2 controls the expression of a high-affinity CAR for HER2. Increasing HER2 density thus has cooperative effects on T cells—it increases both CAR expression and activation—leading to a sigmoidal response. T cells with this circuit show sharp discrimination between target cells expressing normal amounts of HER2 and cancer cells expressing 100 times as much HER2, both in vitro and in vivo.