Lethal toxin–equipped effector cells for the potential treatment of cancer

A Alexander H. Pearlman (Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine) B Brian J. Mog (Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine) M Michael S. Hwang (Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine) J Jordina Rincon-Torroella (Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine) S Sarah R. DiNapoli (Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine) S Suman Paul (Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine) J Jacqueline Douglass (Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine) E Emily Han-Chung Hsiue (Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine) S Stephanie A. Glavaris (Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine) D Drew M. Pardoll (Department of Oncology and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine) N Nickolas Papadopoulos (Department of Oncology, the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine) K Kenneth W. Kinzler (Department of Oncology, the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine) C Chetan Bettegowda S Shibin Zhou (Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine) B Bert Vogelstein (Department of Oncology, the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine) M Maximilian F. Konig (The Ludwig Center for Cancer Genetics and Therapeutics, Johns Hopkins University School of Medicine)

Abstract

Lethal toxins could become potent therapies against cancer, but their clinical utility is limited by adverse events upon systemic administration. These could be reduced if the toxins were delivered by effector cells that specifically infiltrate cancers, thereby releasing toxins locally into the tumor microenvironment. One of the challenges underlying this strategy is that cells delivering toxins would have to be resistant to them. We address this obstacle by showing that effectors derived from transformed human cell lines genetically engineered for resistance to bacterial adenosine diphosphate ribosylating toxins (ADPRTs), including Pseudomonas aeruginosa exotoxin A (PE), can produce targeted immunotoxins that specifically kill cancer cells expressing cognate tumor-associated antigens. Resistance to immunotoxins was achieved by knockout of genes in the diphthamide biosynthesis pathway ( DPH1-4 ) required for the posttranslational modification of eukaryotic elongation factor 2 (EEF2) that is the target of ADPRTs or by mutation of EEF2 itself. We show that engineering resistance to ADPRTs, one of the most potent toxins acting on human cells, is essential to achieve robust function of armored effector cell lines. This work establishes a critical step on the path to equip effector cells with the ability to deliver powerful toxins to cancer cells and introduces a platform to investigate extension to primary autologous or allogeneic therapeutic cell types.

Article Details

Volume / Issue Vol. 123, Issue 12
Published March 24, 2026
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (16)

A

Alexander H. Pearlman

Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine

B

Brian J. Mog

Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine

M

Michael S. Hwang

Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine

J

Jordina Rincon-Torroella

Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine

S

Sarah R. DiNapoli

Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine

S

Suman Paul

Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine

J

Jacqueline Douglass

Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine

E

Emily Han-Chung Hsiue

Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine

S

Stephanie A. Glavaris

Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine

D

Drew M. Pardoll

Department of Oncology and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine

N

Nickolas Papadopoulos

Department of Oncology, the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine

K

Kenneth W. Kinzler

Department of Oncology, the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine

C

Chetan Bettegowda

S

Shibin Zhou

Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine

B

Bert Vogelstein

Department of Oncology, the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine

M

Maximilian F. Konig

The Ludwig Center for Cancer Genetics and Therapeutics, Johns Hopkins University School of Medicine