Mis-splicing-derived neoantigens and cognate TCRs in splicing factor mutant leukemias
- Cell. 2025 Jun 26;188(13):3422-3440.e24. doi: 10.1016/j.cell.2025.03.047.
- 1. Molecular Pharmacology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center (MSK), New York, NY, USA.
- 2. Public Health Sciences and Basic Sciences Divisions, Fred Hutchinson Cancer Center, Seattle, WA, USA.
- 3. Public Health Sciences and Basic Sciences Divisions, Fred Hutchinson Cancer Center, Seattle, WA, USA; Department of Genome Sciences, University of Washington, Seattle, WA, USA.
- 4. Human Oncology and Pathogenesis Program, MSK, New York, NY, USA.
- 5. The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA.
- 6. Codify Therapeutics, Cambridge, MA, USA.
- 7. Department of Medicine, Division of Hematology, Stanford University, Palo Alto, CA, USA.
- 8. Single-cell Analytics Innovation Laboratory, MSK, New York, NY, USA.
- 9. Proteomics Resource Center, Rockefeller University, New York, NY, USA.
- 10. Department of Hematopoietic Biology and Malignancy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- 11. Swim Across America and Ludwig Collaborative Laboratory, Department of Pharmacology, Sandra and Edward Meyer Cancer Center, Weill Cornell Medical Center, New York, NY, USA.
- 12. Computational Oncology, Department of Epidemiology and Biostatistics, MSK, New York, NY, USA.
- 13. Human Oncology and Pathogenesis Program, MSK, New York, NY, USA; Parker Institute for Cancer Immunotherapy, New York, NY, USA. Electronic address: [email protected].
- 14. Public Health Sciences and Basic Sciences Divisions, Fred Hutchinson Cancer Center, Seattle, WA, USA; Department of Genome Sciences, University of Washington, Seattle, WA, USA. Electronic address: [email protected].
- 15. Molecular Pharmacology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center (MSK), New York, NY, USA. Electronic address: [email protected].
Mutations in RNA splicing factors are prevalent across cancers and generate recurrently mis-spliced mRNA isoforms. Here, we identified a series of bona fide neoantigens translated from highly stereotyped splicing alterations promoted by neomorphic, leukemia-associated somatic splicing machinery mutations. We utilized feature-barcoded peptide-major histocompatibility complex (MHC) dextramers to isolate neoantigen-reactive T cell receptors (TCRs) from healthy donors, patients with active myeloid malignancy, and following curative allogeneic stem cell transplant. Neoantigen-reactive CD8+ T cells were present in the blood of patients with active Cancer and had a distinct phenotype from virus-reactive T cells with evidence of impaired cytotoxic function. T cells engineered with TCRs recognizing SRSF2 mutant-induced neoantigens arising from mis-splicing events in CLK3 and RHOT2 resulted in specific recognition and cytotoxicity of SRSF2-mutant leukemia. These data identify recurrent RNA mis-splicing events as sources of actionable public neoantigens in myeloid leukemias and provide proof of concept for genetically redirecting T cells to recognize these targets.