# Discovery and preclinical evaluation of monoclonal antibodies and bispecific engagers targeting the NKG2A inhibitory receptor

## TL;DR

This study discovers new antibodies and bispecific engagers that enhance immune cell activity against cancer by blocking the NKG2A receptor.

## Contribution

The paper introduces fully human monoclonal antibodies and bispecific engagers targeting NKG2A for cancer immunotherapy.

## Key findings

- Monoclonal antibodies blocking NKG2A enhanced NK cell activation and tumor cell killing.
- Bispecific engagers directed immune cells to attack cancer cells and inhibited tumor growth in mice.
- Combining BiNKs with existing therapies improved antitumor effects of both NK and T cells.

## Abstract

NK and T cells are key effectors that eliminate cancer cells, but upregulation of the inhibitory receptor NKG2A on these cells attenuates antitumor immune responses. To counteract NKG2A inhibitory signaling, we identified two specific fully human monoclonal anti-NKG2A antibodies that block HLA-E ligand binding. These antibodies activated NK cells and enhanced antibody-dependent cellular cytotoxicity of tumor-targeting IgG1s both in vitro and in vivo. Bispecific engagers (BiNKs), generated by fusing NKG2A antibodies with tumor targeting binders, promoted immune synapse formation and directed cytotoxicity of NK and CD8+ T cells toward cancer cells. In a human PBMC-engrafted NSG mouse xenograft lung cancer model, an anti-HER2 × anti-NKG2A BiNK markedly inhibited tumor growth as a monotherapy or in combination with pertuzumab. Cell depletion studies revealed that the BiNK enhanced antitumor activity of both NK and T cells. NKG2A blockade with potent and specific, fully human antibodies and BiNKs show promise for further development as cancer immunotherapeutics.

NKG2A antibody blockade and bispecific NKG2A engagers enhance NK and T cell antitumor activity.