N-glycosylation engineering in chimeric antigen receptor T cells enhances anti-tumor activity

Chimeric antigen receptor (CAR) T cell therapy has had limited success in solid tumors, requiring novel enhancement strategies. Modifying the glycocalyx of CAR T cells is unexplored; we report on genome-editing of the MGAT5 gene to abolish human CAR T N-glycan poly-LacNAc modifications. This boosted tumor control in carcinoma and lymphoma models, for donors of whom the non-engineered CAR T cells largely failed in tumor control. More blood-circulating MGAT5 KO CD70 nanoCAR T cells were found, exhibiting potent tumor cell-killing activity ex vivo, while non-glycoengineered CAR T cells faltered. MGAT5 KO CD70 nanoCAR T cells also mediated durable anti-tumor immunity, improving control of secondary carcinoma challenge months later. Single-cell transcriptomics revealed increased mitotic activity and type I interferon signaling, indicating sustained intratumoral activation. The glyco-engineered cells had unaltered antigen sensitivity and dependence on T cell growth factors, preserving key safety features. MGAT5 KO is readily compatible with clinical manufacturing, representing a promising approach to enhance CAR T cell therapy.