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Peer-reviewedCC BYJournal of translational medicine

VHH-based antigen recognition programs Claudin18.2 CAR-T cells for durable activity in low-antigen solid tumors.

1 more authors
  1. 1Cancer Biotherapy Center & Cancer Research Institute, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan, Kunming, 650106, China.
  2. 2Cancer Biotherapy Center & Cancer Research Institute, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan, Kunming, 650106, China. [email protected].
  3. 3Cancer Biotherapy Center & Cancer Research Institute, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan, Kunming, 650106, China. [email protected].

Abstract

Background

Claudin18.2 is a clinically validated target for gastric and gastroesophageal junction adenocarcinoma. However, the antigen heterogeneity, low surface density, and issues related to scFv-associated conformational instability and tonic signaling may limit the durability and therapeutic window of Claudin18.2-directed CAR-T cell therapy. Therefore, improving the design of CAR-T cells targeting Claudin18.2 could enhance their effectiveness in treating these cancers.Methods

We generated third-generation Claudin18.2 CAR-T cells using either a humanized camelid single-domain antibody (VHH) or a conventional scFv as the antigen-recognition module, maintaining an identical CAR backbone for both constructs. To evaluate their performance, we used a gastric cancer cell-line panel with graded Claudin18.2 expression and corresponding xenograft models. We assessed CAR-T cell activity by measuring antigen-dependent cytotoxicity, cytokine secretion (IFN-γ and TNF-α), and reactivity toward antigen-negative targets. In vivo, we examined tumor control, T-cell infiltration, and CD8⁺ T-cell enrichment, and assessed toxicity. Additionally, we investigated the stability of CAR expression, T-cell expansion, and exhaustion-associated phenotypes. Structural modeling and molecular dynamics simulations were performed to evaluate the stability of the binding interface of the VHH-Claudin18.2 complex relative to the scFv-Claudin18.2 complex.Results

VHH-based CAR-T cells exhibited superior antigen-dependent activity compared to scFv-based CAR-T cells. VHH-CAR-T cells maintained higher cytotoxicity and IFN-γ and TNF-α secretion even under low antigen density and displayed minimal reactivity against antigen-negative targets. In vivo, VHH-CAR-T cells achieved faster and more durable tumor control, with enhanced intratumoral T-cell infiltration and CD8⁺ T-cell enrichment, without any overt toxicity. Mechanistically, the use of a VHH recognition domain was associated with better preserved surface CAR expression after antigen engagement, expanded more robustly, displayed fewer exhaustion-associated phenotypes, had a higher proportion of central memory T cells, and showed transcriptional enrichment of proliferative and effector programs with restrained exhaustion signatures. Structural modeling and molecular dynamics simulations further confirmed that the VHH-Claudin18.2 binding interface was more stable than that of scFv-Claudin18.2.Conclusion

Replacing scFv with VHH is associated with enhanced functional performance, persistence, and therapeutic efficacy of Claudin18.2-directed CAR-T. These findings support the further development and translation of VHH-based CAR-T strategies for solid tumor treatment.

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BibTeX
@article{he2026vhhbased,
  title = {{VHH-based antigen recognition programs Claudin18.2 CAR-T cells for durable activity in low-antigen solid tumors.}},
  author = {Dan He and Xiaoyuan Hu and Jiyin Guo and Jiaxing Cheng and Weike Li and Sidi Wan and Yunshan Ye and Lei Zhu and Li Li and Ke Li and Chunlei Ge and Tao Li and Hong Yao},
  journal = {Journal of translational medicine},
  year = {2026},
  month = jul,
  doi = {10.1186/s12967-026-08611-2},
  url = {https://europepmc.org/article/MED/42897545},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - VHH-based antigen recognition programs Claudin18.2 CAR-T cells for durable activity in low-antigen solid tumors.
AU  - Dan He
AU  - Xiaoyuan Hu
AU  - Jiyin Guo
AU  - Jiaxing Cheng
AU  - Weike Li
AU  - Sidi Wan
AU  - Yunshan Ye
AU  - Lei Zhu
AU  - Li Li
AU  - Ke Li
AU  - Chunlei Ge
AU  - Tao Li
AU  - Hong Yao
PY  - 2026
DA  - 2026/07/01
JO  - Journal of translational medicine
DO  - 10.1186/s12967-026-08611-2
UR  - https://europepmc.org/article/MED/42897545
AB  - Background  Claudin18.2 is a clinically validated target for gastric and gastroesophageal junction adenocarcinoma. However, the antigen heterogeneity, low surface density, and issues related to scFv-associated conformational instability and tonic signaling may limit the durability and therapeutic window of Claudin18.2-directed CAR-T cell therapy. Therefore, improving the design of CAR-T cells targeting Claudin18.2 could enhance their effectiveness in treating these cancers.Methods  We generated third-generation Claudin18.2 CAR-T cells using either a humanized camelid single-domain antibody (VHH) or a conventional scFv as the antigen-recognition module, maintaining an identical CAR backbone for both constructs. To evaluate their performance, we used a gastric cancer cell-line panel with graded Claudin18.2 expression and corresponding xenograft models. We assessed CAR-T cell activity by measuring antigen-dependent cytotoxicity, cytokine secretion (IFN-γ and TNF-α), and reactivity toward antigen-negative targets. In vivo, we examined tumor control, T-cell infiltration, and CD8⁺ T-cell enrichment, and assessed toxicity. Additionally, we investigated the stability of CAR expression, T-cell expansion, and exhaustion-associated phenotypes. Structural modeling and molecular dynamics simulations were performed to evaluate the stability of the binding interface of the VHH-Claudin18.2 complex relative to the scFv-Claudin18.2 complex.Results  VHH-based CAR-T cells exhibited superior antigen-dependent activity compared to scFv-based CAR-T cells. VHH-CAR-T cells maintained higher cytotoxicity and IFN-γ and TNF-α secretion even under low antigen density and displayed minimal reactivity against antigen-negative targets. In vivo, VHH-CAR-T cells achieved faster and more durable tumor control, with enhanced intratumoral T-cell infiltration and CD8⁺ T-cell enrichment, without any overt toxicity. Mechanistically, the use of a VHH recognition domain was associated with better preserved surface CAR expression after antigen engagement, expanded more robustly, displayed fewer exhaustion-associated phenotypes, had a higher proportion of central memory T cells, and showed transcriptional enrichment of proliferative and effector programs with restrained exhaustion signatures. Structural modeling and molecular dynamics simulations further confirmed that the VHH-Claudin18.2 binding interface was more stable than that of scFv-Claudin18.2.Conclusion  Replacing scFv with VHH is associated with enhanced functional performance, persistence, and therapeutic efficacy of Claudin18.2-directed CAR-T. These findings support the further development and translation of VHH-based CAR-T strategies for solid tumor treatment.
SN  - 1479-5876
ER  -