Domain-swapped T cell receptors improve the safety of TCR gene therapy

T cells engineered to express a tumor-specific alpha beta T cell receptor (TCR) mediate anti-tumor immunity. However, mispairing of the therapeutic alpha beta chains with endogenous alpha beta chains reduces therapeutic TCR surface expression and generates self-reactive TCRs. We report a general strategy to prevent TCR mispairing: swapping constant domains between the alpha and beta chains of a therapeutic TCR. When paired, domain-swapped (ds)TCRs assemble with CD3, express on the cell surface, and mediate antigen-specific T cell responses. By contrast, dsTCR chains mispaired with endogenous chains cannot properly assemble with CD3 or signal, preventing autoimmunity. We validate this approach in cell-based assays and in a mouse model of TCR gene transfer-induced graft-versus-host disease. We also validate a related approach whereby replacement of alpha beta TCR domains with corresponding gamma delta TCR domains yields a functional TCR that does not mispair. This work enables the design of safer TCR gene therapies for cancer immunotherapy.