B7-H3 (CD276) as Target for T Cell-Based Bispecific Antibody Therapy of Penile Cancer

Aleksander Kielbik,1– 3 Veronika Bahlinger,3,4 Christian M Schürch,3,4 Maria Luisa Barcena,2 Olesya Vakhrusheva,2 Anita Thomas,5 Igor Tsaur,2 Jonas S Heitmann,1,3 Helmut R Salih,1,3,6 Ilona Hagelstein1,3,6 1Clinical Collaboration Unit Translational Immunology, Department of Internal Medicine, University Hospital Tuebingen, Tuebingen, Germany; 2Department of Urology, University Hospital Tuebingen, Tuebingen, Germany; 3Cluster of Excellence iFIT (EXC 2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tuebingen, Tuebingen, Germany; 4Department of Pathology and Neuropathology, University Hospital and Comprehensive Cancer Center Tuebingen, Tuebingen, Germany; 5Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany; 6German Cancer Consortium (DKTK), Partner Site Tuebingen, a Partnership Between DKFZ and University Hospital Tuebingen, Tuebingen, GermanyCorrespondence: Aleksander Kielbik, Clinical Collaboration Unit Translational Immunology, Department of Internal Medicine, University Hospital Tuebingen, Tuebingen, Germany, Email aleksander.kielbik@med.uni-tuebingen.deIntroduction: Metastatic or locally advanced penile cancer (PeCa) has limited systemic treatment options and a 5-year survival rate of ~10% in metastatic disease. Using the in vitro and ex vivo models we preclinically assessed CC-3, a B7-H3xCD3 bispecific antibody (bsAb) currently in a Phase I basket trial (NCT05999396).Methods: Primary PeCa cells were isolated from surgical specimens and characterized for surface antigen expression by flow cytometry (n = 4). B7-H3 expression was additionally evaluated in primary penile cancer tissues by immunohistochemistry (n = 10). The functional activity of the bsAb CC-3 was assessed in co-culture assays with PBMC, analyzing cytotoxicity, cytokine release, and T cell activation.Results: Immunohistochemistry of tumors from ten PeCa patients revealed strong and consistent B7-H3 (CD276) expression, with a mean H-score of 200, in tumor cells and tumor-associated vasculature, potentially enhancing T cell influx upon targeting. In vitro and ex vivo co-cultures of primary PeCa cells with peripheral blood mononuclear cells from healthy donors and PeCa patients showed that CC-3 robustly activated CD4⁺ and CD8⁺ T cells, as defined by upregulation of CD69 and CD25, with donor-dependent kinetics. CC-3 also induced potent tumor cell lysis and T cell proliferation across all patient-derived tumor samples, whereas the isotype control had no effect, confirming target-restricted activity.Discussion: These results demonstrate the strong immunostimulatory capacity of CC-3 and validate B7-H3 as a relevant target for T cell-based immunotherapy in PeCa. Our findings support the ongoing inclusion of PeCa patients in the clinical CC-3 trial and encourage further development of B7-H3-directed strategies for this rare, understudied malignancy.Keywords: penile cancer, bispecific antibody, immunotherapy, CD3, B7-H3, CD276, T cell