# Project 4 Treatment of Advanced Ovarian Cancer Using Gene-Edited NK CAR Cells

> **NIH NIH P50** · MAYO CLINIC ROCHESTER · 2022 · $247,077

## Abstract

ABSTRACT – PROJECT 4
Women diagnosed with advanced epithelial ovarian cancer (EOC) have a median 5-year survival rate of ~20%,
and recurrent EOC remains essentially incurable. Novel immunotherapies, including immune checkpoint
blockade and chimeric antigen receptor (CAR) T cell therapies have had some success, but response rates
have been typically below 20%. Similarly, the response rates to molecularly targeted therapies have been
limited, partly due to the lack of recurrently mutated targets and the high level of chromosomal instability
characteristic of EOC. Synthetic lethality via PARP inhibition and VEGF blockade have demonstrated some
benefit, but mechanisms of resistance have already surfaced for these new therapies. The long-term goal of
our research program is to develop highly effective immune cell-based therapies capable of eliminating
recurrent EOC. In Project 4, we will use advanced gene editing techniques that we have developed to produce
hyperfunctional Natural Killer (NK) cells for treating advanced EOC. We focus on NK cells because i) they do
not require antigen priming and ii) side effects, such as graft versus host disease and cytokine release
syndrome, are minimal compared to T cell therapy. We propose to make two fundamental alterations to human
NK cells obtained from healthy donors. The first genetic alteration removes an intracellular signaling protein
that dampens NK activation (the CISH gene) using a modified CRISPR/Cas9 protocol we have developed that
is highly effective in primary human NK cells. The second genetic alteration is to site-specifically integrate a
chimeric antigen receptor (CAR) gene that we have developed specifically for NK cells. This CAR NK targets
the mesothelin protein, a prevalent EOC tumor antigen. Our central hypothesis is that gene editing can be
used to overcome signaling inhibition and improve NK cell targeting, persistence and function, resulting in
improved therapeutic outcomes for women with advanced EOC. The work proposed in this project includes
generating and testing the gene edited NK cells for enhanced function by co-culturing with ovarian cancer cells
in vitro and testing in both cell line- and patient-derived xenograft models of EOC in vivo. The data from these
preclinical tests will be used to guide the design of the Phase I clinical trial using these gene-edited NK cells.
This project will determine whether gene-edited CAR NK cell immunotherapy in humans is safe and has the
potential to improve outcomes in the setting of recurrent EOC. In addition, what we learn from this study will
have the broader impact of potential future application to other malignancies, as the engineering techniques
can be quickly adapted to remove different negative regulators and to target other tumor antigens with NK-
specific CARs.

## Key facts

- **NIH application ID:** 10452722
- **Project number:** 5P50CA136393-12
- **Recipient organization:** MAYO CLINIC ROCHESTER
- **Principal Investigator:** Branden S Moriarity
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $247,077
- **Award type:** 5
- **Project period:** 2009-07-01 → 2026-08-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10452722

## Citation

> US National Institutes of Health, RePORTER application 10452722, Project 4 Treatment of Advanced Ovarian Cancer Using Gene-Edited NK CAR Cells (5P50CA136393-12). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10452722. Licensed CC0.

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