Abstract TLR9 agonists (unmethylated CpG oligodeoxynucleotides) are clinically validated as vaccine adjuvants and cancer therapeutics1,2. We developed a Toll-like Receptor Agonist Antibody Conjugate (TRAAC) comprised of a potent TLR9 agonist (T-CpG) conjugated to an antibody against CD22, a receptor restricted to B cells (TAC-001). Systemically administered TAC-001 delivers T-CpG to B cells, resulting in TLR9 activation, and innate and adaptive anti-tumor immunity3. TAC-001 is being evaluated as an immunotherapy in a Phase 1 clinical trial in patients with advanced solid tumors (NCT05399654)4. In this study, we investigated whether TAC-001 mouse surrogate, mCD22 TRAAC, can potentiate cancer vaccine efficacy using preclinical vaccination models. Human Nectin-4 ectodomain protein (N4, 94% homology to its mouse ortholog) was used as a neoantigen-like vaccine, alone and in combination with mCD22 TRAAC, MPLA (a TLR4 agonist), or unconjugated T-CpG. Mice were immunized, then challenged 2 months later with syngeneic CT26 tumors expressing N4. Mice in treatment combination cohorts that resisted tumor development were split into two groups and rechallenged 3.5 months later with a more aggressive tumor, syngeneic 4T1 or 4T1 expressing N4. The combination of vaccine with mCD22 TRAAC was the only treatment able to inhibit growth of the 4T1-N4 tumor. No efficacy was observed in mice inoculated with parental 4T1, thereby demonstrating neoantigen vaccine specific anti-tumor immunity. An MHCI restricted peptide of HER2/neu, GP2, fused to a B cell epitope peptide, P4, and conjugated to KLH, was used as another vaccine model5. GP2-P4-KLH was administered to mice alone or in combination with mCD22 TRAAC or unconjugated T-CpG. Ex vivo GP2/GP2-P4 stimulation of lymphoid organ immune cells from mice treated with vaccine plus mCD22 TRAAC resulted in elevated Granzyme B, IFNγ and IL17A levels, indicating that mCD22 TRAAC enhances T cell activation and cytotoxic activity. Lastly, to investigate the effect of mCD22 TRAAC in elderly mice, SARS-CoV-2 spike protein was used as a vaccine. Spike was administered alone or in combination with mCD22 TRAAC, MPLA or T-CpG. Combining mCD22 TRAAC with vaccine resulted in high levels of spike neutralizing IgG in both youth and elderly cohorts, showing that mCD22 TRAAC rejuvenates vaccine responses in elderly. In all studies, mCD22 TRAAC led to the most potent vaccine recall response, with high antigen specific IgG titers skewing towards a Th1 phenotype, as shown by elevated levels of effector function antibodies of IgG2a subclass and increased IFNγ production. These findings provide a strong rationale for combining TAC-001 with cancer vaccines. References1Hyer et al., Vaccine 2018; 36(19) 2Long et al., Annals of Oncology 2018; 29(8) 3Kuo et al., Cancer Research 2021; 81(13)4Perez et al., JITC 2023; 11(1) 5Nordin et al., Cancers 2021; 13(19) Citation Format: Maja Z. Bonacorsi, Amy Chen, Ons Harrabi, Min Li, Emma R. Sangalang, Danielle Fontaine, Janet Sim, Pavel Strop, Hong I. Wan, Maria Jose Costa. A B-cell targeted TLR9 agonist antibody conjugate potentiates cancer vaccine efficacy and rejuvenates vaccine responses in the elderly [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6746.