Epstein-Barr virus mRNA vaccine synergizes with NK cells to enhance nasopharyngeal carcinoma eradication in humanized mice

The close association between nasopharyngeal carcinoma (NPC) and Epstein-Barr virus (EBV) infection highlights the potential of therapeutic vaccination against viral antigens as an attractive immunotherapy for treating EBV⁺ NPC. Maximizing vaccine efficacy often requires selecting optimal T cell epitopes and incorporating co-treatment strategies. Here, we analyzed genomic mutations of 283 cancer-associated EBV strains and predicted epitopes with broad human leukocyte antigen (HLA) coverage from high-frequency nonsynonymous mutations. A polyepitope mRNA vaccine constructed from the predicted epitopes elicited antigen-specific T cell responses but showed suboptimal efficacy in tumor control in a PBMC-humanized mouse EBV⁺ NPC model. To enhance treatment efficacy, we developed an optimized system for expanding human natural killer (NK) cells with high purity and cytotoxicity as a co-treatment modality. Combined administration of mRNA vaccine and NK cells synergistically improved therapeutic efficacy by durably suppressing or eradicating NPC tumors in humanized mice. The concurrent treatment could improve the infiltration of both human T cells and NK cells into the tumor microenvironment and boost their effector functions. Our study suggests the combined therapeutic vaccination and NK cell therapy as a potential strategy for treating EBV⁺ NPC.