Summary In Germany over 2.5 million employees have an increased risk of skin cancer due to their occupational exposure to natural UV‐irradiation. The medical consultation board “Occupational diseases” of the Ministry of Labor and Social affairs has investigated the association between occupational UV‐irradiation and skin cancer risk and recommends to add the following new occupational disease into the appendix1 of the German ordinance on occupational diseases: “Squamous cell carcinoma and multiple actinic keratosis due to natural UV‐irradiation”. In this article we report in the view of the German Society of Occupational and Environmental Dermatology (ABD) and the German Statutory accident insurance (DGUV), whose criteria have to be fulfilled for the notification and recognition of an occupational skin cancer due to natural UV‐irradiation.

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Activating NK cell receptors represent promising target structures to elicit potent antitumor immune responses. In this study, novel immunoligands were generated that bridge the activating NK cell receptor NKp30 on NK cells with epidermal growth factor receptor (EGFR) on tumor cells in a bispecific IgG-like format based on affinity-optimized versions of B7-H6 and the Fab arm derived from cetuximab. To enhance NKp30 binding, the solitary N-terminal IgV domain of B7-H6 (DB7-H6) was affinity matured by an evolutionary library approach combined with yeast surface display. Biochemical and functional characterization of 36 of these novel DB7-H6-derived NK cell engagers revealed an up to 45-fold-enhanced affinity for NKp30 and significantly improved NK cell-mediated, EGFR-dependent killing of tumor cells compared with the NK cell engager based on the wild-type DB7-H6 domain. In this regard, potencies (EC 50 killing) of the best immunoligands were substantially improved by up to 87-fold. Moreover, release of IFN-g and TNF-a was significantly increased. Importantly, equipment of the DB7-H6-based NK cell engagers with a human IgG1 Fc part competent in Fc receptor binding resulted in an almost 10-fold superior killing of EGFR-overexpressing tumor cells compared with molecules either triggering FcgRIIIa or NKp30. Additionally, INF-g and TNF-a release was increased compared with molecules solely triggering FcgRIIIa, including the clinically approved Ab cetuximab. Thus, incorporating affinity-matured ligands for NK cell-activating receptors might represent an effective strategy for the generation of potent novel therapeutic agents with unique effector functions in cancer immunotherapy.

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