Moderna Inc., 200 Technology Square, Cambridge, MA 02139, USA.
Sci Transl Med. 2019 Jan 30;11(477). doi: 10.1126/scitranslmed.aat9143.
Many solid cancers contain dysfunctional immune microenvironments. Immune system modulators that initiate responses to foreign pathogens could be promising candidates for reigniting productive responses toward tumors. Interleukin-1 (IL-1) and IL-12 cytokine family members cooperate at barrier tissues after microbial invasion, in human inflammatory diseases, and in antitumoral immunity. IL-36γ, in classic alarmin fashion, acts in damaged tissues, whereas IL-23 centrally coordinates immune responses to danger signals. In this study, direct intratumoral delivery of messenger RNAs (mRNAs) encoding these cytokines produced robust anticancer responses in a broad range of tumor microenvironments. The addition of mRNA encoding the T cell costimulator OX40L increased complete response rates in treated and untreated distal tumors compared to the cytokine mRNAs alone. Mice exhibiting complete responses were subsequently protected from tumor rechallenge. Treatments with these mRNA mixtures induced downstream cytokine and chemokine expression, and also activated multiple dendritic cell (DC) and T cell types. Consistent with this, efficacy was dependent on Batf3-dependent cross-presenting DCs and cytotoxic CD8 T cells. IL-23/IL-36γ/OX40L triplet mRNA mixture triggered substantial immune cell recruitment into tumors, enabling effective tumor destruction irrespective of previous tumoral immune infiltrates. Last, combining triplet mRNA with checkpoint blockade led to efficacy in models otherwise resistant to systemic immune checkpoint inhibition. Human cell studies showed similar cytokine responses to the individual components of this mRNA mixture, suggesting translatability of immunomodulatory activity to human patients.
许多实体瘤含有功能失调的免疫微环境。能够引发针对外来病原体反应的免疫系统调节剂可能是重新激发针对肿瘤产生有效反应的有前途的候选药物。白细胞介素-1 (IL-1) 和白细胞介素-12 细胞因子家族成员在微生物入侵后、在人类炎症性疾病中和抗肿瘤免疫中在屏障组织中合作。IL-36γ 以经典警报素的方式在受损组织中发挥作用,而 IL-23 则集中协调对危险信号的免疫反应。在这项研究中,直接向肿瘤内递送编码这些细胞因子的信使 RNA (mRNA) 可在广泛的肿瘤微环境中产生强大的抗癌反应。添加编码 T 细胞共刺激因子 OX40L 的 mRNA 可提高治疗和未治疗的远端肿瘤的完全缓解率,高于单独使用细胞因子 mRNA。表现出完全缓解的小鼠随后免受肿瘤再挑战的保护。用这些 mRNA 混合物进行治疗会诱导下游细胞因子和趋化因子的表达,并激活多种树突状细胞 (DC) 和 T 细胞类型。与此一致,疗效取决于依赖 Batf3 的交叉呈递 DC 和细胞毒性 CD8 T 细胞。IL-23/IL-36γ/OX40L 三重 mRNA 混合物可大量招募免疫细胞进入肿瘤,使肿瘤有效破坏,而与先前的肿瘤免疫浸润无关。最后,将三重 mRNA 与检查点阻断联合使用可在对全身免疫检查点抑制有抵抗力的模型中发挥疗效。人体细胞研究显示,对这种 mRNA 混合物的各个成分有类似的细胞因子反应,表明免疫调节活性在人类患者中具有可翻译性。