Cell, Developmental, and Cancer Biology Department, Oregon Health and Science University, Portland, Oregon.
Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, Oregon.
Cancer Immunol Res. 2021 Apr;9(4):430-440. doi: 10.1158/2326-6066.CIR-20-0338. Epub 2021 Feb 16.
CTLA-4 blockade in combination with an agonist OX40-specific monoclonal antibody synergizes to augment antitumor immunity through enhanced T-cell effector function, leading to increased survival in preclinical cancer models. We have shown previously that anti-OX40/anti-CTLA-4 combination therapy synergistically enhances the expression of Eomesodermin (Eomes) in CD8 T cells. Eomes is a critical transcription factor for the differentiation and memory function of CD8 T cells. We hypothesized that EomesCD8 T cells were necessary for anti-OX40/anti-CTLA-4 immunotherapy efficacy and that further enhancement of this population would improve tumor-free survival. Indeed, CD8 T cell-specific deletion of Eomes abrogated the efficacy of anti-OX40/anti-CTLA-4 therapy. We also found that anti-OX40/anti-CTLA-4-induced EomesCD8 T cells expressed lower levels of checkpoint receptors (PD1, Tim-3, and Lag-3) and higher levels of effector cytokines (IFNγ and TNFα) than their Eomes counterparts. Eomes expression is negatively regulated in T cells through interleukin-2-inducible T-cell kinase (ITK) signaling. We investigated the impact of modulating ITK signaling with ibrutinib, an FDA-approved tyrosine kinase inhibitor, and found that anti-OX40/anti-CTLA-4/ibrutinib therapy further enhanced CD8 T cell-specific Eomes expression, leading to enhanced tumor regression and improved survival, both of which were associated with increased T-cell effector function across multiple tumor models. Taken together, these data demonstrate the potential of anti-OX40/anti-CTLA-4/ibrutinib as a triple therapy to improve the efficacy of immunotherapy.
CTLA-4 阻断联合激动型 OX40 特异性单克隆抗体通过增强 T 细胞效应功能协同增强抗肿瘤免疫,导致临床前癌症模型中的存活率增加。我们之前已经表明,抗-OX40/抗-CTLA-4 联合治疗协同增强了 CD8 T 细胞中 Eomesodermin(Eomes)的表达。Eomes 是 CD8 T 细胞分化和记忆功能的关键转录因子。我们假设 EomesCD8 T 细胞是抗-OX40/抗-CTLA-4 免疫治疗疗效所必需的,并且进一步增强该群体将改善无肿瘤存活。事实上,CD8 T 细胞特异性 Eomes 缺失消除了抗-OX40/抗-CTLA-4 治疗的疗效。我们还发现,抗-OX40/抗-CTLA-4 诱导的 EomesCD8 T 细胞表达的检查点受体(PD1、Tim-3 和 Lag-3)水平较低,效应细胞因子(IFNγ 和 TNFα)水平较高,而它们的 Eomes 对应物则较低。T 细胞中的 Eomes 表达通过白细胞介素-2 诱导的 T 细胞激酶(ITK)信号通路负调节。我们研究了用伊布替尼(一种 FDA 批准的酪氨酸激酶抑制剂)调节 ITK 信号的影响,发现抗-OX40/抗-CTLA-4/伊布替尼治疗进一步增强了 CD8 T 细胞特异性 Eomes 表达,从而增强了肿瘤消退并改善了存活,这与多种肿瘤模型中的 T 细胞效应功能增强有关。综上所述,这些数据表明抗-OX40/抗-CTLA-4/伊布替尼作为三联疗法具有提高免疫疗法疗效的潜力。