Division of Immunology and Molecular Medicine, Department of Molecular and Cell Biology, University of California, Berkeley, CA 94720.
HHMI, Stanford University School of Medicine, Stanford, CA 94305.
Proc Natl Acad Sci U S A. 2022 May 31;119(22):e2200568119. doi: 10.1073/pnas.2200568119. Epub 2022 May 19.
Cyclic dinucleotides (CDN) and Toll-like receptor (TLR) ligands mobilize antitumor responses by natural killer (NK) cells and T cells, potentially serving as complementary therapies to immune checkpoint therapy. In the clinic thus far, however, CDN therapy targeting stimulator of interferon genes (STING) protein has yielded mixed results, perhaps because it initiates responses potently but does not provide signals to sustain activation and proliferation of activated cytotoxic lymphocytes. To improve efficacy, we combined CDN with a half life-extended interleukin-2 (IL-2) superkine, H9-MSA (mouse serum albumin). CDN/H9-MSA therapy induced dramatic long-term remissions of the most difficult to treat major histocompatibility complex class I (MHC I)–deficient and MHC I+ tumor transplant models. H9-MSA combined with CpG oligonucleotide also induced potent responses. Mechanistically, tumor elimination required CD8 T cells and not NK cells in the case of MHC I+ tumors and NK cells but not CD8 T cells in the case of MHC-deficient tumors. Furthermore, combination therapy resulted in more prolonged and more intense NK cell activation, cytotoxicity, and expression of cytotoxic effector molecules in comparison with monotherapy. Remarkably, in a primary autochthonous sarcoma model that is refractory to PD-1 checkpoint therapy, the combination of CDN/H9-MSA with checkpoint therapy yielded long-term remissions in the majority of the animals, mediated by T cells and NK cells. This combination therapy has the potential to activate responses in tumors resistant to current therapies and prevent MHC I loss accompanying acquired resistance of tumors to checkpoint therapy.
环二核苷酸 (CDN) 和 Toll 样受体 (TLR) 配体通过自然杀伤 (NK) 细胞和 T 细胞动员抗肿瘤反应,可能作为免疫检查点治疗的补充疗法。然而,迄今为止,针对干扰素基因刺激蛋白 (STING) 的 CDN 治疗产生了混合结果,这可能是因为它强烈启动反应,但不能提供信号来维持激活和增殖的细胞毒性淋巴细胞。为了提高疗效,我们将 CDN 与半衰期延长的白细胞介素 2 (IL-2) 超激动剂 H9-MSA(鼠血清白蛋白)结合。CDN/H9-MSA 治疗诱导了最难以治疗的主要组织相容性复合体 I (MHC I) 缺陷和 MHC I+肿瘤移植模型的戏剧性长期缓解。H9-MSA 与 CpG 寡核苷酸联合也诱导了强烈的反应。从机制上讲,对于 MHC I+肿瘤,需要 CD8 T 细胞而不是 NK 细胞来消除肿瘤,而对于 MHC 缺陷肿瘤,则需要 NK 细胞而不是 CD8 T 细胞。此外,与单药治疗相比,联合治疗导致 NK 细胞激活、细胞毒性和细胞毒性效应分子表达更持久、更强烈。值得注意的是,在对 PD-1 检查点治疗有抗性的原发性同源肉瘤模型中,CDN/H9-MSA 与检查点治疗的组合在大多数动物中产生了长期缓解,由 T 细胞和 NK 细胞介导。这种联合治疗有可能激活对当前治疗有抗性的肿瘤的反应,并防止肿瘤对检查点治疗获得性耐药时 MHC I 的丧失。
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