Low-dose IL-12 preconditions the tumor microenvironment to enhance the efficacy of PD-1 blockade.

Authors

null

C. Marcela Diaz-Montero

Cleveland Clinic Lerner Research Institute, Cleveland, OH

C. Marcela Diaz-Montero, Sairekha Ravichandran, Paul G. Pavicic, Patricia A. Rayman, Charles Tannenbaum, James Finke, Jennifer S. Ko, Pauline Funchain, Ahmad A. Tarhini

Organizations

Cleveland Clinic Lerner Research Institute, Cleveland, OH, Cleveland Clinic, Cleveland, OH, Case Comprehensive Cancer Center/Cleveland Clinic Taussig Cancer Institute, Cleveland, OH

Research Funding

Other

Background: The immunomodulatory effects of IL-12 are well known to result in potent anti-tumor responses. However its therapeutic development has been hindered by its potential toxicity. Here we explored the impact of systemic low dose IL-12 administration as a strategy to enhance the efficacy of PD-1 blockade. Methods: Mice bearing D4M melanoma tumors were treated with anti PD-1 antibody alone or in combination with low dose IL-12 (100ng twice a week). Tumor progression was monitored, and characterization of immune cell types was performed by flow cytometry and gene expression analysis. Results: A significant reduction in tumor progression after combinatorial treatment with low dose IL-12 and anti PD-1 was observed. This synergistic effect was associated with elevated levels of intratumoral IFN-γ, iNOS, CXCL9, CXCL10, CXCL11, and perforin. Single treatment with low dose IL-12 induced a decrease in the levels of circulating neutrophils and an increase in the levels of circulating CD8+ T cells. Within the TME, low dose IL-12 treatment was associated with an increase in the frequencies of tumor infiltrating M-MDSCs expressing high levels of CXCL9. Elevated levels of CD8+ TILs were also found, which were characterized by their increased expression of PD-1 and PD-L1, as well as CD107a, CXCR3 and CD103. No signs of toxicity were noted. Conclusions: Low dose IL-12 synergizes with anti PD-1 to induce superior regression of D4M melanoma tumors. This effect was associated with an increase in the levels of molecules involved in the recruitment and effector function of CD8+ T cells. Analysis of tissues from animals treated with low dose IL-12 alone showed significant changes in the composition and phenotype of myeloid and T cells in both the tumor and blood. Expression of CXCL9 on tumor infiltrating MDSCs suggested a reversal of their immunosuppressive function to an immunopromoting one, and could explain the elevated accumulation of CD8+ TILs via enhanced CXCR3-dependent recruitment. These findings suggest that low dose IL-12 is sufficient to induce changes in the TME, with minimal toxicity,that enhance the anti-tumor effects of PD-1 blockade. A clinical study testing the safety of this combination is currently underway.

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Abstract Details

Meeting

2019 ASCO-SITC Clinical Immuno-Oncology Symposium

Session Type

Poster Session

Session Title

Poster Session A

Track

Breast and Gynecologic Cancers,Developmental Therapeutics,Genitourinary Cancer,Head and Neck Cancer,Lung Cancer,Melanoma/Skin Cancers,Gastrointestinal Cancer,Combination Studies,Implications for Patients and Society,Miscellaneous Cancers,Hematologic Malignancies

Sub Track

Novel Clinical Trial Designs

Citation

J Clin Oncol 37, 2019 (suppl 8; abstr 20)

DOI

10.1200/JCO.2019.37.8_suppl.20

Abstract #

20

Poster Bd #

B4

Abstract Disclosures

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