Abstract

Inhibition of mTOR signaling enhances antitumor memory lymphocytes. However, pharmacologic mTOR inhibition also enhances regulatory T-cell (Treg) activity. To counter this effect, Treg control was added to mTOR inhibition in preclinical models. Tregs were controlled with CD4-depleting antibodies because CD4 depletion has high translational potential and already has a well-established safety profile in patients. The antitumor activity of the combination therapy was CD8 dependent and controlled growth of syngeneic tumors even when an adoptive immunotherapy was not used. Lymphocytes resulting from the combination therapy could be transferred into naïve mice to inhibit aggressive growth of lung metastases. The combination therapy enhanced CD8 memory formation as determined by memory markers and functional studies of immune recall. Removal of FoxP3-expressing T lymphocytes was the mechanism underlying immunologic memory formation following CD4 depletion. This was confirmed using transgenic DEREG (depletion of regulatory T cells) mice to specifically remove Foxp3(+) T cells. It was further confirmed with reciprocal studies where stimulation of immunologic memory because of CD4 depletion was completely neutralized by adoptively transferring tumor-specific Foxp3(+) T cells. Also contributing to tumor control, Tregs that eventually recovered following CD4 depletion were less immunosuppressive. These results provide a rationale for further study of mTOR inhibition and CD4 depletion in patients.

Highlights

  • The immune system can provide protection against cancers

  • This was a surprising finding because mTOR inhibitors are used to suppress the immune system in patients who have had solid organ transplants

  • Temsirolimus is a rapamycin analog and one of the first mTOR inhibitors approved by the Food and Drug Administration (FDA) as a cancer treatment

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Summary

Introduction

The immune system can provide protection against cancers. Effective immune stimulation produces long-lasting memory lymphocytes, capable of rapidly responding to repeat antigen challenge. In mouse models, decreased mTOR signaling promotes formation of CD8 memory cells that provide protection against bacteria [4], virus [1] or cancer [2, 3]. This is surprising because rapamycin, which is the prototypic mTOR inhibitor, is considered an immunosuppressant and is widely used to prevent rejection of solid organ transplants.

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