Combination Of IL-2 Research Articles

An effective therapeutic regime for treatment of glioma using oncolytic vaccinia virus expressing IL-21 in combination with immune checkpoint inhibition

Glioblastoma (GBM) is the most common primary malignant tumor in the brain, accounting for 51.4% of all primary brain tumors. GBM has a highly immunosuppressive tumor microenvironment (TME) and, as such, responses to immunotherapeutic strategies are poor. Vaccinia virus (VV) is an oncolytic virus that has shown tremendous therapeutic effect in various tumor types. In addition to its directly lytic effect on tumor cells, it has an ability to enhance immune cell infiltration into the TME allowing for improved immune control over the tumor. Here, we used a new generation of VV expressing the therapeutic payload interleukin-21 to treat murine GL261 glioma models. After both intratumoral and intravenous delivery, virus treatment induced remodeling of the TME to promote a robust anti-tumor immune response that resulted in control over tumor growth and long-term survival in both subcutaneous and orthotopic mouse models. Treatment efficacy was significantly improved in combination with systemic α-PD1 therapy, which is ineffective as a standalone treatment but synergizes with oncolytic VV to enhance therapeutic outcomes. Importantly, this study also revealed the upregulation of stem cell memory T cell populations after the virus treatment that exert strong and durable anti-tumor activity.

Interleukins of the IL-2 family have different activity against natural killer cells when used in combination with IL-18.

e14511 Background: The main effort to improve adoptive cancer immunotherapy is aimed at overcoming the limitations associated with low MHC expression on tumor cells. Reinfusion of patient's ex vivo activated NK cells, which eliminate tumor cells, regardless of the MHC molecules presence on their surface, is among promising approaches. Natural killers fate is regulated by a whole set of cytokines, of which IL-18 and interleukins of the IL-2 family (IL-2, IL-15, IL-7, IL-21) are of particular importance. Despite the common structure of their receptor, interleukins of the IL-2 family may exert different influence on NK phenotype when combined with IL-18. The aim of the study was to investigate the effect of IL-18 combinations with interleukins of IL-2 family on activation markers expression on breast cancer patients’ peripheral blood NK cells. Methods: Peripheral blood NK cells were enriched by magnetic cell sorting from PBMC using the NK Cell Isolation Kit (#130-092-657, Miltenyi Biotec, Germany). Next, the sorted NK were incubated at 106 cells/ml in RPMI 1640 medium (Gibco, USA) with addition of cytokines at a concentration of 10 ng/ml in 5 variants: 1) IL-18; 2) IL-18 + IL-2; 3) IL-18 + IL-7; 4) IL-18 + IL-15; 5) IL-18 + IL-21. Cells were further incubated at 5.0% CO2 and 370C. After 48 hours of incubation, the expression of CD16, CD56 and CD25 markers on NK was assessed by flow cytometry. Results: A decrease in CD16++CD56+ subpopulation percentage up to 52.5% and 54.9% compared to 62.2% in the control was observed after incubation with IL-18 alone and when it was combined with IL-2, respectively. At the same time, the addition of IL-15 and IL-21 caused a further decrease to 38.7% and 39.1%, respectively. Nevertheless the combination of IL-18 and IL-7 led to an increase in CD16++CD56+ subpopulation percentage up to 71.8%. The percentage of CD25-positive NK cells on the whole followed the dynamics of CD16++CD56+ subpopulation with the IL-18 +IL-15 combination causing the maximum decrease (up to 7.6%). The proportion of NK cells with the CD16+CD56++ phenotype, on the contrary, increased after incubation with IL-18 alone and its combination with IL-2 from 34.5% in control to 46.9% and 44.3%, respectively. Interleukin 18 combinations with IL-15 and IL-21 exhibited even more prominent effect causing increase in CD16+CD56++ proportion to 59.6% and 60.4%, respectively. At the same time, incubation with IL-18+IL-7 caused only a slight decrease in the percentage of the CD16++CD56+ NK subpopulation (up to 27.5%). Conclusions: Thus, IL-18 stimulated the generation of the cytokine-producing NK fraction while suppressing the cytolytic fraction. Also the antagonistic effect of IL-7 with IL-18 and the synergistic effect of IL-15 and IL-21 with IL-18 were revealed on NK cells in vitro.

An In-Vitro Study of the Expansion and Transcriptomics of CD4+ and CD8+ Naïve and Memory T Cells Stimulated by IL-2, IL-7 and IL-15.

Simple SummaryT cell-based therapies can be costly, inconsistent, and differentially effective for patients. The limiting reagent for T cell-based immunotherapies is the T cell itself. T cell growth has been linked to endogenously delivered cytokines and messenger proteins that indicate the status of inflammation of the local system in the body. IL-2, IL-7, and IL-15 are the specific cytokines that have been identified in combination to deliver accelerated growth to different T cell subsets. This study focuses on the growth of T cell subsets subject to different combinations of IL-2, IL-7, and IL-15 in the experiment. Based on growth data, mathematical models were developed to project the optimal growth conditions for CD4+ and CD8+ Naïve and Memory T Cells. RNA sequence data is finally analyzed to study the gene networks that influence growth pathways, specifically for CD4+ and CD8+ naïve and memory subsets.The growth of T cells ex vivo for the purpose of T cell therapies is a rate-limiting step in the overall process for cancer patients to achieve remission. Growing T cells is a fiscally-, time-, and resource-intensive process. Cytokines have been shown to accelerate the growth of T cells, specifically IL-2, IL-7, and IL-15. Here a design of experiments was conducted to optimize the growth rate of different naïve and memory T cell subsets using combinations of cytokines. Mathematical models were developed to study the impact of IL-2, IL-7, and IL-15 on the growth of T cells. The results show that CD4+ and CD8+ naïve T cells grew effectively using moderate IL-2 and IL-7 in combination, and IL-7, respectively. CD4+ and CD8+ memory cells favored moderate IL-2 and IL-15 in combination and moderate IL-7 and IL-15 in combination, respectively. A statistically significant interaction was observed between IL-2 and IL-7 in the growth data of CD4+ naïve T cells, while the interaction between IL-7 and IL-15 was found for CD8+ naïve T cells. The important genes and related signaling pathways and metabolic reactions were identified from the RNA sequencing data for each of the four subsets stimulated by each of the three cytokines. This systematic investigation lays the groundwork for studying other T cell subsets.

IL-15 synergizes with IL-12 to enhance NK cell function in vivo during chronic SIV infection

Abstract Natural killer (NK) cells play a critical role in viral immunity. During early HIV/SIV infection, they are known to protect/limit viremia at the very early stage of infection. However, during chronic HIV infection NK cells are less functional, thus elicitation of highly functional NK cells are important for HIV cure strategy. It has been shown that cytokines IL-15 and IL-12 individually can activate NK cells during SIV infection. However, the synergistic effect of these cytokines to induce NK cell function has not been studied. We performed in vivo experiment to evaluate the effect of cytokines IL-15 (20ug/Kg)/IL-15R(100ug/kg) and IL-12 (10ug/kg) and its combination in inducing functional NK cells during chronic infection (6 weeks PI) and with no cytokine treatment as a control. Lymphocytes from blood and lymph nodes were analyzed for NK cell functions using multicolor flow cytometry. Our in vivo data clearly indicates that IL-15/IL-15R synergistically act with IL-12 to induce proliferation (Ki-67) and cytotoxicity (Granzyme-B+) of NK cells both in blood and lymph node. Interestingly, the cytotoxic NK cells CD16+ (FCgRIII) expanded significantly in the combination group. In addition, the degranulation capacity of NK cells (IFN-gamma+ CD107a+) significantly enhanced in the combination group when compared to either cytokine group alone, suggesting that combined cytokine treatment enhanced NK cell cytotoxicity during chronic SIV infection. Our data clearly showed that the combination of IL-15 plus IL-12 cytokine treatment increased NK cell function in vivo with proliferative and cytotoxic capacity, which is important for HIV cure strategy considering directing functional NK cells to immune privileged sites such as lymph nodes. This work was supported in part by National Institutes of Health Grants CFAR R03, R01 HD095741-01, 1R01AI148377-01A1 (to VV), U19 AI109633 (to R.R.A.), Emory University CFAR grant P30 AI050409, NIH Office of Research Infrastructure Programs (ORIP) grants P51 OD011132 and U42 OD011023 (to YNPRC) and R24 OD010947 to the Resource for NHP Immune Reagents.

The Role of Interleukin-4 and Interleukin-10 in Osteoarthritic Joint Disease: A Systematic Narrative Review.

ObjectiveA fusion protein of interleukin-4 and interleukin-10 (IL4-10 FP) was developed as a disease-modifying osteoarthritis drug (DMOAD), and chondroprotection, anti-inflammation, and analgesia have been suggested. To better understand the mechanisms behind its potential as DMOAD, this systematic narrative review aims to assess the potential of IL-4, IL-10 and the combination of IL-4 and IL-10 for the treatment of osteoarthritis. It describes the chondroprotective, anti-inflammatory, and analgesic effects of IL-4, IL-10, and IL4-10 FP.DesignPubMed and Embase were searched for publications that were published from 1990 until May 21, 2021 (moment of search). Key search terms were: Osteoarthritis, Interleukin-4, and Interleukin-10. This yielded 2,479 hits, of which 43 were included in this review.ResultsIL-4 and IL-10 showed mainly protective effects on osteoarthritic cartilage in vitro and in vivo, as did IL4-10 FP. Both cytokines showed anti-inflammatory effects, but also proinflammatory effects. Only in vitro IL4-10 FP showed purely anti-inflammatory effects, indicating that proinflammatory effects of one cytokine can be counteracted by the other when given as a combination. Only a few studies investigated the analgesic effects of IL-4, IL-10 or IL4-10 FP. In vitro, IL-4 and IL4-10 FP were able to decrease pain mediators. In vivo, IL-4, IL-10, and IL4-10 FP were able to reduce pain.ConclusionsIn conclusion, this review describes overlapping, but also different modes of action for the DMOAD effects of IL-4 and IL-10, giving an explanation for the synergistic effects found when applied as combination, as is the case for IL4-10 FP.

Immuno-Diagnosis of Active Tuberculosis by a Combination of Cytokines/Chemokines Induced by Two Stage-Specific Mycobacterial Antigens: A Pilot Study in a Low TB Incidence Country.

Active tuberculosis (aTB) remains a major killer from infectious disease, partially due to delayed diagnosis and hence treatment. Classical microbiological methods are slow and lack sensitivity, molecular techniques are costly and often unavailable. Moreover, available immuno-diagnostic tests lack sensitivity and do not differentiate between aTB and latent TB infection (LTBI). Here, we evaluated the performance of the combined measurement of different chemokines/cytokines induced by two different stage-specific mycobacterial antigens, Early-secreted-antigenic target-6 (ESAT-6) and Heparin-binding-haemagglutinin (HBHA), after a short in vitro incubation of either peripheral blood mononuclear cells (PBMC) or whole blood (WB). Blood samples were collected from a training cohort comprising 22 aTB patients, 22 LTBI subjects and 17 non-infected controls. The concentrations of 13 cytokines were measured in the supernatants. Random forest analysis identified the best markers to differentiate M. tuberculosis-infected from non-infected subjects, and the most appropriate markers to differentiate aTB from LTBI. Logistic regression defined predictive abilities of selected combinations of cytokines, first on the training and then on a validation cohort (17 aTB, 27 LTBI, 25 controls). Combining HBHA- and ESAT-6-induced IFN-γ concentrations produced by PBMC was optimal to differentiate infected from non-infected individuals in the training cohort (100% correct classification), but 2/16 (13%) patients with aTB were misclassified in the validation cohort. ESAT-6-induced-IP-10 combined with HBHA-induced-IFN-γ concentrations was selected to differentiate aTB from LTBI, and correctly classified 82%/77% of infected subjects as aTB or LTBI in the training/validation cohorts, respectively. Results obtained on WB also selected ESAT-6- and HBHA-induced IFN-γ concentrations to provided discrimination between infected and non-infected subjects (89%/90% correct classification in the training/validation cohorts). Further identification of aTB patients among infected subjects was best achieved by combining ESAT-6-induced IP-10 with HBHA-induced IL-2 and GM-CSF. Among infected subjects, 90%/93% of the aTB patients were correctly identified in the training/validation cohorts. We therefore propose a two steps strategy performed on 1 mL WB for a rapid identification of patients with aTB. After elimination of most non-infected subjects by combining ESAT-6 and HBHA-induced IFN-γ, the combination of IP-10, IL-2 and GM-CSF released by either ESAT-6 or HBHA correctly identifies most patients with aTB.

IL15 and Anti-PD-1 Augment the Efficacy of Agonistic Intratumoral Anti-CD40 in a Mouse Model with Multiple TRAMP-C2 Tumors.

IL15 promotes activation and maintenance of natural killer (NK) and CD8+ T effector memory cells making it a potential immunotherapeutic agent for the treatment of cancer. However, monotherapy with IL15 was ineffective in patients with cancer, indicating that it would have to be used in combination with other anticancer agents. The administration of high doses of common gamma chain cytokines, such as IL15, is associated with the generation of "helpless" antigen-nonspecific CD8 T cells. The generation of the tumor-specific cytotoxic T cells can be mediated by CD40 signaling via agonistic anti-CD40 antibodies. Nevertheless, parenteral administration of anti-CD40 antibodies is associated with unacceptable side effects, such as thrombocytopenia and hepatic toxicity, which can be avoided by intratumoral administration. We investigated the combination of IL15 with an intratumoral anti-CD40 monoclonal antibody (mAb) in a dual tumor TRAMP-C2 murine prostate cancer model and expanded the regimen to include an anti-PD-1 mAb. Here we demonstrated that anti-CD40 given intratumorally not only showed significant antitumor activity in treated tumors, but also noninjected contralateral tumors, indicative of abscopal efficacy. The combination of IL15 with intratumoral anti-CD40 showed an additive immune response with an increase in the number of tumor-specific tetramer-positive CD8 T cells. Furthermore, the addition of anti-PD-1 further improved efficacy mediated by the anti-CD40/IL15 combination. These studies support the initiation of a clinical trial in patients with cancer using IL15 in association with the checkpoint inhibitor, anti-PD-1, and intratumoral optimized anti-CD40.

Endometrial cytokines in patients with and without endometriosis evaluated for infertility

To evaluate whether endometrial molecular profiles distinguish subsets of patients according to clinical characteristics, and to infer dysregulated immune networks, by measuring cytokines, chemokines, and growth factors in endometrial biopsy specimens from a cohort of infertile women with a high incidence of endometriosis. Prospective cohort study. Department of Gynecology at a university hospital. Patients undergoing laparoscopy for infertility assessment (n = 103). Endometrial biopsies were performed during surgery. Fertility outcome and clinical parameters were registered preoperatively and after 6 months. The concentrations of 48 factors in endometrial biopsy specimens were analyzed with respect to clinical status in univariate and multivariate frameworks. The concentrations of 44 factors from endometrial tissues of 74 patients were suitable for analysis. Although the tissue concentrations of interleukin (IL)15, IL-7, and interferon γ-induced protein (IP)-10 were individually lower in patients with endometriosis than in those without endometriosis, the differences were not significant after multiple comparison. However, multivariate modeling incorporating covariation showed separation between subsets of endometriotic and nonendometriotic patients, based predominantly on IP-10, monocyte chemoattractant protein-1, IL-16, and IL-18; this result was independent of cycle and fertility status. Analysis restricted to endometrial tissues from the secretory phase separated endometriotic and nonendometriotic patients by a combination of IL-15, IP-10, monocyte chemoattractant protein-1, IL-16, and IL-18. This combination suggests a uterine natural killer cell defect. We found no significant correlations between endometrial cytokines and fertility outcome. A molecular signature in endometrial tissue was able to distinguish endometriotic from nonendometriotic patients, implicating uterine natural killer cells in endometriosis.

Combined IL-2, agonistic CD3 and 4-1BB stimulation preserve clonotype hierarchy in propagated non-small cell lung cancer tumor-infiltrating lymphocytes

BackgroundAdoptive cell transfer (ACT) of tumor-infiltrating lymphocytes (TIL) yielded clinical benefit in patients with checkpoint blockade immunotherapy-refractory non-small cell lung cancer (NSCLC) prompting a renewed interest in TIL-ACT. This preclinical...

Il-2 in combination with immune checkpoints
 inhibitors as a promising approach for cancer
 immunotherapy:
 A literature review

Relevance: Interleukin-2 (IL-2) alone has been shown to induce tumor regression and approved to treat metastatic renal cancer and melanoma. Checkpoint inhibitors realize their therapeutic
 effect through stimulation of immune system effectors; one of such
 mechanisms is the enhancement of IL-2 production by T-helpers.
 The purpose of the study was to determine the effectiveness
 of IL-2 administration as a component of combined immunotherapy with immune checkpoint inhibitors and to suggest the mechanisms by which IL-2 can reduce the frequency and severity of side
 effects during checkpoint inhibitor therapy without reducing their
 effectiveness.
 Methods: The literature search was performed in the PubMed,
 SCOPUS, and Web of Science databases by the keywords in article titles: “immunotherapy,” “checkpoint inhibitors,” “interleukin-2,” and
 “combination therapy” for the period 2011-2021. A total of 248 relevant articles were found. The review’s inclusion criteria were: clinical
 cases; data of clinical research methods; data on humans/body fluids from humans; literature reviews and meta-analyses. The selected
 24 articles met the search criteria and were included in the review.
 Results: The combined action of IL-2 and сheckpoint inhibitors increases the proliferative and killer activity of the antitumor
 immunity effectors compared to the action of the same drugs in
 mono-mode at a level exceeding the summation effect.
 Conclusion: The combination of IL-2 and сheckpoint inhibitors can increase the effectiveness of anticancer treatment and is
 a promising area of immunotherapy

IMMU-19. EVALUATING EFFECTS OF REVERSING DISTINCT FACETS OF IMMUNOSUPPRESSION IN EXPERIMENTAL GBM

Abstract Glioblastoma is associated with severe and multifaceted immunosuppression affecting all immune organs. Immunosuppression in GBM is a critical barrier to the success of immunotherapies and patient survival. We demonstrated that immunosuppression in the GL261-model of experimental GBM presents with significant thymic and spleen atrophy, MHCII downregulation, presence of potent immunosuppressive factors in serum, and sequestration of T-cells in the bone marrow. Parabiosis studies determined that soluble factors mediate immunosuppression by inhibiting T-cell proliferation, thymic involution, and loss of peripheral T-cells. In contrast, bone marrow T-cell sequestration was not mediated through soluble factors. While the immunosuppression in GBM is severe, a causative link between each facet of immunosuppression and overall survival is lacking. We used two strategies to block T-cell sequestration into the bone marrow and evaluated the extent survival was impacted in experimental GBM. First, we evaluated the extent a novel and off-the-shelf combination immunotherapy that uses extended 1/2-life IL-2 and anti-PD-1 reverses bone marrow T-cell sequestration. Sham treatment or anti-PD1 monotherapy did not alter T-cell sequestration in the bone marrow and animals had no enhanced survival. Extended 1/2-life IL-2 monotherapy and combination strategy both prevented T-cell sequestration into the bone marrow. However, only combined therapy, which also prevented MHC class II downregulation, improved survival. Second, we determined that glioma-bearing adrenalectomized mice do not present with bone marrow T-cell sequestration. However, sera of glioma-bearing adrenalectomized mice is as immunosuppressive as glioma-bearing controls. Blocking bone marrow T-cell sequestration in the presences of serum immunosuppression led to no survival benefit in glioma-bearing adrenalectomized mice compared to controls. In short, bone marrow T-cell sequestration alone does not correspond with overall survival in experimental glioma. Importantly, a concerted effort to reverse MHC class II downregulation and define inhibitory circulating factors may have the highest impact in immunotherapeutic efficacy and improving patient survival.

Efficacy of Enhanced Cytokine-Induced Killer Cells as an Adjuvant Immunotherapy for Renal Cell Carcinoma: Preclinical and Clinical Studies.

Cytokine-induced killer (CIK) cells have been proved to be an effective method of tumor immunotherapy in numerous preclinical and clinical studies. In our previous study, a new method was developed to prime and propagate CIK cells by the combination of IL-2 and IL-15, and this kind of CIK cells had enhanced antitumor effect on lung cancer. For renal cell carcinoma (RCC), immunotherapy plays an important role because of the poor efficacy of radiotherapy and chemotherapy. In this study, we further evaluated the antitumor effects of these enhanced CIK cells against RCC. Enhanced CIK cells were generated by IL-2 combined with IL-15 and identified by flow cytometry. HEK-293 and ACHN cell lines were used to verify the efficiency of CIK cells in vitro, and then the ACHN tumor xenograft model was also employed for in vivo study. In addition, the secreted cytokines including IFN-γ, granzyme B, TNF-α, and perforin, as well as the local microstructure were also studied. Subsequently, 20 patients with RCC were enrolled into our study, and 11 patients were randomly divided into the autologous CIK treatment group for clinical research. The results showed that enhanced CIK cells exert better antitumor effects in RCC in vitro (p < 0.01 in HEK-293 and p < 0.05 in ACHN）and in vivo (p < 0.05). Patients benefit overall survival from enhanced CIK therapy in our clinical study. Our present preclinical and clinical studies for the first time elucidated that these enhanced CIK cells would be used as an effective adjuvant therapy in the treatment of RCC.

Th1 polarization in the tumor microenvironment upregulates the myeloid-derived suppressor-like function of macrophages

Here, we investigated the effect of Th1 polarization in the tumor microenvironment (TME) on tumor-associated macrophage (TAM) maturation and activation. In our immunotherapy mouse model, with a Th1-dominant TME, tumors regressed in all cases, with complete regression in 80% of the cases. Monocyte-derived dendritic cells and activated CD4+ and CD8+T-cells increased in the tumor-draining lymph node, and correlated with each other in the therapeutic model. However, the cytotoxicity of tumor-infiltrating CD8+T-cells was slightly inhibited, whereas the number of T-cells significantly increased. Moreover, the number of TAMs increased; their maturation was inhibited; and nitrotyrosine (NT) production, as well as iNOS and arginase I expression, was increased, suggestive of the myeloid-derived suppressor cell-like immunosuppressive function of TAMs. IFN-γ knockout in the therapeutic model decreased NT production and induced macrophage maturation. Hence, Th1 polarization in the IFN-γ-dominant condition induces T-cell immune responses; however, it also enhances the immunosuppressive activity of TAMs.

Neutrophilokines and the morphofunctional state of circulating neutrophils in ovarian tumors

There is currently no clear understanding of the molecular participants providing cytotoxic and/or cytostatic activity of neutrophils (Nph) in relation to tumor cells. Cytokines produced by neutrophils are necessary for their paracrine and autocrine interactions with surrounding cells. In order to assess the effect of regulatory neutrophilokines on the morphofunctional state of circulating Nph in benign ovarian tumors and ovarian cancer, the ELISA method was used to assess the level of IL-4, IL-6, IL-10, IL-8, IL-18, IFNγ, MCP-1 and MMP-1in neutrophils, expression of CD11b, CD63, CD16, CD95. Determined the rigidity of the membrane and the ability of neutrophils to form NET. Statistical processing of the obtained data was carried out using the software Statistica 13.0, Jamovi 1.6.5.0. It was found that in ovarian cancer the rigidity of neutrophils depends on the level of IL-10, MCP-1, IL-18, IL-8, IL-4, IFNγ, IL-6 in neutrophils. The method of multiple regression revealed the dependence of the ability to form NETs on the level of IL-4 and IL-6 in Nph. Revealed an inverse correlation between the rigidity of the membrane Nph and their ability to form traps in ovarian cancer. In benign ovarian tumors, a noticeable direct correlation was found between the rigidity of the neutrophil membrane and the adhesive marker CD11b. In ovarian cancer, a correlation was found between the rigidity of the Nph membrane and the CD63 degranulation marker. At benign ovarian tumors, no correlations were found between the number of activated neutrophils and the level of intracellular cytokines in Nph. In ovarian cancer, correlations were found between the number of CD11b+Nph and the level of IL-6, IL-8 in them; between the amount of CD63, CD95 and intracellular IL-8. The amount of CD16+Nph correlated with the level of MMP-1 and IL-8 in Nph. The amount of CD95+Nph correlated with the level of IL-18 in Nph. Thus, the change in the level of neutrophilokines in benign ovarian tumors did not correlate with changes in the ability to NETosis, expression of activation markers, but was accompanied by an increase in the rigidity of the membrane of circulating neutrophils. In ovarian cancer, an increase in IL-8 correlated with a decrease in CD16 expression and an increase in CD63; a decrease in CD16 correlated with an increase in MMP-1. An increase in membrane rigidity in ovarian cancer was associated with changes in all considered neutrophilokines (IL-4, IL-6, IL-8, IL-10, IL-18, MCP-1, IFNγ). The combination of IL-4, IL-6, IL-18 indices, NET number and membrane rigidity of circulating Nph (according to the results of multivariate analysis) can be used for differential diagnosis of ovarian cancer.

IL-15 Enhances the Persistence and Function of BCMA-Targeting CAR-T Cells Compared to IL-2 or IL-15/IL-7 by Limiting CAR-T Cell Dysfunction and Differentiation.

Simple SummaryT cells modified with a chimeric antigen receptor (CAR) that targets BCMA, a protein expressed on malignant plasma cells, represent a novel treatment option for multiple myeloma. Despite initially eliminating the disease, the function of BCMA-directed CAR-T cells diminishes within a year of administration, leading to disease relapse. The aim of this research was to alter the cytokines used in the ex vivo expansion of anti-BCMA CAR-T cells, to avoid the development of an unfavorable phenotype that would impair in vivo function. We discovered that CAR-T cells expanded with IL-15 had reduced dysfunction and enhanced persistence compared to those grown with IL-2 or a combination of IL-15 and IL-7, which resulted in longer and improved anti-tumor responses in a mouse model. Therefore, the use of IL-15 alone in place of IL-2 or IL-15/IL-7 should be considered when designing CAR-T cell production protocols, to improve the duration of patient responses.Chimeric antigen receptor (CAR)-T cell immunotherapy has revolutionized the treatment of B-lymphoid malignancies. For multiple myeloma (MM), B-cell maturation antigen (BCMA)-targeted CAR-T cells have achieved outstanding complete response rates, but unfortunately, patients often relapse within a year of receiving the therapy. Increased persistence and reduced dysfunction are crucial features that enhance the durability of CAR-T cell responses. One of the factors that influence CAR-T cell in vivo longevity and loss of function, but which has not yet been extensively studied for BCMA-directed CAR-T cells, are the cytokines used during their production. We here compared the impact of IL-2, IL-15 and a combination of IL-15/IL-7 on the phenotype and function of ARI2h, an academic BCMA-directed CAR-T cell that is currently being administered to MM patients. For this study, flow cytometry, in vitro cytotoxicity assays and analysis of cytokine release were performed. In addition, ARI2h cells expanded with IL-2, IL-15, or IL-15/IL-7 were injected into MM tumor-bearing mice to assess their in vivo efficacy. We demonstrated that each of the cytokine conditions was suitable for the expansion of ARI2h cells, with clear in vitro activity. Strikingly, however, IL-15-produced ARI2h cells had improved in vivo efficacy and persistence. When explored further, it was found that IL-15 drove a less-differentiated ARI2h phenotype, ameliorated parameters related to CAR-T cell dysfunction, and lowered the release of cytokines potentially involved in cytokine release syndrome and MM progression. Moreover, we observed that IL-15 was less potent in inducing T cell senescence and DNA damage accumulation, both of which may contribute to an unfavorable CAR-T cell phenotype. These findings show the superiority of IL-15 to IL-2 and IL-15/IL-7 in the quality of anti-BCMA CAR-T cells, particularly their efficacy and persistence, and as such, could improve the duration of responses if applied to the clinical production of CAR-T cells for patients.

Abstract 1566: Monitoring the impact of IL15 in combination with Sting agonists and nivolumab on activation and proliferation of tumor resident immune cells in 3D-EX platform of intact patient tumoroids

Abstract Background: The major goal of many immune-oncology (IO) therapeutics is improving the functionality of cytotoxic T cells through inhibiting checkpoints or through targeting stimulatory pathways. Tumor infiltrating myeloid cells are often educated within the tumor microenvironment (TME) to adopt regulatory phenotypes and become a major barrier to effective immune responses. Generation of an optimal immune response likely requires a combination of agents designed to promote anti-tumor T cell activation and to recondition the TME to support T cell functions. We generated patient derived 3D-tumoroids which retain the tumors stroma and suppressive immune landscape. This platform allowed for the screening of immune agonists targeting the IL15, Sting, or 41BB pathways alone or in combination with checkpoint inhibitors to identify the most effective combination in fresh patient tumoroid samples ex vivo. Methods: 3D-tumoroids approximately 150 µm in size were generated from fresh patient tumor samples which were obtained with informed consent and relevant IRB approval. Tumoroids were treated ex vivo with an IL15 agonist or Sting pathway agonists alone or in combination with nivolumab. Multi-parameter flow cytometry was used to analyze treatment-mediated changes inCD4/CD8 and NK cell activation. Additionally, we directly measured proliferation of T-cells, Tregs and myeloid cell populations in response to ex vivo treatments through EDU incorporation assay by flowcytometry. Immune cell function was further assessed by multiplex cytokine analysis and treatment-induced tumor cell killing was determined by high content confocal imaging. Results: Our data showed that IL15 treatment alone and select Sting agonists in combination and nivolumab had significant impact on activation and proliferation of tumor resident T-cells in their intact TME. Additionally, by using the 3D-EX platform, somewhat unexpectedly, we also observed meaningful changes in Tregs and multiple tumor infiltrating myeloid subsets including macrophages and dendritic cells upon ex vivo treatment with the IO drugs used in this study. Enhancement in pro-inflammatory cytokines production and immune cell functional phenotype were further correlated with tumor cell killing ex vivo. Conclusion: Our data reveals the power of the 3D-EX platform to identify combinations of immunotherapy agents capable of overcoming the unique suppressive environment developed by an individual tumor. Furthermore, the 3D-EX platform provides unique insight into the microenvironment to better identify compensatory mechanisms limiting the efficacy of IO therapeutics that may help to develop rational combination strategies. We believe the 3D-EX platform is clinically relevant and capable of significantly accelerating immuno-oncology drug discovery. Citation Format: Mibel M. Pabón, Jared Ehrhart, Stephen Iwanowycz, Zhisong Tong, Tina Pastoor, Soner Altiok. Monitoring the impact of IL15 in combination with Sting agonists and nivolumab on activation and proliferation of tumor resident immune cells in 3D-EX platform of intact patient tumoroids [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1566.

Abstract 1567: IL-15 and anti-PD-1 augment the abscopal efficacy of agonistic intratumoral anti-CD40 in the TRAMP-C2 murine tumor model

Abstract IL-15 promotes activation and maintenance of natural killer (NK) and CD8+ T-effector memory (TEM) cells making it a potential immunotherapeutic agent for the treatment of cancer. However, high doses of γc cytokines lead to the paralysis/depression of naïve CD4 but not CD8 T-cells that is mediated through transient expression of suppressor of cytokine signaling 3 (SOCS3). Thus, the out-of-normal order addition of γc cytokines is associated with generation of “helpless” tumor antigen nonspecific CD8 T cells. The role of CD4 helper T cells can be alternatively mediated by CD40 signaling through the addition of agonistic anti-CD40 antibodies. However, parenteral administration of an agonistic anti-CD40 antibody is associated with unacceptable toxicity that can be avoided by intratumoral administration. Intratumoral immunotherapy that aims at generating a potent low toxic priming of antitumor immunity uses the tumor as its own vaccine. We investigated the combination of IL-15 with an intratumoral anti-CD40 monoclonal antibody using a dosing schedule based on our previous study in the TRAMP-C2 murine prostate cancer model. Here we demonstrated that given intratumorally anti-CD40 had abscopal efficacy, and that the combination of IL-15 with the intratumoral anti-CD40 showed an augmented immune response with an increase in the number of tumor specific tetramer positive CD8+ T-cells. Furthermore, anti-PD-1 antibody was additive to the anti-CD40 IL-15 combination. These studies support the initiation of a clinical trial in patients with cancer involving IL-15 in association with intratumoral optimized anti-CD40. Citation Format: Wei Chen. IL-15 and anti-PD-1 augment the abscopal efficacy of agonistic intratumoral anti-CD40 in the TRAMP-C2 murine tumor model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1567.

Abstract 1448: Combination therapy of anti-sense oligonucleotide targeting TGF-beta2 (TASO) and IL-2 (Proleukin) has anti-cancer effect in solid cancer

Abstract Background: TGF-Β (transforming growth factor-beta) is an essential cytokine for tumor proliferation and metastasis. The expression of TGF-Β correlates with malignancy of various cancers and involves immunosuppression and angiogenesis of a tumor. IL-2 is a major cytokine to proliferate T cells and NK cells which are major players of cancer immunity. However, the toxicity of high dose IL-2 limits its use in cancer therapy. Combination treatment of TGF-Β inhibitor and IL-2 would have an anti-tumor effect by immune cells through diminishing immunosuppression by TGF-Β and enforcement of immune cells by IL-2. Trabedersen is an anti-sense oligonucleotide targeting human TGF-Β mRNA. It is shown that Trabedersen is well tolerable in cancer patients and effective reagent to treat pancreatic cancer, melanoma, and glioblastoma. Proleukin is the only approved IL-2 reagent to treat Renal cell carcinoma and Melanoma. Methods: Trabedersen and Proleukin activated human PBMC (Peripheral Blood Mononuclear Cell) are treated to several solid cancer cell lines, such as Breast cancer, Pancreatic cancer, Melanoma, Lung cancer, and Colon cancer to see the cytotoxicity effect of combination therapy of Trabedersen and Proleukin. NSG mouse (NOD Scid Gamma mouse, NOD.Cg-Prkdcscid Il2rgtm1Wjl/SzJ) which are humanized by human PBMC engraftment and the tumor growth of Melanoma and TNBC (Triple Negative Breast Cancer cell) cell line are monitored. Results: The combination treatment of Trabedersen and low dose Proleukin decreased cancer cell viability in vitro experiment in solid cancer cell lines. Melanoma and TNBC tumor growth was delayed in humanized NSG mouse model by Trabedersen and low dose IL-2 combination therapy and tumor growth delay was statistically significant to Trabedersen alone or IL-2 alone group. Tumor infiltrating lymphocyte population was increased in Trabedersen treated group and FoxP3+ regulatory T cell population in blood and tumor microenvironment was decreased by treatment of Trabedersen. Conclusion: TGF-Β inhibitor (Trabedersen) and low dose IL-2 (Proleukin) combination treatment is expected to be an effective regimen in solid cancer treatment than individual treatment by alteration of tumor environment. Modulation of the dose of Proleukin expects to help reduce the toxicity of IL-2 and increase the anti-cancer effect by combination with Trabedersen. Citation Format: Jun-Eui Park, Jihye Koo, Hong-Kyu Lee, Tae Hun Kim. Combination therapy of anti-sense oligonucleotide targeting TGF-beta2 (TASO) and IL-2 (Proleukin) has anti-cancer effect in solid cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1448.

Abstract 1569: Role of NK and CD8+T cells in the antitumor effect elicited by combined treatment with radiation, tumor-specific antibody, and IL2 in a syngeneic murine model of head and neck squamous cell carcinoma

Abstract Background: Radiation therapy (RT) has been shown to activate an in situ vaccine (ISV) effects. Recently, we reported that combining tumor-antigen-specific monoclonal antibody (mAb), RT, and intratumoral (IT) injection of IL2 activates a much greater ISV response compared to RT alone. In this combination, RT can enhance the mAb-dependent cell-mediated cytotoxicity response by NK cells when delivered with a tumor-specific mAb. Here we evaluated the role of NK cells in activating the CD8+ T cell-dependent ISV effect following RT, mAb, and IT-IL2. Methods: MOC2 murine head and neck squamous cell carcinoma (HNSCC) cells expressing human epidermal growth factor receptor (MOC2-huEGFR+) were engrafted on the right flank of C57BL/6 mice. Tumors were treated with RT, the anti-huEGFR mAb cetuximab, and IT-IL2. In mice rendered tumor-free, immune memory was tested by re-engraftment with MOC2 wild-type tumor cells on the left flank. Splenic cells were isolated from a cohort of treated mice and cultured with MOC2 cells. These were analyzed by flow cytometry to quantify IFNγ expression. To test ISV efficacy in metastatic settings, mice were engrafted with MOC2-huEGFR+ right flank tumors and MOC2 wild-type left flank tumors. After treatment, immune infiltration was analyzed in both tumors, blood, and spleen. To assess the necessity of immune cells, CD4+, CD8+, or NK1.1+ cells were depleted. Results: Combining RT and IT cetuximab and IL2 resulted in greater tumor regression and overall survival compared to single or dual treatments in mice with MOC2-huEGFR+ tumors. Six of 7 disease-free mice exhibited immune memory. Coculture of splenocytes from ISV treated mice with MOC2-huEGFR cells in vitro showed increased IFNγ expression in CD4+, CD8+, and NK cells. However, when splenocytes were first sorted and then co-cultured, only CD8+ T cells showed increased IFNγ expression after coculture with MOC2-huEGFR+. In a two-tumor model, delivering this ISV regimen to a right flank MOC2-huEGFR+ tumor increased CD8+ T cell infiltration in a distant left flank MOC2 wild-type tumor without affecting the number of, or IFNγ expression in, CD4+ or NK cells. Depletion of CD8+ cells eliminated antitumor response at both the right and left flank tumors in this model. Interestingly, NK cells, while not necessary for tumor response at the ISV-targeted right flank, were essential to the activation of a systemic CD8+ T cell response at the distant left flank tumor. Conclusions: In a syngeneic murine model of HNSCC, the local combination of RT, cetuximab, and IL2 destroys the targeted tumor and enables this site to serve as a potent immune stimulus and personalized source of antigenicity for activation of adaptive T cell immunity. NK cells are necessary for the activation of this ISV effect and the resulting CD8+ T cell-dependent systemic antitumor response. Citation Format: Wonjong Jin. Role of NK and CD8+T cells in the antitumor effect elicited by combined treatment with radiation, tumor-specific antibody, and IL2 in a syngeneic murine model of head and neck squamous cell carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1569.

Flow cytometry data mining by cytoChain identifiesdeterminants of exhaustion and stemness in TCR-engineered T cells.

The phenotype of infused cells is a major determinant of Adoptive T-cell therapy (ACT) efficacy. Yet, the difficulty in deciphering multiparametric cytometry data limited the fine characterization of cellular products. To allow the analysis of dynamic and complex flow cytometry samples, we developed cytoChain, a novel dataset mining tool and a new analytical workflow. CytoChain was challenged to compare state-of-the-art and innovative culture conditions to generate stem-like memory cells (TSCM ) suitable for ACT. Noticeably, the combination of IL-7/15 and superoxides scavenging sustained the emergence of a previously unidentified nonexhausted Fit-TSCM signature, overlooked by manual gating and endowed with superior expansion potential. CytoChain proficiently traced back this population in independent datasets, and in T-cell receptor engineered lymphocytes. CytoChain flexibility and function were then further validated on a published dataset from circulating T cells in COVID-19 patients. Collectively, our results support the use of cytoChain to identify novel, functionally critical immunophenotypes for ACT and patients immunomonitoring.