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Decoy-resistant IL-18 reshapes the tumor microenvironment and enhances rejection by anti–CTLA-4 in renal cell carcinoma
David A. Schoenfeld, Dijana Djureinovic, David G. Su, Lin Zhang, Benjamin Y. Lu, Larisa Kamga, Jacqueline E. Mann, John D. Huck, Michael Hurwitz, David A. Braun, Lucia Jilaveanu, Aaron M. Ring, Harriet M. Kluger
David A. Schoenfeld, Dijana Djureinovic, David G. Su, Lin Zhang, Benjamin Y. Lu, Larisa Kamga, Jacqueline E. Mann, John D. Huck, Michael Hurwitz, David A. Braun, Lucia Jilaveanu, Aaron M. Ring, Harriet M. Kluger
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Research Article Immunology Oncology

Decoy-resistant IL-18 reshapes the tumor microenvironment and enhances rejection by anti–CTLA-4 in renal cell carcinoma

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Abstract

The cytokine IL-18 has immunostimulatory effects but is negatively regulated by a secreted binding protein, IL-18BP, that limits IL-18’s anticancer efficacy. A decoy-resistant form of IL-18 (DR-18) that avoids sequestration by IL-18BP while maintaining its immunostimulatory potential has recently been developed. Here, we investigated the therapeutic potential of DR-18 in renal cell carcinoma (RCC). Using pantumor transcriptomic data, we found that clear cell RCC had among the highest expression of IL-18 receptor subunits and IL18BP of tumor types in the database. In samples from patients with RCC treated with immune checkpoint inhibitors, IL-18BP protein expression increased in the tumor microenvironment and in circulation within plasma in nonresponding patients, and it decreased in the majority of responding patients. We used immunocompetent RCC murine models to assess the efficacy of DR-18 in combination with single- and dual-agent anti–PD-1 and anti–CTLA-4. In contrast to preclinical models of other tumor types, in RCC models, DR-18 enhanced the activity of anti–CTLA-4 but not anti–PD-1 treatment. This activity correlated with intratumoral enrichment and clonal expansion of effector CD8+ T cells, decreased Treg levels, and enrichment of proinflammatory antitumor myeloid cell populations. Our findings support further clinical investigation of the combination of DR-18 and anti–CTLA-4 in RCC.

Authors

David A. Schoenfeld, Dijana Djureinovic, David G. Su, Lin Zhang, Benjamin Y. Lu, Larisa Kamga, Jacqueline E. Mann, John D. Huck, Michael Hurwitz, David A. Braun, Lucia Jilaveanu, Aaron M. Ring, Harriet M. Kluger

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Figure 5

DR-18 alters immune subset composition in Renca tumors, including enrichment and clonal expansion of CD8+ effector T cells.

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DR-18 alters immune subset composition in Renca tumors, including enrich...
(A) Uniform Manifold Approximation and Projection (UMAP) dimensionality reduction plot of clustering and annotation of all cell populations isolated from Renca tumors treated for 3 cycles with PBS, DR-18, anti–CTLA-4, or DR-18 + anti–CTLA-4 (Combo) (n = 3 mice/group, pooled) based on scRNA-Seq analysis. Annotations were performed using SingleR. (B) Quantification of the proportion of each cell population from A within each of the treatment groups, showing enrichment of granulocytes with DR-18 treatment and CD8+ and CD4+ T cells with DR-18 + anti–CTLA-4. For select cell populations (boxed), the percentages within each treatment group are shown. (C) Neighborhood group plot from Milo analysis of T cell subsets from scRNA-Seq data. (D) Differential abundance fold changes of the neighborhood groups in C, comparing the Combo treatment with control, showing enrichment and deenrichment of certain groups. (E) Heatmap of the top differentially expressed genes between neighborhood group #7, enriched with DR-18 + anti–CTLA-4 treatment and with high expression levels of markers of T cell activation, cytolytic activity, and exhaustion, versus neighborhood group #4, deenriched with combination treatment. (F) Relative proportion of the top 20 clonotypes out of the total for each treatment group based on TCR analysis. (G) Clonotype proportions by size category based on TCR analysis, showing clonal expansion with DR-18 + anti–CTLA-4 (Combo). Statistical testing performed using Fisher’s exact test comparing control with all other treatment conditions, with only significant comparisons shown F, and χ2 test comparing DR-18 + anti–CTLA-4 (Combo) to all other conditions. *P < 0.05; ****P < 0.0001

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