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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, … , Aaron M. Ring, Harriet M. Kluger
David A. Schoenfeld, … , Aaron M. Ring, Harriet M. Kluger
Published November 19, 2024
Citation Information: JCI Insight. 2025;10(1):e184545. https://doi.org/10.1172/jci.insight.184545.
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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 6

DR-18 + anti–CTLA-4 leads to intratumoral expansion of proinflammatory myeloid populations.

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DR-18 + anti–CTLA-4 leads to intratumoral expansion of proinflammatory m...
(A and B) UMAP plots of all macrophages/monocytes identified by scRNA-Seq analysis with overlaid treatment groups (A) and annotated clusters (B). Annotation was performed based on the phenotypic groups and markers described in Ma et al. (18). (C) Quantification of the proportion of each macrophage/monocyte subtype from B within each of the treatment groups, showing relative enrichment of proinflammatory and loss of protumorigenic subtypes. For select cell populations (boxed), the percentages within each treatment group are shown. (D) UMAP plot of all granulocytes identified by scRNA-Seq analysis with overlaid treatment groups. (E) Volcano plot of differential gene expression between granulocytes from tumors treated with combination DR-18 + anti–CTLA-4 (Combo) versus all other treatment groups (Other) (log2 fold-change thresholds of 0.5 and –0.5; P value-adjusted threshold of 1 × 10–6). (F) The top gene sets from enrichment analysis of genes enriched in granulocytes from Combo-treated tumors. (G and H) UMAP plot of all neutrophils from scRNA-Seq analysis with overlaid neutrophil subtype classification based on Zilionis et al. (25) (G), with quantification of the relative proportion of each subtype by treatment group (H). For select cell populations (boxed), the percentages within each treatment group are shown. (I) UMAP plots of neutrophils showing trajectory analysis using Slingshot from the given starting point, with overlaid treatment groups (left) and neutrophil subtypes (right), as in G.

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