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Sequential JAK inhibition enhances antitumor immunity after combined anti–PD-1 and anti-CTLA4
Marcel Arias-Badia, PeiXi Chen, Yee May Lwin, Aahir Srinath, Aram Lyu, Zenghua Fan, Serena S. Kwek, Diamond N. Luong, Ali Setayesh, Mason Sakamoto, Matthew Clark, Averey Lea, Rachel M. Wolters, Andrew Goodearl, Fiona A. Harding, Jacob V. Gorman, Wendy Ritacco, Lawrence Fong
Marcel Arias-Badia, PeiXi Chen, Yee May Lwin, Aahir Srinath, Aram Lyu, Zenghua Fan, Serena S. Kwek, Diamond N. Luong, Ali Setayesh, Mason Sakamoto, Matthew Clark, Averey Lea, Rachel M. Wolters, Andrew Goodearl, Fiona A. Harding, Jacob V. Gorman, Wendy Ritacco, Lawrence Fong
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Research Article Immunology Oncology

Sequential JAK inhibition enhances antitumor immunity after combined anti–PD-1 and anti-CTLA4

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Abstract

While immune checkpoint inhibition (CPI) has reshaped cancer treatment, the majority of patients with cancer do not benefit from this approach, which can also cause immune-related adverse events. Induction of IFN-γ responses is thought be necessary for antitumor immunity, but growing evidence also implicates IFN-γ as a tumor-intrinsic mediator of CPI resistance. CPI-induced IFN-γ mediates activation-induced cell death in T cells as an immune-intrinsic mechanism of resistance. In this study, we found that transient block of IFN-γ signaling through administration of the JAK1 inhibitor ABT-317 enhanced antitumor T cell responses with CPI in preclinical models. Importantly, sequential but not concomitant ABT-317 treatment led to significantly reduced toxicity and improved tumor efficacy. Sequential treatment reduced activation-induced T cell death and enhanced expansion of tumor-reactive T cell subsets with increased effector function in vivo and ex vivo. Only CPI in combination with ABT-317 also enhanced memory responses by protecting mice from tumor rechallenge. These results demonstrate that JAK inhibition within a discrete time window following CPI addresses an immune-intrinsic mechanism of therapeutic resistance.

Authors

Marcel Arias-Badia, PeiXi Chen, Yee May Lwin, Aahir Srinath, Aram Lyu, Zenghua Fan, Serena S. Kwek, Diamond N. Luong, Ali Setayesh, Mason Sakamoto, Matthew Clark, Averey Lea, Rachel M. Wolters, Andrew Goodearl, Fiona A. Harding, Jacob V. Gorman, Wendy Ritacco, Lawrence Fong

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Figure 1

Sequential, but not concomitant, ABT-317 synergizes with CPI for improved antitumor efficacy.

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Sequential, but not concomitant, ABT-317 synergizes with CPI for improve...
(A) A total of 105 naive mouse splenocytes were stimulated with PMA-ionomycin for 4 hours in the presence of 0, 0.125, 0.25, or 0.5 μg/μL ABT-317. Plots show CD69+ T cells by flow cytometry and IFN-γ concentration in culture supernatants by ELISA. Significant P values by Kruskal-Wallis are shown. (B) Experiment design for sequential versus concomitant ABT-317 regimes in an early tumor burden (ETB) scenario. C57BL/6J mice implanted with 1 million (1M) mouse prostate adenocarcinoma TRAMP-C2 cells were treated with CPI (anti–PD-1 and anti-CTLA4) on days 3, 6, and 9 after implantation. In the sequential (seq) regime, mice were treated with ABT-317 on days 12, 15, and 21. In the concomitant (conc), mice were treated with ABT-317 on days 3, 6, and 12. While most mice were assessed for tumor growth, TDLNs from n = 3 animals from n = 2 experiments were harvested and immunophenotyped by flow cytometry. (C) Tumor volume curves for mice involved in B until day 66 after implantation. *, P < 0.05 CPI + ABT-317 (seq) vs. isotype by 1-way ANOVA applying Kruskal-Wallis; #, P < 0.05 CPI + ABT-317 (seq) vs. all other groups by 1-way ANOVA applying Kruskal-Wallis. Error bars represent SEM. (D) Kaplan-Meier survival curves for all mice involved in B. *, P < 0.05 CPI + ABT-317 (seq) vs. CPI + ABT-317 (conc) by log-rank Mantel-Cox test. (E) Scatterplots showing flow cytometry parameters from TDLNs harvested on day 22 from the studies described in B. From left to right, CD8+/CD4+FoxP3+ (Treg) ratio, Ki67 MFI in gated CD8+ T cells, percentage of PRF1+ effector cells within CD8+ T cells, and percentage of TRAMP-C2 antigen-specific CD8+SPAS-1+ T cells within the CD45+ compartment. Significant P values obtained by Kruskal-Wallis are shown.

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