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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 3

ABT-317 attenuates early IFN-γ–driven responses elicited by CPI to provide delayed expansion of tumor-reactive T cells.

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ABT-317 attenuates early IFN-γ–driven responses elicited by CPI to provi...
(A) Time course immunophenotyping of T cell responses in the ETB TRAMP-C2 model. IFN-γ–YFP reporter GREAT/Smart mice implanted s.c. with 1M TRAMP-C2 cells were treated i.p. with CPI alone or in combination with ABT-317 (20 mg/kg). TDLNs (n = 3 per group) were harvested on days 12, 15, 21, and 25. (B) Percentage of YFP+ (IFN-γ+) CD4+ T cells. Significant P values between groups in each time point by Kruskal-Wallis. (C) Percentage of YFP+CD8+ T cells. Significant P values between groups in each time point by Kruskal-Wallis. (D) Percentage of CD4+FoxP3+ Tregs within CD45+ cells. Significant P values between groups in each time point by Kruskal-Wallis. (E) Percentage of overall CD8+ T cells within the CD45+ compartment. Significant P values between groups in each time point by Kruskal-Wallis. (F) Percentage of tumor-reactive CD8+CD39+ T cells within CD45+ cells. Significant P values between groups in each time point by Kruskal-Wallis. (G) Percentage of proliferating and activated CD8+CD44+Ki67+ T cells within the CD45+ compartment. Significant P values between groups in each time point by Kruskal-Wallis. (H) Percentage of TRAMP-C2 antigen-specific CD8+SPAS-1+ T cells within the CD45+ compartment. Significant P values between groups in each time point by Kruskal-Wallis. (I) Representative mode-normalized histograms showing MFI of SPAS-1+ staining in gated CD8+ T cells from TDLNs on days 15 and 25. Values represent percentages of SPAS-1+ cells. (J) Geometric mean fluorescence intensity (MFI) of Ki67, PRF1, PD-1, and LAG3 in CD8+SPAS-1+ T cells from day 25 TDLNs. Significant P values by Kruskal-Wallis. (K) TRAMP-C2 cell death by total counts versus time (hours) (n = 2 experiments) (see Methods), normalized vs. unstimulated controls. *, P < 0.05 CPI + ABT-317 (orange) vs. isotype (black) by Kruskal-Wallis.

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