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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 6

JAK inhibition attenuates IFN-γ–responsive signatures in the tumor microenvironment.

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JAK inhibition attenuates IFN-γ–responsive signatures in the tumor micro...
(A) Study of CPI and ABT-317 in a minimal-burden tumor model. Briefly, 1M MC38 cells were implanted in the right flank of C57BL/6J mice. Mice were enrolled into treatment groups when tumors reached 50 mm3 (day 0). Antibodies were injected i.p. on days 3, 6, and 9. ABT-317 (20 mg/kg) was injected i.p. on days 12, 15, and 21. Tumors (n = 3 per group) were harvested on day 15 for scRNA-Seq, while n = 5 mice were assessed for tumor growth. (B) Tumor volume curves for mice involved in n = 1 of 2 experiments. Error bars represent SEM. (C) Uniform manifold approximation and projection showing 2,432 MC38 tumor-infiltrating T cells, distributed in 6 phenotypic clusters by Leiden (res. 0.5). (D) Heatmap showing log-transformed expression of Jak1, Jak2, and Jak3 in MC38-infiltrating T cells. (E) T cell phenotypic cluster frequencies by treatment group. *, P < 0.05 vs. rest by Kruskal-Wallis. (F) Volcano plot showing DEGs in tumor-infiltrating CD8+ T cells from CPI-treated mice. Significantly enriched genes in blue. (G) IFN-γ score in tumor-infiltrating T cells. ***, P = 0.0409 by 1-way ANOVA. (H) CD8+ T cell counts/mg of tumor. (I) CD8+ADPGK+ T cell counts/mg of tumor. (J) Representative flow cytometry dot plots showing MC38 antigen-reactive CD8+ADPGK+ T cells from MC38 tumors. Values represent percentages. (K) MFI of Ki67, PRF1, PD-1, and TCF1 in tumor-infiltrating CD8+ADPGK+ T cells. Significant P values by Kruskal-Wallis are shown. (L) CD8+PD-1+TCF1+ (Tpex) cell counts/mg of tumor. ***, P < 0.001 by Kruskal-Wallis; ****, P < 0.0001 by Kruskal-Wallis. (M) Representative flow cytometry dot plots showing tumor-infiltrating Tpex cells. Values represent percentages.

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