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Combination immunotherapy with TLR agonists and checkpoint inhibitors suppresses head and neck cancer
Fumi Sato-Kaneko, Shiyin Yao, Alast Ahmadi, Shannon S. Zhang, Tadashi Hosoya, Megan M. Kaneda, Judith A. Varner, Minya Pu, Karen S. Messer, Cristiana Guiducci, Robert L. Coffman, Kazutaka Kitaura, Takaji Matsutani, Ryuji Suzuki, Dennis A. Carson, Tomoko Hayashi, Ezra E.W. Cohen
Fumi Sato-Kaneko, Shiyin Yao, Alast Ahmadi, Shannon S. Zhang, Tadashi Hosoya, Megan M. Kaneda, Judith A. Varner, Minya Pu, Karen S. Messer, Cristiana Guiducci, Robert L. Coffman, Kazutaka Kitaura, Takaji Matsutani, Ryuji Suzuki, Dennis A. Carson, Tomoko Hayashi, Ezra E.W. Cohen
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Research Article Immunology

Combination immunotherapy with TLR agonists and checkpoint inhibitors suppresses head and neck cancer

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Abstract

Checkpoint inhibitors have demonstrated efficacy in patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC). However, the majority of patients do not benefit from these agents. To improve the efficacy of checkpoint inhibitors, intratumoral (i.t.) injection with innate immune activators, TLR7 and TLR9 agonists, were tested along with programmed death-1 receptor (PD-1) blockade. The combination therapy suppressed tumor growth at the primary injected and distant sites in human papillomavirus–negative (HPV-negative) SCC7 and MOC1, and HPV-positive MEER syngeneic mouse models. Abscopal effects and suppression of secondary challenged tumor suggest that local treatment with TLR agonists in combination with anti–PD-1 provided systemic adaptive immunity. I.t. treatment with a TLR7 agonist increased the ratio of M1 to M2 tumor-associated macrophages (TAMs) and promoted the infiltration of tumor-specific IFNγ-producing CD8+ T cells. Anti–PD-1 treatment increased T cell receptor (TCR) clonality of CD8+ T cells in tumors and spleens of treated mice. Collectively, these experiments demonstrate that combination therapy with i.t. delivery of TLR agonists and PD-1 blockade activates TAMs and induces tumor-specific adaptive immune responses, leading to suppression of primary tumor growth and prevention of metastasis in HNSCC models.

Authors

Fumi Sato-Kaneko, Shiyin Yao, Alast Ahmadi, Shannon S. Zhang, Tadashi Hosoya, Megan M. Kaneda, Judith A. Varner, Minya Pu, Karen S. Messer, Cristiana Guiducci, Robert L. Coffman, Kazutaka Kitaura, Takaji Matsutani, Ryuji Suzuki, Dennis A. Carson, Tomoko Hayashi, Ezra E.W. Cohen

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Figure 3

I.t. injection of 1V270 increases M1/M2 ratio in TAMs.

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I.t. injection of 1V270 increases M1/M2 ratio in TAMs.
(A–D) SCC7-bearin...
(A–D) SCC7-bearing C3H mice (n = 4–8/group) were treated as described in Figure 1A. Tumors were harvested on day 13 (A) and 21 (B) and tumor-infiltrating cells were analyzed by flow cytometry. TAMs were identified as CD45+CD11b+F4/80+ subset. CD206 expression was used to identify M2 macrophages. The ratios of M1 to M2 (M1/M2) were calculated as % M1 (CD206–) population in CD45+CD11b+F4/80+ divided by % M2 (CD206+) population in CD45+CD11b+F4/80+. M1/M2 ratios of TAMs on days 13 (A) and 21 (B) are shown as scatter plots. Each dot represents an individual animal, and bars indicate means ± SEM. *P < 0.05 and **P < 0.01 (Kruskal-Wallis test with Dunn’s post hoc test). (C) The relationship between the M1/M2 ratio and tumor volume (day 21). Spearman r = –0.74, P < 0.0001. Both the tumor volume at day 21 and the M1/M2 ratio differ significantly among treatment groups (P < 0.05). The significant correlation between tumor volumes and M1/M2 ratio disappeared when we adjusted for the treatment groups. (D) Representative IHC images of the tumors (day 21). Section (5 μm) of cryopreserved tumor tissue was stained for F4/80 (magenta), CD206 (green), and DAPI (blue). Scale bars: 20 μm. (E and F) Kinetics of M1 and M2 population after the 1V270 injection. TAMs on days 13 and 21 were analyzed. M1- and M2 -like macrophages were identified as CD206−MHC class II+ and CD206+MHC class II– populations, respectively. Each dot represents an individual animal, and bars indicate means ± SEM. *P < 0.05 and **P < 0.01 (Kruskal-Wallis test with Dunn’s post hoc test).

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