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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 4

I.t. 1V270 treatment enhances antigen-presenting function of TAMs.

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I.t. 1V270 treatment enhances antigen-presenting function of TAMs.
(A an...
(A and B) Analysis of antigen uptake by TAMs in vivo. SCC7-bearing mice (n = 4–5/group) were given the combination treatment (Figure 1A). Antigen (OVA–Alexa Fluor 488) was i.t. injected with the last 1V270 injection. Twenty-four hours later (day 13 after tumor implantation), tumors (A) and draining lymph nodes (dLNs) (B) were harvested, and OVA–Alexa Fluor 488–positive cells in the gated CD45+ population were evaluated by flow cytometry. *P < 0.05 (two-tailed, Welch’s t test). (C) Combination therapy enhanced the expression of costimulatory molecules in the dLN in vivo. SCC7-bearing mice (n = 4–6/group) received the combination treatment as described in Figure 1A. dLN at 1V270 injected sites were harvested on day13. The dLN cells were pooled from each group, the expression of CD40 and CD80 in CD45+CD11b+F4/80+ macrophages was evaluated by flow cytometry, and the numbers of CD40+, CD80+ and PD-L1+ cells per an individual animal were calculated. (D and E) Activation of TAMs by 1V270 treatment ex vivo. CD11b+ cells were isolated from the untreated SCC7-tumor (day 14) using MACS MicroBeads. CD11b+ cells (1.2 × 106/ml) were incubated with 1V270 (1 μM) or vehicle overnight, and the expression of CD40 and CD80 in the gated CD11b+F4/80+ population was assessed by flow cytometric analysis. (D) Representative flow cytometric histogram of CD40, and CD80, and (E) percentage of CD40+, CD80+, and CD206+ cell populations in the gated CD45+CD11b+F4/80+ macrophage population are shown. Data presented are means ± SEM of triplicates and representative of two independent experiments showing similar results. **P < 0.01, ***P < 0.001 (two-tailed, Welch’s t test).

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