Multimodal Intralesional Therapy for Reshaping the Myeloid Compartment of Tumors Resistant to Anti–PD-L1 Therapy via IRF8 Expression

A Patel, T Oba, R Kajihara, T Yokoi… - The Journal of …, 2021 - journals.aai.org
A Patel, T Oba, R Kajihara, T Yokoi, SI Abrams, F Ito
The Journal of Immunology, 2021journals.aai.org
Intralesional therapy is a promising approach for remodeling the immunosuppressive tumor
microenvironment while minimizing systemic toxicities. A combinatorial in situ
immunomodulation (ISIM) regimen with intratumoral administration of Fms-like tyrosine
kinase 3 ligand (Flt3L), local irradiation, and TLR3/CD40 stimulation induces and activates
conventional type 1 dendritic cells in the tumor microenvironment and elicits de novo
adaptive T cell immunity in poorly T cell–inflamed tumors. However, the impact of ISIM on …
Abstract
Intralesional therapy is a promising approach for remodeling the immunosuppressive tumor microenvironment while minimizing systemic toxicities. A combinatorial in situ immunomodulation (ISIM) regimen with intratumoral administration of Fms-like tyrosine kinase 3 ligand (Flt3L), local irradiation, and TLR3/CD40 stimulation induces and activates conventional type 1 dendritic cells in the tumor microenvironment and elicits de novo adaptive T cell immunity in poorly T cell–inflamed tumors. However, the impact of ISIM on myeloid-derived suppressor cells (MDSCs), which may promote treatment resistance, remains unknown. In this study, we examined changes in the frequencies and heterogeneity of CD11b+ Ly-6C lo Ly-6G+ polymorphonuclear (PMN)–MDSCs and CD11b+ Ly-6C hi Ly-6G− monocytic (M)–MDSCs in ISIM-treated tumors using mouse models of triple-negative breast cancer. We found that ISIM treatment decreased intratumoral PMN-MDSCs, but not M-MDSCs. Although the frequency of M-MDSCs remained unchanged, ISIM caused a substantial reduction of CX3CR1+ M-MDSCs that express F4/80. Importantly, these ISIM-induced changes in tumor-residing MDSCs were not observed in Batf3−/− mice. ISIM upregulated PD-L1 expression in both M-MDSCs and PMN-MDSCs and synergized with anti–PD-L1 therapy. Furthermore, ISIM increased the expression of IFN regulatory factor 8 (IRF8) in myeloid cells, a known negative regulator of MDSCs, indicating a potential mechanism by which ISIM decreases PMN-MDSC levels. Accordingly, ISIM-mediated reduction of PMN-MDSCs was not observed in mice with conditional deletion of IRF8 in myeloid cells. Altogether, these findings suggest that ISIM holds promise as a multimodal intralesional therapy to alter both lymphoid and myeloid compartments of highly aggressive poorly T cell–inflamed, myeloid-enriched tumors resistant to anti–PD-L1 therapy.
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