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Balakrishnan PB, Ledezma DK, Cano-Mejia J, Andricovich J, Palmer E, Patel VA, Latham PS, Yvon ES, Villagra A, Fernandes R, Sweeney EE. CD137 agonist potentiates the abscopal efficacy of nanoparticle-based photothermal therapy for melanoma. Nano Res 2022; 15:2300-2314. [PMID: 36089987 PMCID: PMC9455608 DOI: 10.1007/s12274-021-3813-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Despite the promise of immunotherapy such as the immune checkpoint inhibitors (ICIs) anti-PD-1 and anti-CTLA-4 for advanced melanoma, only 26%-52% of patients respond, and many experience grade III/IV immune-related adverse events. Motivated by the need for an effective therapy for patients non-responsive to clinically approved ICIs, we have developed a novel nanoimmunotherapy that combines locally administered Prussian blue nanoparticle-based photothermal therapy (PBNP-PTT) with systemically administered agonistic anti-CD137 monoclonal antibody therapy (aCD137). PBNP-PTT was administered at various thermal doses to melanoma cells in vitro, and was combined with aCD137 in vivo to test treatment effects on melanoma tumor progression, animal survival, immunological protection against tumor rechallenge, and hepatotoxicity. When administered at a melanoma-specific thermal dose, PBNP-PTT elicits immunogenic cell death (ICD) in melanoma cells and upregulates markers associated with antigen presentation and immune cell co-stimulation in vitro. Consequently, PBNP-PTT eliminates primary melanoma tumors in vivo, yielding long-term tumor-free survival. However, the antitumor immune effects generated by PBNP-PTT cannot eliminate secondary tumors, despite significantly slowing their growth. The addition of aCD137 enables significant abscopal efficacy and improvement of survival, functioning through activated dendritic cells and tumor-infiltrating CD8+ T cells, and generates CD4+ and CD8+ T cell memory that manifests in the rejection of tumor rechallenge, with no long-term hepatotoxicity. This study describes for the first time a novel and effective nanoimmunotherapy combination of PBNP-PTT with aCD137 mAb therapy for melanoma.
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Affiliation(s)
- Preethi Bala Balakrishnan
- GW Cancer Center, Department of Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA
| | - Debbie K. Ledezma
- The Institute for Biomedical Sciences, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA
| | - Juliana Cano-Mejia
- GW Cancer Center, Department of Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA
| | - Jaclyn Andricovich
- The Institute for Biomedical Sciences, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA
| | - Erica Palmer
- GW Cancer Center, Department of Biochemistry and Molecular Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA
| | - Vishal A. Patel
- Department of Dermatology & Oncology, School of Medicine and Health Sciences, George Washington University, Washington, DC 20037, USA
| | - Patricia S. Latham
- Department of Pathology, School of Medicine and Health Sciences, George Washington University, Washington, DC 20037, USA
| | - Eric S. Yvon
- GW Cancer Center, Department of Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA
| | - Alejandro Villagra
- GW Cancer Center, Department of Biochemistry and Molecular Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA
| | - Rohan Fernandes
- GW Cancer Center, Department of Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA
- The Institute for Biomedical Sciences, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA
- ImmunoBlue, Bethesda, MD 20817, USA
| | - Elizabeth E. Sweeney
- GW Cancer Center, Department of Biochemistry and Molecular Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA
- ImmunoBlue, Bethesda, MD 20817, USA
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Blake SJ, James J, Ryan FJ, Caparros-Martin J, Eden GL, Tee YC, Salamon JR, Benson SC, Tumes DJ, Sribnaia A, Stevens NE, Finnie JW, Kobayashi H, White DL, Wesselingh SL, O’Gara F, Lynn MA, Lynn DJ. The immunotoxicity, but not anti-tumor efficacy, of anti-CD40 and anti-CD137 immunotherapies is dependent on the gut microbiota. Cell Rep Med 2021; 2:100464. [PMID: 35028606 PMCID: PMC8714857 DOI: 10.1016/j.xcrm.2021.100464] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 09/30/2021] [Accepted: 11/11/2021] [Indexed: 02/06/2023]
Abstract
Immune agonist antibodies (IAAs) are promising immunotherapies that target co-stimulatory receptors to induce potent anti-tumor immune responses, particularly when combined with checkpoint inhibitors. Unfortunately, their clinical translation is hampered by serious dose-limiting, immune-mediated toxicities, including high-grade and sometimes fatal liver damage, cytokine release syndrome (CRS), and colitis. We show that the immunotoxicity, induced by the IAAs anti-CD40 and anti-CD137, is dependent on the gut microbiota. Germ-free or antibiotic-treated mice have significantly reduced colitis, CRS, and liver damage following IAA treatment compared with conventional mice or germ-free mice recolonized via fecal microbiota transplant. MyD88 signaling is required for IAA-induced CRS and for anti-CD137-induced, but not anti-CD40-induced, liver damage. Importantly, antibiotic treatment does not impair IAA anti-tumor efficacy, alone or in combination with anti-PD1. Our results suggest that microbiota-targeted therapies could overcome the toxicity induced by IAAs without impairing their anti-tumor activity.
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Affiliation(s)
- Stephen J. Blake
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Jane James
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5000, Australia
| | - Feargal J. Ryan
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Jose Caparros-Martin
- School of Pharmacy and Biomedical Sciences, Curtin University, Perth, WA, Australia
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA, Australia
| | - Georgina L. Eden
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Yee C. Tee
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5000, Australia
| | - John R. Salamon
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5000, Australia
| | - Saoirse C. Benson
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5000, Australia
| | - Damon J. Tumes
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Centre for Cancer Biology, SA Pathology and University of South Australia, Adelaide, SA 5000, Australia
| | - Anastasia Sribnaia
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Natalie E. Stevens
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - John W. Finnie
- Adelaide Medical School, University of Adelaide and SA Pathology, Adelaide, SA 5000, Australia
| | - Hiroki Kobayashi
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - Deborah L. White
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - Steve L. Wesselingh
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5000, Australia
| | - Fergal O’Gara
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA, Australia
- BIOMERIT Research Centre, University College Cork, Cork, Ireland
| | - Miriam A. Lynn
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - David J. Lynn
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5000, Australia
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Souza-Fonseca-Guimaraes F, Blake SJ, Makkouk A, Chester C, Kohrt HE, Smyth MJ. Anti-CD137 enhances anti-CD20 therapy of systemic B-cell lymphoma with altered immune homeostasis but negligible toxicity. Oncoimmunology 2016; 5:e1192740. [PMID: 27622048 DOI: 10.1080/2162402x.2016.1192740] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 05/13/2016] [Accepted: 05/17/2016] [Indexed: 02/06/2023] Open
Abstract
Studies of sequential anti-CD137/anti-CD20 therapy have previously shown that the efficacy of anti-CD20 was heavily reliant upon anti-CD137; however, the exact mechanism of the anti-B-cell lymphoma efficacy, and whether this correlates with enhanced adverse effects or toxicity, had not been elucidated. Here, we observed that sequential anti-CD137 administration with anti-CD20 resulted in a synergistic therapy, largely dependent upon Fc receptors (FcR), to prolong survival in an experimental B-cell lymphoma therapy model. Tumor suppression was accompanied by B cell depletion, which was not dependent on one activating FcR. Surprisingly, the B-cell activating factor (BAFF) was elevated in the plasma of mice receiving anti-CD137 alone or in combination with anti-CD20, while a selective increase in some plasma cytokines was also noted and triggered by anti-CD137. These effects were independent of activating FcR. Sustained treatment of advanced lymphoma revealed increased lymphocyte infiltrates into the liver and a significant decrease in the metabolic capability of the liver in mice receiving anti-CD137. Importantly, these effects were not exacerbated in mice receiving the anti-CD20/CD137 combination, and elevations in classical liver damage markers such as alanine aminotransferase (ALT) were less than that caused by the lymphoma itself. Thus, combined anti-CD20/anti-CD137 treatment increases the therapeutic index of anti-CD20 or anti-CD137 alone. These mouse data were corroborated by ongoing clinical development studies to assess safety, tolerability and pharmacodynamic activity of human patients treated by this approach. Together, these data support the use of this sequential antibody therapeutic strategy to improve the efficacy of rituximab in B-cell lymphoma patients.
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Affiliation(s)
- Fernando Souza-Fonseca-Guimaraes
- Immunology in Cancer and Infection Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; Molecular Immunology Division, Walter & Elisa Hall Institute of Medical Research, Parkville, VIC, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Stephen J Blake
- Cancer Immunoregulation and Immunotherapy Laboratory, QIMR Berghofer Medical Research Institute , Herston, QLD, Australia
| | - Amani Makkouk
- Department of Medicine, Division of Oncology, Stanford University , Stanford, CA, USA
| | - Cariad Chester
- Department of Medicine, Division of Oncology, Stanford University, Stanford, CA, USA; Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, CA, USA
| | - Holbrook E Kohrt
- Department of Medicine, Division of Oncology, Stanford University , Stanford, CA, USA
| | - Mark J Smyth
- Immunology in Cancer and Infection Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; School of Medicine, University of Queensland, St Lucia, QLD, Australia
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