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J Clin Invest. 2019 Jul 22;129(8):3435-3447. doi: 10.1172/JCI128562. eCollection 2019 Jul 22.

In situ vaccination with defined factors overcomes T cell exhaustion in distant tumors.

Author information

1
Ludwig Collaborative and Swim Across America Laboratory.
2
Parker Institute for Cancer Immunotherapy, and.
3
Department of Medicine, Memorial Sloan Kettering Cancer Center (MSKCC), New York, New York, USA.
4
Weill Cornell Medicine, New York, New York, USA.
5
Human Oncology and Pathogenesis Program.
6
Computational and Systems Biology Program, and.
7
Department of Epidemiology and Biostatistics, MSKCC, New York, New York, USA.
8
Department of Surgery, MSKCC, New York, New York, USA .
9
National Cancer Institute (NCI), NIH, Bethesda, Maryland, USA.
10
Hepatopancreatobiliary Service, Department of Surgery and David M. Rubenstein Center for Pancreatic Cancer Research, MSKCC, New York, New York, USA.

Abstract

Irreversible T cell exhaustion limits the efficacy of programmed cell death 1 (PD-1) blockade. We observed that dual CD40-TLR4 stimulation within a single tumor restored PD-1 sensitivity and that this regimen triggered a systemic tumor-specific CD8+ T cell response. This approach effectively treated established tumors in diverse syngeneic cancer models, and the systemic effect was dependent on the injected tumor, indicating that treated tumors were converted into necessary components of this therapy. Strikingly, this approach was associated with the absence of exhausted PD-1hi T cells in treated and distant tumors, while sparing the intervening draining lymph node and spleen. Furthermore, patients with transcription changes like those induced by this therapy experienced improved progression-free survival with anti-PD-1 treatment. Dual CD40-TLR4 activation within a single tumor is thus an approach for overcoming resistance to PD-1 blockade that is unique in its ability to cause the loss of exhausted T cells within tumors while sparing nonmalignant tissues.

KEYWORDS:

Cancer immunotherapy; Oncology

PMID:
31329159
PMCID:
PMC6668692
[Available on 2019-11-01]
DOI:
10.1172/JCI128562
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