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A bispecific Clec9A-PD-L1 targeted type I interferon profoundly reshapes the tumor microenvironment towards an antitumor state
Molecular Cancer volume 22, Article number: 191 (2023)
Abstract
Despite major improvements in immunotherapeutic strategies, the immunosuppressive tumor microenvironment remains a major obstacle for the induction of efficient antitumor responses. In this study, we show that local delivery of a bispecific Clec9A-PD-L1 targeted type I interferon (AcTaferon, AFN) overcomes this hurdle by reshaping the tumor immune landscape.
Treatment with the bispecific AFN resulted in the presence of pro-immunogenic tumor-associated macrophages and neutrophils, increased motility and maturation profile of cDC1 and presence of inflammatory cDC2. Moreover, we report empowered diversity in the CD8+ T cell repertoire and induction of a shift from naive, dysfunctional CD8+ T cells towards effector, plastic cytotoxic T lymphocytes together with increased presence of NK and NKT cells as well as decreased regulatory T cell levels. These dynamic changes were associated with potent antitumor activity. Tumor clearance and immunological memory, therapeutic immunity on large established tumors and blunted tumor growth at distant sites were obtained upon co-administration of a non-curative dose of chemotherapy.
Overall, this study illuminates further application of type I interferon as a safe and efficient way to reshape the suppressive tumor microenvironment and induce potent antitumor immunity; features which are of major importance in overcoming the development of metastases and tumor cell resistance to immune attack. The strategy described here has potential for application across to a broad range of cancer types.
One sentence summary
Treatment with type I interferon simultaneously targeting Clec9A- and PD-L1-expressing cells profoundly reshapes the immune landscape leading to immunological memory, therapeutic immunity and clearance of large established tumors when combined with low-dose chemotherapy.
Introduction
The immunosuppressive tumor microenvironment exerts a plethora of inhibitory mechanisms, creating a major obstacle to cancer immunotherapy [1]. One such mechanism is defective antigen-presentation resulting in inefficient tumor-antigen (cross-)presentation towards T cells [2]. Tumor-associated antigen-presenting cells (APC) might also contribute to a suppressive or tolerogenic state resulting in T cell silencing rather than T cell stimulation [2]. Moreover, several immune cell types including pro-tumorigenic tumor-associated macrophages (TAM) and regulatory T cells (Treg) are key regulators of immunosuppression, tumor-promoting angiogenesis and the formation of metastases [3]. On the level of T cells, the induced and tumor-infiltrating tumor-specific cytotoxic T lymphocytes (CTL) often fail to exercise antitumor effector functions [4]. Furthermore, antitumor immune responses are often curtailed due to overexpression of inhibitory immune checkpoint molecules such as Programmed Death-Ligand 1 (PD-L1) [5]. Current cancer immunotherapeutic strategies are therefore strongly focusing on promoting antitumor immunity while simultaneously overcoming tumor-induced immune suppression.
Due to its pleiotropic role, type I interferon (IFN) [6] might be key to promote antitumor immunity and to overcome tumor-induced immune suppression [7]. Despite its considerable potential, clinical application of type I IFN has been impeded due to significant systemic toxicities, which are a consequence of ubiquitous expression of the type I IFN receptor complex [8].
As an answer to the need for safe and adequate cancer treatments, we are developing ‘AcTakines’, Activity-on-Target Cytokines, consisting of mutated cytokines coupled to a specific targeting domain. As such, AcTakines only exert potent activity on targeted cells, while avoiding pleiotropic systemic cytokine activity and associated toxicities [9]. We already provided evidence for the broad applicability of AcTakines in cancer immunotherapy [10,11,12,13], auto-immunity [14, 15] and as an adjuvant in prophylactic vaccination strategies such as influenza [16].
In this study, we elaborate on a type I IFN AcTakine (AcTaferon, AFN) simultaneously targeting Clec9A and PD-L1. The protein-engineered AcTakine presented here includes a mutated version of the IFN-α2 sequence. The choice for Clec9A as a targeting moiety that delivers type I IFN activity towards cross-presenting type I cDC (cDC1) was made in view of our earlier work, which described potent antitumor immunity obtained upon treatment with this AcTakine [10]. Clec9A encodes for DNGR-1 [17], which represents a C-type lectin receptor with an expression profile that’s restricted to cDC1s in human [17], making it an ideal therapeutic target for selective delivery of payload and subsequent triggering of cDC1 [18].
PD-L1 is a co-inhibitory ligand for the Programmed Death receptor (PD-1) and is constitutively expressed or induced on many immune cells as well as on various cancer cell types. Under normal physiological conditions, the PD-1/PD-L1 interaction is essential for the development of immune tolerance and prevents excessive activation of the immune system or immune exhaustion. However, cancer cells in particular use PD-L1 as an immune evasion mechanism [19]. Over the years, immune checkpoint blockade agents that interfere with the PD-1/PD-L1 pathway have gained significant importance as anticancer immunotherapeutics.
Here, we demonstrate that treatment with a bispecific Clec9A-PDL1 targeted AcTaferon induces tumor control accompanied with changes at the level of various cell types including myeloid cells, DCs, antigen-specific CTLs, increased presence of NK and NKT cells as well as decrease of tumor-resident Tregs. Moreover, in combination with a non-curative dose of chemotherapy, tumor clearance, immunological memory, therapeutic immunity against large established tumors and blunted tumor growth at distant sites were observed. Strikingly, the bispecific AcTaferon was able to reshape the suppressive tumor microenvironment towards an antitumor state and induced TCR epitope spreading.
Results
Superior tumor control by bispecific AcTaferon with high safe profile
Here, we aim to investigate whether simultaneous targeting of type I IFN activity towards Clec9A and PD-L1 can induce antitumor efficacy (Fig. 1A-B). In first instance, we evaluated the antitumor potential in different mouse tumor models including B16 (Fig. 1C-D) as well as 4T1 mammary carcinoma, both subcutaneously (s.c.) (Suppl. Fig. 1A-B) and orthotopically implanted (Suppl. Fig. 1C-D). Administration of the bispecific Clec9A-PDL1-AFN didn’t affect body weight, body temperature nor analysed blood parameters in the 4T1 model (data not shown). Treatment with the Bisp-AFN resulted in B16 tumor stasis comparable to wild type (wt) IFN (Fig. 1C-D). However, wt IFN caused severe body weight loss (Fig. 1E), a decrease in body temperature although not statistically significant (Fig. 1F), and affected all blood parameters monitored (Fig. 1G, Suppl. Fig. 1E) causing anemia, lymphopenia, leukopenia and platelet destruction, which resulted in high mortality. In sharp contrast to this, treatment with Bisp-AFN was very well tolerated.
To bring the strategy closer to clinical application, we additionally tested our findings in a humanized setting. To that end, both Humanized Immune System (HIS) mice and irradiated non-HIS NSG mice were inoculated with RL cells, a human non-Hodgkin B cell lymphoma (Fig. 1H). The antitumor potential of the humanized Bisp-AFN was favorable and resulted in delayed tumor growth after therapy termination (Fig. 1I-J). Absence of a response in non-HIS NSG mice indicated the need for an active immune system, rather than the direct anti-proliferative effects of type I IFN on the tumor (Fig. 1K).
AcTaferon therapy combined with doxorubicin leads to tumor cure, therapeutic immunity and abscopal systemic effects
As evidenced in the cancer immunity cycle, establishment of durable antitumor immunity results from a cyclic process, which can be fueled at different levels using strategic interventions [20]. Combined treatment with immunogenic chemotherapeutics might be an interesting strategy (Fig. 2A), as we have shown before [10]. Combination of Bisp-AFN with a non-curative dose of doxorubicin (doxo) resulted in promising effects. In the B16 melanoma tumor model, which is considered to be non- or low-immunogenic, we observed a cure rate of 30% (6/20) (Fig. 2B, E). The outcome was even more striking in the 4T1 mammary carcinoma model. In the s.c. model, we observed a 100% cure (Fig. 2C, F). Also in an orthotopic setting, which mimics the biological and metastatic tumor cell properties observed in clinical cancer patients [21], promising cure rates were observed (70%) (Fig. 2D, G).
In clinical settings, there is often an urgent need for adequate therapies against fast growing and fully developed tumors. Hence, we analyzed the antitumor potential of AFN and doxo therapy in large established tumors (Fig. 3A). Bisp-AFN with doxo could suppress and diminish tumor growth even after the treatment was stopped, resulting in prolonged survival (Fig. 3B-C). In addition, 20% were cured upon treatment with Bisp-AFN plus doxo.
Encouraged by these results, we set up a 2-site tumor model to analyze abscopal effects and systemic therapeutic immunity (Fig. 3D). Strikingly, treatment with doxo plus Bisp-AFN resulted in complete cure of the treated tumor and prolonged growth inhibition of the non-treated 4T1 tumor (Fig. 3E-F).
These results demonstrate that antitumor immune effects elicited by local immunomodulation upon treatment with Bisp-AFN in combination with non-curative doses of doxorubicin can induce systemic effects and affect tumor growth at distant sites.
Induction of immunological memory by combined treatment of Bispecific AcTaferon with doxorubicin
Since combined therapy with doxo resulted in complete tumor eradication (Fig. 2A-G), we could evaluate the potential immunological memory of the treatments in the cured mice (Fig. 4A). Despite that only few tumors were cured in the B16 model (Fig. 2B, E), 100% (6/6) protective immunity was observed upon treatment with doxo plus the Bisp-AFN (Fig. 4B-C). In the s.c. 4T1 model, 80% (4/5) immunological memory was achieved in mice that had been cured following doxo plus Bisp-AFN treatment (Fig. 4D-E). The one individual that was not protected showed delayed tumor development and growth (Fig. 4D). Finally, in the 4T1 orthotopic model, we observed 100% (6/6) immunological memory that was achieved in mice that had been cured upon doxo plus Bisp-AFN treatment (Fig. 4F-G).
These data indicate the strong curative potential of Bisp-AFN and doxorubicin treatment, independent of the histological origin of the tumor.
Role of IFN signaling and PD-L1 expression
In contrast to the bispecific Clec9A-PDL1-AFN, administration of Clec9A-PDL1-huIFN, which cannot signal in mouse cells, hardly showed any antitumor efficacy against B16 melanoma (Fig. 5A), in the 4T1 mammary carcinoma s.c. (Fig. 5B) or orthotopic (Fig. 5C) model. These data were additionally confirmed by administration of Clec9A-PDL1, a bispecific control construct without an IFN moiety (Fig. 5A-C). Altogether, these findings indicate that the pure tethering effect might be insufficient and that IFN signaling is key for the robust antitumor efficacy. Next, we analyzed antitumor responses in B16-mCD20-IFNAR−/− tumors, lacking a functional IFN-α and -β Receptor subunit 1 (IFNAR1). Potent antitumor responses were observed with the Bisp-AFN (Fig. 5D), indicating that IFN signaling in tumor cells is not needed for the antitumor effect upon administration of the BiSp-AFN. These data suggest that IFN signaling in immune cells rather than direct intrinsic and anti-proliferative effects on tumor cells is key for the observed effects. In contrast to IFNAR expression by tumor cells, PD-L1 expression by the tumor cells was needed for the antitumor efficacy of Bisp-AFN (Fig. 5E). These results were confirmed in a tumor antigen-specific proliferation assay using gp100 in a B16 melanoma model. To that end, CFSE labeled CD8+ T cells carrying a TCR specifically recognizing the melanoma differentiation antigen gp100 were adoptively transferred into B16 melanoma bearing mice. After treatment, dilution of CFSE was analyzed in draining LN. Proliferation was significantly impaired in the B16-PD-L1−/− tumor model following Bisp-AFN therapy (Fig. 5F).
Besides the importance of co-localized interferon signaling in immune cell populations, we additionally suggest a role for PD-L1 expression by the tumor, which contributes to the strong and potent antitumor potential of Bisp-AFN treatment.
Single cell RNA sequencing indicates key shifts in both lymphoid and myeloid cells in the tumor microenvironment
To obtain a comprehensive understanding of the immune cell heterogeneity in the tumor microenvironment as well as effects induced by AcTaferon treatment, we performed single cell RNA sequencing (scRNAseq) on B16 tumor samples (Fig. 6A). Uniform Manifold Approximation and Projection (UMAP) for dimension reduction visualization was performed on the CD45+ living immune cell population. Cells from the various treatment conditions were pooled in a single dataset (Fig. 6B) whereupon the origin of each cell was visualized in a color-coded UMAP and linked to the different treatment conditions (Fig. 6C). Clusters were identified based on detection of differentially expressed (DE) genes (Fig. 6D, Suppl. Fig. 2, Suppl. Table 1). Based on these data, we could provide detailed information on the immune cell composition of B16 tumors (Suppl. Fig. 3). In addition, these scRNAseq data revealed key shifts in several immune cell compartments.
Therapy with the Bisp-AFN resulted in strong proliferation in the lymphoid compartment (NK cells, NKT cells and T cells) compared to PBS (Fig. 6E). Interestingly, tumors treated with Bisp-AFN showed less regulatory T cells compared to PBS (Fig. 6E).
On the level of APC, different DC subtypes were determined based on expression of DE genes (Suppl. Fig. 4A, Suppl. Table 1). The majority of cDC were detected in the PBS condition rather than in the Bisp-AFN condition (Fig. 6F). As cDC maturation and motility are tightly regulated, we presume that at the time-point of scRNAseq analysis (Fig. 6A) cDC in the Bisp-AFN condition already migrated from the tumor towards the draining LN. Indeed, flow cytometry analysis under the same conditions showed decreased amounts of cDC in B16 tumors after AFN treatment compared to PBS, while an increase was observed in draining LNs (Suppl. Fig. 4B). Besides cDC1, cDC2, migratory DC (migrDC) and pDC, scRNAseq data showed the presence of an additional DC population, which mainly arose in the Bisp-AFN treated condition (Fig. 6F). Based on the expression of Fcgre1, Cd300a, Mafb, Bex6, Dnajc6 and Ly6c2, this population could represent monocyte-derived cells. However, additional genes including Dpp4, Irf8, Sirpa, March1 as well as Rsad2, Iigp1, Stat1, Ifit1, Ifit3 and Ifi205 could be detected (Suppl. Table 1). Identification of these DE genes suggests that these cells could be an inflammatory cDC2 (inf-cDC2) population, as described by Bosteels et al. [22]. Inf-cDC2 arise from cDC2 upon inflammation and share phenotype, gene expression and function with both cDC1s and monocyte-derived cells [22]. Indeed, based on UMAP representation, this inf-cDC2 population is more closely related to cDC1 and cDC2 compared to the cluster of monocytes/macrophages (Fig. 6B-C). While only a negligible amount (6,4%) could be detected in the PBS condition, this inf-cDC2 population was most abundant in the Bisp-AFN condition (93,6%) (Fig. 6F).
Finally, clear differences between the different treatment conditions were detected on other cells of the myeloid compartment (Fig. 6G).
From pro-tumorigenic towards pro-immunogenic TAMs and TANs
It is well known that the tumor microenvironment is a complex heterogeneity of tumor cells, stroma and a variety of infiltrated immune cell types [23]. Among these, tumor-associated neutrophils (TAN) and macrophages (TAM) comprise two noteworthy subtypes. To underscore this, our scRNAseq data in B16 tumors revealed key changes in these subtypes.
Although neutrophils infiltrate in numerous cancer types, only low numbers were detected here. The identified neutrophils did not only almost selectively belong to the Bisp-AFN treated condition (Fig. 6G), they also showed a gene expression profile that is correlated with a pro-immunogenic TAN phenotype (Fig. 7A, Suppl. Fig. 2).
Depending on the immune context and the environmental stimuli, macrophages can adopt extreme phenotypes, ranging from pro-immunogenic TAM to tumorigenic TAMs [24, 25]. Indeed, our scRNAseq data of B16 tumors clearly revealed distinct TAM subsets (Fig. 6G). Remarkably, the vast majority of cells in the pro-immunogenic TAM cluster were derived from the Bisp-AFN group (96%), while most of the cells in the pro-tumorigenic TAM cluster belonged to the PBS group (94,5%). These data were visualized in an heatmap showing pooled clusters with TAM signatures. DE genes linked with pro-immunogenic TAMs are upregulated in the Bisp-AFN treatment, while DE genes specific for pro-tumorigenic TAMs are clearly upregulated in the PBS condition (Fig. 7B).
Together, these data clearly indicate the ability of Bisp-AFN treatment to reshape the suppressive tumor environment and revert the tumor-promoting activities of myeloid cells.
Bispecific AcTaferon induces migration and potent maturation of dendritic cells
cDC1 are considered as critical for antitumor immunity and their abundance within tumors has been associated with immune-mediated rejection and the success of immunotherapy [26]. We analyzed the presence and maturation status of cDC1 18 h after a single administration of either PBS or the Bisp-AFN (Fig. 8A, flow cytometry gating strategy in Suppl. Fig. 5). A significant increased presence of cDC1 in B16 tumors (Fig. 8B) as well as migratory cDC1 in draining LN (Fig. 8C), was observed upon administration of Bisp-AFN. Although not statistically significant, we observed a trend to increased presence of resident cDC1 in the draining lymph nodes (Fig. 8D) upon treatment with Bisp-AFN. In addition, these cDC1 showed a favorable matured phenotype demonstrated by their CD40 expression (Fig. 8B-D).
Bispecific AcTaferon induces a shift from naive and dysfunctional T cells towards effector and reprogrammable CTLs
During cancer progression, CTLs often progress to a dysfunctional or exhausted state due to immune-related tolerance or immune-suppression within the tumor microenvironment [27, 28]. Therefore, we analyzed the status of CD8+ T cells in B16 tumors and draining LN (Fig. 9A-B). Administration of the Bisp-AFN drives T cells from a naive state into T cells with an effector phenotype in both draining LN (Fig. 9C) and tumor (Fig. 9B, D). In addition, in draining LN, CD8+ T cells with a memory phenotype, based on CD44highCD62Lhigh expression, could be increased after treatment with Bisp-AFN (Fig. 9C). Finally, in the PBS condition many tumor-resident CTLs showed a fixed dysfunctional state, while Bisp-AFN therapy resulted in presence of plastic, reprogrammable CTLs (Fig. 9B, E).
Bispecific AcTaferon is a superior inducer of tumor-specific CTLs and promotes diversity in the TCR repertoire
To analyze the antigen-presentation skills of DCs, we performed a proliferation assay showing superior proliferation of gp100-specific T cells after Bisp-AFN treatment (Fig. 10A-C). Moreover, administration of Bisp-AFN resulted in a high fraction of gp100-specific T cells in the latest stages of proliferation (Fig. 10B-C). Induction of tumor-specific cytotoxic T cell responses is a fundamental objective in anticancer therapeutic strategies. Therefore, we analyzed the potency of the induced antigen-specific T cell response. Again, Bisp-AFN induced ample effects (Fig. 10D). In addition, the induced specific lysis inversely correlated with tumor size (Fig. 10E).
Next, we evaluated whether these DCs were able to establish diversity in the T cell repertoire, which we addressed via TCR analysis. To that end, B16 tumor-bearing mice were treated with either PBS or Bisp-AFN, after which CD8+ T cells were sorted from draining LNs and tumor for RNA sequencing. In both compartments, increased frequencies of several clones retrieved within the top-10 most-abundant TCRB sequences after treatment with the Bisp-AFN were noticed (Fig. 10F), which validates the findings from the abovementioned proliferation experiments (Fig. 10A-C). We further investigated this by measuring the average frequencies of TCRB V/J pairing usage per group in the LN. While CD8+ T cells isolated from control mice treated with PBS are more enriched in a selected number of relatively larger V/J pairings, the T cell response in Bisp-AFN-treated animals is spread over numerous V/J pairings that appear in lower frequencies, which is indicative of improved epitope spreading in the LN (Fig. 10G-H). Upon comparing matched tissues, we observed that more TCRB sequences initially retrieved in the draining LN also appeared and expanded in the tumor after treatment with Bisp-AFN, imposing a correlation between a durable antitumor response and T cell clone sharing between sentinel LN and tumor (Fig. 10I). In addition, average V/J pairing usage analysis for these particular shared clones reveals more oligoclonal CD8+ T cells expansion for certain TCRB V/J combinations in the tumor after treatment with Bisp-AFN compared with control (Fig. 10J-K).
Altogether, simultaneous targeting of type I interferon towards Clec9A and PD-L1 in a Bisp-AFN construct induces strong tumor-specific immune responses and increases diversity in the CD8+ T cell TCR repertoire without the need for tumor markers, as such representing a potent immunotherapeutic with broad applications.
Discussion
Here, we described the superior efficacy of a bispecific AcTaferon construct simultaneously targeting type I IFN activity towards Clec9A- and PD-L1-expressing cells. This bispecific construct showed ample antitumor activity and resulted in modulation of the tumor microenvironment towards a pro-immunogenic state.
The general layout of the Bisp-AFN, by which two targeting moieties are linked together, resembles that of bispecific antibodies, engineered artificial antibodies capable of recognizing two epitopes of an antigen or recognizing two antigens [29], and in particular Bispecific T cell Engagers (BiTEs). The ‘BiTE-platform’ belongs to advanced T cell immunotherapeutic options of which CAR-T cells are most explored, and physically bridges two cells leading to the formation of an immunological synapse [30]. Given that the mode of action of Bisp-AFN invokes both cDC1 and PD-L1, including PD-L1 expressed on the tumor cells, tethering and retention may possibly also lead to formation of a ‘synapse-like event’ between the immune cell and the tumor cell. This is an interesting notion that might have possibly contributed to the observed effects and is currently subject of further investigation. Type I IFN signaling is crucial as unarmed bispecific constructs are completely inactive, suggesting that pure tethering alone is insufficient. In addition, co-localized signaling and co-signaling loops might be in play. It is known that type I IFNs induce upregulation of PD-L1 resulting in expression of PD-L1 on tumor cells and immune cells [11, 31, 32], making them more susceptible to IFN activity by PD-L1-targeted AFN, as such creating a feed-forward loop. Noteworthy, our scRNAseq data revealed a significant expression of PD-L1 on subpopulations of myeloid cells including TANs and TAMs expressing pro-immunogenic phenotype as well as moDCs, which correlated with the increased expression of genes related with IFN activity. One of the main signaling roles of the PD-L1 molecule includes protection of the tumor cells from the cytolytic effects of type I and type II interferons [33]. However, several studies raised the debate on the importance of PD-L1 expression on tumor cells versus host immune cells for successful antitumor therapies [34,35,36,37]. Here, we show that PD-L1 expression on tumor cells was partially responsible for the antitumor efficacy induced by the treatment with the Bisp-AFN. Of note, also proliferating NK and NKT cells are significantly increased in the tumor upon Bisp-AFN treatment, suggesting a co-signaling loop for NK cells and cDC1. Although not in the scope of this paper, this might be an interesting observation to further explore in view of the findings by Barry and colleagues [18] showing correlation of NK cell frequency in human cancers with protective intratumoral stimulatory DCs, increased responsiveness to immune checkpoint therapy and hence increased overall survival.
Our scRNAseq data showed decreased presence of cDC1 in B16 tumors three days after the first AFN administration, which was explained by their increased motility towards draining LN. This favors the induced tumor-specific immunity, as DC migration directly correlates with the extent of T cell proliferation and effector cell differentiation [38]. On top, few hours after Bisp-AFN delivery, increased presence of cDC1 in B16 tumors and draining LN together with a favorable maturation pattern was observed, in sharp contrast to administration of PBS. These is important as cDC1 are regarded as major players in regulating anticancer immune responses locally within tumor tissue [39], as they attract T cells [40], re-stimulate and expand tumor-specific CD8+ T cells [41] and support T cell effector function [42]. Furthermore, we could demonstrate the presence of infl-cDC2 in a tumor setting. In this regard, Bosteels et al. described that upon inflammation cDC2 acquire a hybrid inf-cDC2 phenotype capable of optimally priming both CD4+ and CD8+ T cell immunity [22]. As this differentiation was driven by type I IFN [22], we hypothesize an important role for AFN-signaling in the induction of inf-cDC2 detected in our study. Indeed, scRNAseq showed only few inf-cDC2 in the PBS condition compared to abundant presence in the Bisp-AFN condition.
In addition, our results reveal the modulation of several suppressive immune cell types in the tumor niche. Indeed, our scRNAseq data showed increased presence of pro-immunogenic TAMs as well as TANs. It has been extensively reported that depending on the environmental stimuli, TAMs can adopt distinct and opposing functions during differentiation [25, 43,44,45]. Our results indicate that the Bisp-AFN can provide the right stimuli to direct cells towards this favorable profile. One other strategy to improve the therapeutic efficacy against tumors includes reversing T cell suppression and tolerance. Tregs are regarded as key players in maintaining immunological tolerance and immunosuppressive effects, thereby limiting the power of cancer immunotherapies [46, 47]. Typically, their increased presence in tumors has been correlated with poor survival [48, 49]. In this regard, scRNAseq analysis revealed a decreased proportion of Tregs in B16 tumors upon treatment with the Bisp-AFN. Furthermore, we report on the induction of effector CD8+ T cells with a plastic phenotype upon treatment with the Bisp-AFN. Again, this stands in sharp contrast to the mainly naive and/or dysfunctional CD8+ T cell phenotype observed after PBS treatment. These results were observed already five days after the first AFN delivery and three days after the second administration, which might be considered as “early” in T cell differentiation and reprogramming. However, T cell dysfunction as observed in late stage clinical cancer patients may have already been established early during tumorigenesis [50]. Our results show that Bisp-AFN drives CD8+ T cell expansion, acquisition of an effector phenotype and effector functionality, next to increased diversity in the CTL TCR repertoire. TCR analysis revealed epitope spreading in the draining LN, evidenced by distribution of the T cell clonotypes over multiple TCRB V/J combinations present in lower frequencies, which indicates a highly polyclonal response. In addition, we showed a higher overlap in T cell clones between the sentinel LN and the tumor, together with a more pronounced oligoclonal expansion of several of these clones in tumors of mice treated with Bisp-AFN. Although this warrants further investigation, one might argue that these findings refer to better trafficking of the induced antigen-specific T cells from the LN towards the tumor area and/or the existence of tertiary lymphoid structures. Altogether, Bisp-AFN is a generic strategy that enabled very potent tumor-specific cytotoxic T lymphocyte responses and antitumor activity. In combination with a non-curative dose of chemotherapy, we showed tumor clearance and immunological memory, therapeutic immunity on large established tumors and blunted tumor growth at distant sites.
In conclusion, treatment with the Bisp-AFN fulfills two key aspects of cancer immunotherapy by promoting antitumor immunity and overcoming tumor-induced immune suppression. Indeed, our Bispecific AcTaferon affects many cells that play an important role in cancer immunoediting and is highly efficient in reshaping the suppressive tumor microenvironment. Therefore, this strategy might be considered as a safe, potent and broad-spectrum therapeutic approach to solid tumors and hematological cancers.
Materials and methods
Construction and production of the AcTakines
The mutations Q124R or R149A were introduced into the human IFNα2 sequence by site-directed mutagenesis using the QuikChange II-E Site-Directed Mutagenesis Kit (Agilent Technologies). Single domain antibodies (sdAb) were generated at the VIB Nanobody Core, as described previously [9]. The mutated cytokines as well as the wt human IFNα2 (not active in mice) and wt murine IFN were coupled N-terminally to targeting sdAbs via a 20xGGS-linker. For bispecific AcTakines, two different targeting moieties were connected with a 10xGGS linker and coupled via a 20xGGS linker to the mutated cytokine. AcTakines were constructed and produced as previously described [10].
Mice
Female, 7–8 weeks old C57BL/6 J and 7–8 weeks old (s.c. tumor inoculation) or 10–12 weeks old (orthotopic tumor inoculation) Balb/cJ mice were purchased from Charles River Laboratories (France). pMel mice that carry a transgenic TCR specific for the MHC-I restricted gp100 peptide were a kind gift from Prof. K. Breckpot (VUB, Belgium). All strains were bred in our own facility. NOD-scid IL2Rγnull (NSG) mice were bred at our own facility or at the breeding facility of the University Hospital Ghent (UZGhent, Belgium). Humanized Immune System (HIS) mice were generated as previously described [10]. Mice were housed in individually ventilated cages under pathogen-free conditions in a temperature- and humidity-controlled environment with 12/12 h light/dark cycle and received food and water ad libitum.
Animals were treated according to the Federation of European Laboratory Animal Science Association (FELASA) guidelines. Experiments were reviewed and approved by the Ethical Committee of Ghent University (ECD15/88, ECD18/82 and ECD17/11). Mice were allocated randomly to a group. Where possible, the investigators were blinded during data collection and analysis.
Cell lines
Murine tumor cell lines include melanoma cell lines B16, B16-PD-L1−/− and B16-mCD20-IFNAR−/− as well as 4T1 mammary carcinoma. For the humanized model, human follicular B cell lymphoma RL cells were used. B16, 4T1 and RL cell lines were purchased from American Type Culture Collection (ATCC) and cultured in conditions specified by the manufacturer. B16-mCD20-IFNAR−/− cells were generated as previously described [11]. The B16-mCD20-PD-L1−/− cell line was generated via the CRISPR-Cas9 editing system, using a gRNA sequence targeting exon 3 of PD-L1, 5’- AGGTCCAGCTCCCGTTCTAC-3’ (determined via http://crispr.mit.edu). The gRNA was cloned in the pSpCas9(BB)-2A-Puro vector (PX459) [51] and transfected into B16 cells via Jetprime. After 4 weeks of culture with 1 µg/ml puromycine, negative selection was performed using MACS with anti-CD274-PE (eBioScience) and anti-PE microbeads (Miltenyi Biotec). The absence of PD-L1 was verified with flow cytometry. All cell lines used for inoculation were free of mycoplasma. Cell lines were analyzed by Eurofins Scientific (Luxembourg) for authentication.
Tumor implantation, analysis and treatments
For s.c. tumor models, cells were injected in 50 μl PBS suspension and include 6 × 105 B16, B16-mCD20-IFNAR−/−, B16-PD-L1−/− cells or 105 4T1 cells. For the orthotopic 4T1 tumor model, mice were anesthetized with a mixture of ketamine (Nimatek, 70 mg/kg, EuroVet) and xylazine (Rompun, 10 mg/kg, Bayer), whereupon the fourth mammary fat pad was surgically exposed and injected with 104 4T1 cells in a volume of 10 μl PBS. The incision was closed using 6–0 coated vicryl absorbable suture (Ethicon). For the humanized mice model, HIS mice were s.c. inoculated with 2 × 106 human follicular lymphoma RL cells, 12 weeks after human stem cell transfer. In addition, mice received daily intraperitoneal (i.p.) injections for 8 to 12 times with 30 μg Fms-like Tyrosine kinase 3 ligand (Flt3L) protein, known to activate hematopoietic progenitors and playing an important role in the development and mobilization of DCs [52, 53], according a schedule indicated in the experiment layout.
Tumor size was defined by caliper measurements of tumor dimensions in mm and calculated using the formula for a prolate ellipsoid i.e. length x width2/2. Survival was indicated as tumors < 1000 mm3. To analyze tumor immunity, mice were re-challenged on the contralateral flank with a new dose of tumor cells. Tumor-free mice in the orthotopic setting were re-challenged subcutaneously.
To analyze abscopal effects, a 2-site tumor model was performed. To that end, mice were inoculated with a primary tumor at the right flank followed by a secondary tumor at the left flank, three days later. When both tumors were palpable, only the primary tumor (right flank) was treated after which systemic effects of the local treatment were evaluated on both the treated as well as the non-treated, distant tumor.
Tumor treatments were done perilesionally (p.l.), which is s.c. at the tumor border. For tumor growth experiments, daily treatments were performed for at least 8 to 10 times, indicated by the black line in the X-axis. For scRNAseq, B16 tumors were p.l. injected on three consecutive days and isolated 6 h after the last injection. For analysis of DC presence and maturation, mice received a single p.l. injection. For analysis of CTL influx, activation and tumor-specificity, B16 tumors were injected twice, with a one-day interval. For TCR analysis, daily treatments were performed for 6 consecutive days.
As a control, mice were injected with PBS. For the different treatment groups, protein dose was kept constant to finally obtain equal targeting amongst the different groups. The different treatment groups include 30 μg of the Bisp-AFN Clec9A-PDL1-AFN, 30 μg Clec9A-PDL1-IFN or Clec9A-PDL1-huIFN. For combination therapies, a non-curative dose of doxo (3 mg/kg) was injected s.c. in near proximity of the tumor every other day for 5–6 times as indicated by the red arrows.
Hematological analysis
One day after the last treatment, blood was collected using EDTA-coated microvette tubes (Sarstedt) and analyzed for blood parameters in a Hemavet 950FS whole blood counter (Drew Scientific).
Single cell RNA sequencing
To minimize bias effects and to finally obtain a sufficient number of immune cells, tumors of six individual mice for each treatment condition were pooled. Approximately 4 × 104 CD45+ live immune cells were sorted from single cell suspensions of B16 tumors using BD FACS Aria™ III cell sorter (Becton Dickinson). Sorted cells were re-suspended at an estimated final concentration of 1000 cells/μl in PBS/0,04% BSA to proceed to single cell RNA sequencing.
To that end, the cellular suspensions were loaded on a GemCode Single Cell Instrument (10 × Genomics) to generate single cell Gel Bead-in-Emulsions (GEMs). Single cell RNA-seq libraries were prepared using GemCode Single-cell 3’Gel Bead and Library Kit (10 × Genomics) according to the manufacturer’s instructions. GEM-RT was performed (45 min at 55 °C, 5 min at 85 °C, end at 4 °C) in 96-deep well reaction modules followed by break down of the GEMs and clean-up of the cDNA using DynaBeads MyOne Silane Beads (Thermo Fisher Scientific) and SPRIselect Reagent Kit (Beckman Coulter). Next, cDNA was amplified with 96-deep well reaction module according to following schedule: 3 min at 98 °C followed by 12 cycle times of 15 s at 98 °C, 20 s at 67 °C, 1 min at 72 °C. Last step included 1 min at 72 °C and end at 4 °C. The amplified cDNA product was cleaned up using SPRIselect Reagent Kit prior to enzymatic fragmentation. GemCode Single Cell 3’ Library kit (V2 chemistry) was used to generate indexed sequencing libraries and include following intermediates: end repair, A-tailing, adaptor ligation, post-ligation SPRIselect cleanup and sample index PCR. Pre-fragmentation and post-sample index PCR samples were analyzed using Agilent 2100 Bioanalyzer.
Sequencing was performed at VIB Nucleomics Core. To that end, sequencing libraries were loaded on a HiSeq4000 with sequencing settings following recommendations of 10xGenomics. 10x’s CellRanger software was used for demultiplexing of the raw data, whereupon these reads were used as the input for CellRanger (10X Genomics), which align the reads to the mouse reference genome (mm10) using STAR and collapse to unique molecular identifier (UMI) counts. Scran and scatter R package was used for processing of the data in accordance to the workflow as described [54, 55]. Outlier cells were identified based on three metrics i.e. library size, number of expressed genes and mitochondrial proportion. Cells from the control (PBS treated) sample were tagged as outliers when they were three median absolute deviations (MADs) away from the median value of library size and number of expressed genes, four MADs for the sample treated with Clec9A-PDL1-AFN. Likewise for both samples, cells 25 MADs away from the median proportion were identified as outlier. These outlier cells were removed from the analysis. Genes expressed in less than 3 cells and cells expressing less than 200 genes were removed. The samples were aggregated using the merge function, counts were normalized and log2 transformed using the NormalizeData function, both from the Seurat R package (v4.0.2) using default parameters. Detecting highly variable genes, scaling, finding clusters, and creating UMAP plots was done using the Seurat pipeline. Clustering was performed using the first 37 principal components and a resolution of 1.5.
In vivo proliferation assay
Gp100-specific CD8+ T cells were isolated from spleens of naive pMel mice using MACS separation protocols (Miltenyi Biotec) and subsequently labeled with 0,5 μM carboxyfluorescein succinimidyl ester (CFSE, Life Technologies). Cells were adoptively transferred into B16-tumor bearing mice. Mice were p.l. injected with PBS or the AcTakine condition twice, one day after adoptive transfer and an additional administration 2 days later. Proliferation of gp100-specific T cells, measured as a dilution of CFSE, was analyzed in draining LN three days after the last AcTakine delivery. Samples were acquired on an Attune Nxt Acoustic Focusing Cytometer (Life Technologies) and analyzed using FlowJo software.
In vivo cytotoxicity assay
To analyze the potency of the induced antigen-specific T cells, an in vivo cytotoxicity assay was performed. To that end, B16 tumor-bearing mice were p.l. injected twice with a one-day interval with PBS or the Bisp-AFN. Three days after the last delivery, the killing assay was performed according to current Protocols of Immunology [56]. In brief, spleen cells from syngeneic mice were pulsed or not with 5 μM EGSRNQDWL peptide (mouse gp100 25–33). Peptide pulsed cells were labeled with 2,5 μM CFSE after which they were mixed at a 1:1 ratio with 0,25 μM CFSE labeled, non-peptide pulsed cells. At least 107 cells were injected intravenously (i.v.). Spleen and draining LN were isolated 24 h later. Specific lysis was analyzed in draining LN using an Attune Nxt Acoustic Focusing Cytometer (Life Technologies) to acquire the samples and FlowJo software to analyze the data. The percentage killing was calculated as described [56].
CD8+ T cell sorting, RNA isolation and TCR repertoire analysis
Daily perilesional treatments were performed for 6 consecutive days after which CD8+ T cells were sorted from draining LNs and B16 tumor tissue using a three-laser FACSAria II (BD Biosciences) and captured in 350 μL RLT lysis buffer supplemented with β-mercaptoethanol. RNA was isolated using the RNeasy Plus Micro Kit (74034, Qiagen) according to the manufacturer’s instructions. Concentration, quality and integrity of the RNA was measured using an Agilent 2100 Bioanalyzer (Agilent). Samples for which RIN ≥ 8 and 280/260 and 260/230 values > 1.8 were used for library preparation with the Qiagen QIAseq™ Mouse TCR Panel Immune Repertoire RNA Library Kit (Qiagen) following the manufacturer’s instruction. RNA was first reverse-transcribed into cDNA using primers specific to the TCR region, after which double-stranded cDNA was generated, end-repaired and A-tailed. All original cDNA molecules were ligated to a 12-base random adaptor sequence used as a Unique Molecular Identifier (UMI). Enrichment for target sequences was performed with a first PCR reaction using a primer against the TCR constant region and a primer against the adaptor sequence. A second PCR was used to further amplify the library, add platform-specific adaptor sequences and introduce additional sample indices. Samples were next pooled and sequenced in two Illumina MiSeq v2 500 runs. All raw read data was merged and analyzed using the CLC Genomics Workbench (GWB) 21 (https://digitalinsights.qiagen.com/) [57] via the mouse “Immune Repertoire Analysis” workflow. We used default parameters for this analysis, except for “min UMI group size” (set to 1 to increase sensitivity).
Flow cytometry
Commercially available antibodies used throughout the paper are listed in Supplementary Table 2. To prevent aspecific binding, cells were pre-incubated with anti-mouse CD16/CD32 (clone 93, eBioScience). Samples were acquired on an Attune Nxt Acoustic Focusing Cytometer (Life Technologies) and analyzed using FlowJo software.
Statistical analysis
Shapiro–Wilk Normality test was performed to determine Gaussian distribution (α = 0,05) of the data. When data were normally distributed according to Shapiro–Wilk testing, unpaired two-tailed student t-test or ANOVA followed by Tukey’s multiple comparisons test was performed. If data were not normally distributed according to Shapiro–Wilk testing, unpaired nonparametric Mann–Whitney test or ANOVA Kruskal–Wallis test with Dunn’s multiple comparisons test was performed. Time to reach a specific tumor size as well as survival were represented in a Kaplan Meier plot compared by log-rank (Mantel-Cox) testing. Statistical analyses were performed using the GraphPad Prism software. The numbers of independent biological replicates or the numbers of individual mice have been indicated in the figure legends.
Availability of data and materials
All data supporting the findings of this study are available within the article of upon further request.
Abbreviations
- AFN:
-
AcTaferon
- APC:
-
Antigen-presenting cell
- Bisp-AFN:
-
Bispecific AcTaferon
- BiTE:
-
Bispecific T cell Engager
- CAR:
-
Chimeric antigen receptor
- CD:
-
Cluster of differentiation
- cDC:
-
Conventional Dendritic cell
- CFSE:
-
Carboxyfluorescein succinimidyl ester
- CLEC9A:
-
C-type lectin domain containing 9A
- CTL:
-
Cytotoxic T Lymphocyte
- DC:
-
Dendritic cell
- DE:
-
Differentially expressed
- doxo:
-
Doxorubicin
- Flt3L:
-
FMS-like Tyrosine kinase 3 Ligand
- GEM:
-
Gel Bead-in-Emulsions
- HIS:
-
Humanized Immune System
- IFN:
-
Interferon
- IFNAR:
-
IFN-α and -β Receptor
- Inf-cDC2:
-
Inflammatory cDC2
- i.p.:
-
Intraperitoneal
- LN:
-
Lymph node
- MAD:
-
Median absolute deviation
- migrDC:
-
Migratory DC
- moDC:
-
Monocyte-derived dendritic cell
- NK:
-
Natural Killer
- NKT:
-
Natural Killer T cell
- PD-1:
-
Programmed cell Death protein 1
- pDC:
-
Plasmacytoid DC
- PD-L1:
-
Programmed Death-Ligand 1
- p.l.:
-
Perilesional
- s.c.:
-
Subcutaneous
- scRNAseq:
-
Single cell RNA sequencing
- sdAb:
-
Single domain Antibody
- SEM:
-
Standard error of the mean
- TAM:
-
Tumor-associated macrophages
- TAN:
-
Tumor-associated neutrophils
- TCR:
-
T cell receptor
- Treg:
-
Regulatory T cell
- UMAP:
-
Uniform Manifold Approximation and Projection
- UMI:
-
Unique molecular identifier
- wt:
-
Wild type
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Acknowledgements
We thank the VIB Nanobody Core (Gholamreza Hassanzadeh Gassabeh) for the sdAb selection; the VIB Flow Core (Gert Van Isterdael and Julie Van Duyse) for the cell sorting experiments and the VIB Nucleomics Core (Stefaan Derveaux and Ruth Maes) for their help in the scRNAseq and TCR sequencing study. Additional acknowledgements are attributed to Kevin Verstaen for his help with processing and visualization of the scRNAseq data.
Funding
The authors receive financial support for their research from the Ghent University Institutes BOF and Methusalem grants, an advanced ERC (CYRE, 340941) and by Orionis Biosciences NV. BVDE is a doctoral fellow receiving FWO-SB funding (project 132118N).
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GU, NK, and JT conceptualized the research. SVL, AC, NK and JT designed the experiments. SVL, BVDE, AVP performed the experiments. NVD and JR contributed to the performance and analysis of the scRNAseq data. SP and BVDE contributed to the analysis of the TCR data. AV, DC, JDG and NV provided excellent technical assistance. SVL analysed and interpreted the data and wrote the manuscript. GU, NK and JT provided guidance and expertise and supervised the study. All authors provided input and edited and approved the final version of the manuscript.
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NK and JT are affiliated with Orionis Biosciences NV and hold equity interests. NK and JT have no additional financial interests. The following patent applications are related to the work presented in this paper: WO/2017/134305, Bispecific signaling agents and uses thereof. Applicants: VIB-Ghent University and Orionis Biosciences N.V. Inventors: N.K., J.T., S.V.L., A.C. The remaining authors declare no competing interests.
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Van Lint, S., Van Parys, A., Van Den Eeckhout, B. et al. A bispecific Clec9A-PD-L1 targeted type I interferon profoundly reshapes the tumor microenvironment towards an antitumor state. Mol Cancer 22, 191 (2023). https://doi.org/10.1186/s12943-023-01908-6
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DOI: https://doi.org/10.1186/s12943-023-01908-6