IL-15 Stimulation with TIGIT Blockade Reverses CD155-Mediated NK Cell
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Author Manuscript Published OnlineFirst on June 26, 2020; DOI: 10.1158/1078-0432.CCR-20-0575 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. IL-15 stimulation with TIGIT blockade reverses CD155-mediated NK cell dysfunction in melanoma Joe-Marc Chauvin1, Mignane Ka1, Ornella Pagliano1, Carmine Menna1, Quanquan Ding1, Richelle DeBlasio1, Cindy Sanders1, Jiajie Hou2, Xian-Yang Li3, Soldano Ferrone4, Diwakar Davar1, John M. Kirkwood1, Robert Johnston5, Alan J. Korman5, Mark J. Smyth3, and Hassane M. Zarour1,6. 1Department of Medicine and Division of Hematology/Oncology, University of Pittsburgh, School of Medicine, Pittsburgh, PA 15213, USA. 2Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China. 3Immunology in Cancer and Infection Laboratory, QIMR Berghofer Medical Research Institute, Queensland, Australia. 4Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. 5Biologics Discovery California, Bristol-Myers Squibb, Redwood City, CA 94063, USA. 6Department of Immunology, University of Pittsburgh, School of Medicine, Pittsburgh, PA 15213, USA. Running title: IL-15 and TIGIT blockade reverse NK dysfunction in melanoma Keywords: Melanoma, Immunotherapy, TIGIT, IL-15, NK cells This work was supported by NIH/NCI grants R01CA228181 and R01CA222203 (to HMZ), a research grant by Bristol-Myers Squibb BMS (to HMZ), a cancer vaccine collaborative clinical strategy team grant (to HMZ), and NCI grant P50CA121973 (to 1 Downloaded from clincancerres.aacrjournals.org on September 25, 2021. © 2020 American Association for Cancer Research. Author Manuscript Published OnlineFirst on June 26, 2020; DOI: 10.1158/1078-0432.CCR-20-0575 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. JMK). MJS was supported by a National Health and Medical Research Council of Australia (NH&MRC) Senior Principal Research Fellowship (1078671), a NH&MRC Program grant (1132519), a NH&MRC Project grant (1124784), a CLIP award from the Cancer Research Institute (New-York, NY), and a Project Grant from the Cancer Council of Queensland (1140251). This work benefited from ImageStreamX MARKII grant NIH 1S10OD019942-01. Address correspondence and reprint requests to Dr. Hassane M. Zarour, Hillman Cancer Center, Research Pavilion, Suite 1.32a, 5117 Centre Avenue, Pittsburgh, PA 15213-2582, Phone: 412 623 3272 Fax: 412 623 7704 Email: [email protected] MJS has a scientific research agreement with Bristol Myers Squibb and Tizona Therapeutics and is on the scientific advisory board of Tizona Therapeutics and Compass Therapeutics. 2 Downloaded from clincancerres.aacrjournals.org on September 25, 2021. © 2020 American Association for Cancer Research. Author Manuscript Published OnlineFirst on June 26, 2020; DOI: 10.1158/1078-0432.CCR-20-0575 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. Translational relevance Here, we show that membrane-bound poliovirus receptor (PVR)/CD155 triggers CD226 internalization and degradation, resulting in decreased NK cell-mediated tumor reactivity. We also show that IL-15 increases TIGIT and CD226 gene expression by tumor- infiltrating NK cells, and together with TIGIT blockade, increases NK cell-mediated melanoma cytotoxicity in vitro and decreases tumor metastasis in vivo. Collectively, our findings support the novel combinatorial therapy with IL-15 together with TIGIT blockade to promote NK cell-mediated destruction of MHC class I-deficient melanoma, which are refractory to CD8+ T cell-mediated immunity and PD-1 blockade. 3 Downloaded from clincancerres.aacrjournals.org on September 25, 2021. © 2020 American Association for Cancer Research. Author Manuscript Published OnlineFirst on June 26, 2020; DOI: 10.1158/1078-0432.CCR-20-0575 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. Abstract Purpose: Natural Killer (NK) cells play a critical role in tumor immunosurveillance. Multiple activating and inhibitory receptors regulate NK cell-mediated tumor control. The inhibitory receptor TIGIT and its counter-receptor CD226 exert opposite effects on NK cell-mediated tumor reactivity. Experimental design: We evaluated the frequency, phenotype and functions of NK cells freshly isolated from healthy donors and melanoma patients with multiparameter flow cytometry. We assessed TIGIT and CD226 cell surface expression and internalization upon binding to CD155. We evaluated the role of Interleukin (IL)-15 and TIGIT blockade in increasing NK cell-mediated cytotoxicity in vitro and in two mouse models. Results: NK cells are present at low frequencies in metastatic melanoma, are dysfunctional and downregulate both TIGIT and CD226 expression. As compared with TIGIT- NK cells, TIGIT+ NK cells exhibit higher cytotoxic capacity and maturation but paradoxically lower cytotoxicity against CD155+ MHC class I-deficient melanoma cells. Membrane-bound CD155 triggers CD226 internalization and degradation, resulting in decreased NK cell-mediated tumor reactivity. IL-15 increases TIGIT and CD226 gene expression by tumor-infiltrating NK cells (TiNKs) and, together with TIGIT blockade, increases NK cell-mediated melanoma cytotoxicity in vitro and decreases tumor metastasis in two mouse melanoma models. Specific deletion of TIGIT on transferred NK cells enhances the anti-metastatic activity of IL-15, while CD226 blockade decreases the effects of IL-15 and TIGIT blockade. Conclusion: Our findings support the development of novel combinatorial immunotherapy with IL-15 and TIGIT blockade to promote NK cell-mediated destruction 4 Downloaded from clincancerres.aacrjournals.org on September 25, 2021. © 2020 American Association for Cancer Research. Author Manuscript Published OnlineFirst on June 26, 2020; DOI: 10.1158/1078-0432.CCR-20-0575 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. of MHC class I-deficient melanoma, which are refractory to CD8+ T cell-mediated immunity. 5 Downloaded from clincancerres.aacrjournals.org on September 25, 2021. © 2020 American Association for Cancer Research. Author Manuscript Published OnlineFirst on June 26, 2020; DOI: 10.1158/1078-0432.CCR-20-0575 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. Introduction There is ample evidence that NK cells exhibit tumor-killing capacity and play a critical role in mediating tumor immunosurveillance of primary tumors and controlling metastases (1). NK cells express multiple activating receptors (ARs) and inhibitory receptors (IRs) that regulate their function. Hence, therapeutic strategies to engage ARs and/or counteract NK cell inhibition have the potential to promote NK cell-mediated tumor reactivity (2). Solid tumors are usually poorly infiltrated by NK cells (3), thus the phenotypic and functional studies of TiNKs remain very challenging in humans. TiNKs in ovarian, breast, lung and prostate tumors downregulate multiple ARs, including DNAM-1/CD226, CD16, NKG2D, NKp30, NKp46, and 2B4, and are dysfunctional (4- 9). NK cells upregulate multiple IRs that are also expressed by activated T cells, including CD94/NKG2A (10) and the T cell immunoglobulin and ITIM domain (TIGIT) (11). TIGIT binds with high and low affinity to CD155 (PVR) and CD112 (Nectin-2), respectively which are expressed on monocytes, dendritic cells, and tumor cells, including melanoma, and can also bind to the adhesion protein CD113 (Nectin-3) (12). TIGIT competes with its costimulatory counter-receptor CD226 (DNAM-1), which binds to CD155 with lower affinity (11,12). CD226 competes with CD112R for binding to CD112 (Nectin-2) (13,14). In mouse-bearing tumors and in humans, dual PD-1/TIGIT blockade potently augmented tumor-antigen CD8+ T cell functions and promoted tumor rejection (15,16). TIGIT acts in regulatory T cells (Tregs) to promote tumor growth (17), and CD226 opposes TIGIT to disrupt Treg stability in melanoma (18). Several lines of evidence support the critical role of the TIGIT/CD226 axis in regulating NK cell- mediated antitumor activity. First, TIGIT is highly expressed by circulating human NK 6 Downloaded from clincancerres.aacrjournals.org on September 25, 2021. © 2020 American Association for Cancer Research. Author Manuscript Published OnlineFirst on June 26, 2020; DOI: 10.1158/1078-0432.CCR-20-0575 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. cells (cNKs) and impedes NK cell-mediated killing of tumor cells (11). Upon CD155 binding to TIGIT, the ITT-like motif is phosphorylated and binds to Grb2 to recruit the SH domain-containing inositol-5-phosphatase (SHIP1), impeding PI3 and MAP kinase pathways, and NFKB signaling (19,20). Second, CD226 associates with LFA-1 and is recruited to the immunological synapse to promote NK cell-mediated tumor cytotoxicity (21,22). In vivo, CD226 is involved in NK cell-mediated tumor surveillance and control of melanoma metastases and NK cell-mediated lysis of melanoma (23-26). Third, one recent study in mouse tumor models has suggested that TIGIT acted primarily in NK cells to regulate CD8+ T cell-mediated tumor reactivity (27). Among the various cytokines that expand and activate NK cells, IL-15 potently enhances NK cell-mediated tumor killing and is being actively investigated in many clinical trials (1). NK