Targeted Therapy Given after Anti-PD-1 Leads to Prolonged Responses in Mouse Melanoma Models through Sustained Antitumor Immunity

• Published in: Cancer immunology research 2021-05, Vol.9 (5), p.554-567
• Main Authors: Phadke, Manali S, Chen, Zhihua, Li, Jiannong, Mohamed, Eslam, Davies, Michael A, Smalley, Inna, Duckett, Derek R, Palve, Vinayak, Czerniecki, Brian J, Forsyth, Peter A, Noyes, David, Adeegbe, Dennis O, Eroglu, Zeynep, Nguyen, Kimberly T, Tsai, Kenneth Y, Rix, Uwe, Burd, Christin E, Chen, Yian A, Rodriguez, Paulo C, Smalley, Keiran S M
• Format: Article
• Language: English
• Subjects: Animals; Antineoplastic Agents - chemistry; Antineoplastic Agents - therapeutic use; CD8-Positive T-Lymphocytes - immunology; Cell Line, Tumor; Disease Models, Animal; Female; Imidazoles - chemistry; Immunotherapy; Melanoma - drug therapy; Melanoma - genetics; Melanoma - immunology; Mice; Mice, Inbred C3H; Mice, Inbred C57BL; Molecular Targeted Therapy; Monomeric GTP-Binding Proteins - antagonists & inhibitors; Monomeric GTP-Binding Proteins - genetics; Mutation; Oximes - chemistry; Programmed Cell Death 1 Receptor - antagonists & inhibitors; Proto-Oncogene Proteins B-raf - antagonists & inhibitors; Proto-Oncogene Proteins B-raf - genetics; Pyridones - chemistry; Pyrimidines - chemistry; Pyrimidinones - chemistry; Skin Neoplasms - drug therapy; Skin Neoplasms - genetics; Skin Neoplasms - immunology; Sulfones - chemistry; T-Lymphocytes, Regulatory - immunology
• ISSN: 2326-6066; 2326-6074
• DOI: 10.1158/2326-6066.CIR-20-0905

Immunotherapy (IT) and targeted therapy (TT) are both effective against melanoma, but their combination is frequently toxic. Here, we investigated whether the sequence of IT (anti-PD-1)→ TT (ceritinib-trametinib or dabrafenib-trametinib) was associated with improved antitumor responses in mouse models of and -mutant melanoma. Mice with mutant (SW1) or -mutant (SM1) mouse melanomas were treated with either IT, TT, or the sequence of IT→TT. Tumor volumes were measured, and samples from the -mutant melanomas were collected for immune-cell analysis, single-cell RNA sequencing (scRNA-seq), and reverse phase protein analysis (RPPA). scRNA-seq demonstrated that the IT→TT sequence modulated the immune environment, leading to increased infiltration of T cells, monocytes, dendritic cells and natural killer cells, and decreased numbers of tumor-associated macrophages, myeloid-derived suppressor cells, and regulatory T cells. Durable responses to the IT→TT sequence were dependent on T-cell activity, with depletion of CD8 , but not CD4 , T cells abrogating the therapeutic response. An analysis of transcriptional heterogeneity in the melanoma compartment showed the sequence of IT→TT enriched for a population of melanoma cells with increased expression of MHC class I and melanoma antigens. RPPA analysis demonstrated that the sustained immune response induced by IT→TT suppressed tumor-intrinsic signaling pathways required for therapeutic escape. These studies establish that upfront IT improves the responses to TT in and -mutant melanoma models.