TY - JOUR
T1 - Local delivery of low-dose anti-CTLA-4 to the melanoma lymphatic basin leads to systemic Treg reduction and effector T cell activation
AU - van Pul, Kim M.
AU - Notohardjo, Jessica C. L.
AU - Fransen, Marieke F.
AU - Koster, Bas D.
AU - Stam, Anita G. M.
AU - Chondronasiou, Dafni
AU - Lougheed, Sinéad M.
AU - Bakker, Joyce
AU - Kandiah, Vinitha
AU - van den Tol, M. Petrousjka
AU - Jooss, Karin
AU - Vuylsteke, Ronald J. C. L. M.
AU - van den Eertwegh, Alfons J. M.
AU - de Gruijl, Tanja D.
N1 - Funding Information: This work was supported by grants from the Harry J. Lloyd Charitable Trust (to A.J.M.v.d.E. and T.D.d.G.) and Dutch Cancer Society (KWF) grant no. 14102 (to M.F.F. and T.D.d.G.). Tremelimumab was provided by Pfizer Inc. Publisher Copyright: Copyright © 2022 The Authors, some rights reserved.
PY - 2022/7/15
Y1 - 2022/7/15
N2 - Preclinical studies show that locoregional CTLA-4 blockade is equally effective in inducing tumor eradication as systemic delivery, without the added risk of immune-related side effects. This efficacy is related to access of the CTLA-4 blocking antibodies to tumor-draining lymph nodes (TDLNs). Local delivery of anti-CTLA-4 after surgical removal of primary melanoma, before sentinel lymph node biopsy (SLNB), provides a unique setting to clinically assess the role of TDLN in the biological efficacy of locoregional CTLA-4 blockade. Here, we have evaluated the safety, tolerability, and immunomodulatory effects in the SLN and peripheral blood of a single dose of tremelimumab [a fully human immunoglobulin gamma-2 (IgG2) mAb directed against CTLA-4] in a dose range of 2 to 20 mg, injected intradermally at the tumor excision site 1 week before SLNB in 13 patients with early-stage melanoma (phase 1 trial; NCT04274816). Intradermal delivery was safe and well tolerated and induced activation of migratory dendritic cell (DC) subsets in the SLN. It also induced profound and durable decreases in regulatory T cell (Treg) frequencies and activation of effector T cells in both SLN and peripheral blood. Moreover, systemic T cell responses against NY-ESO-1 or MART-1 were primed or boosted (N = 7), in association with T cell activation and central memory T cell differentiation. These findings indicate that local administration of anti-CTLA-4 may offer a safe and promising adjuvant treatment strategy for patients with early-stage melanoma. Moreover, our data demonstrate a central role for TDLN in the biological efficacy of CTLA-4 blockade and support TDLN-targeted delivery methods.
AB - Preclinical studies show that locoregional CTLA-4 blockade is equally effective in inducing tumor eradication as systemic delivery, without the added risk of immune-related side effects. This efficacy is related to access of the CTLA-4 blocking antibodies to tumor-draining lymph nodes (TDLNs). Local delivery of anti-CTLA-4 after surgical removal of primary melanoma, before sentinel lymph node biopsy (SLNB), provides a unique setting to clinically assess the role of TDLN in the biological efficacy of locoregional CTLA-4 blockade. Here, we have evaluated the safety, tolerability, and immunomodulatory effects in the SLN and peripheral blood of a single dose of tremelimumab [a fully human immunoglobulin gamma-2 (IgG2) mAb directed against CTLA-4] in a dose range of 2 to 20 mg, injected intradermally at the tumor excision site 1 week before SLNB in 13 patients with early-stage melanoma (phase 1 trial; NCT04274816). Intradermal delivery was safe and well tolerated and induced activation of migratory dendritic cell (DC) subsets in the SLN. It also induced profound and durable decreases in regulatory T cell (Treg) frequencies and activation of effector T cells in both SLN and peripheral blood. Moreover, systemic T cell responses against NY-ESO-1 or MART-1 were primed or boosted (N = 7), in association with T cell activation and central memory T cell differentiation. These findings indicate that local administration of anti-CTLA-4 may offer a safe and promising adjuvant treatment strategy for patients with early-stage melanoma. Moreover, our data demonstrate a central role for TDLN in the biological efficacy of CTLA-4 blockade and support TDLN-targeted delivery methods.
UR - http://www.scopus.com/inward/record.url?scp=85134854372&partnerID=8YFLogxK
U2 - https://doi.org/10.1126/sciimmunol.abn8097
DO - https://doi.org/10.1126/sciimmunol.abn8097
M3 - Article
C2 - 35857579
SN - 2470-9468
VL - 7
SP - eabn8097
JO - Science immunology
JF - Science immunology
IS - 73
M1 - eabn8097
ER -