Leshem et al. tested locally-delivered, recombinant immunotoxins SS1P or LMB-100 with anti-CTLA-4 checkpoint blockade in mice with one or two tumors of BALB/c breast cancer expressing human mesothelin. The complete regression rate was 86% for injected tumors and 53% for uninjected tumors, indicating efficacy against metastatic tumor growth.

Immune checkpoint blockade using antibodies to cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) benefits a limited number of cancer patients. SS1P and LMB-100 are immunotoxins that target mesothelin. We observed delayed responses to SS1P in patients with mesothelioma suggesting that anti-tumor immunity was induced. Our goal was to stimulate anti-tumor immunity by combining SS1P or LMB-100 with anti-CTLA-4. We constructed a BALB/c breast cancer cell line expressing human mesothelin (66C14-M) which was implanted in one or two locations. SS1P or LMB-100 was injected directly into established tumors and anti-CTLA-4 administered i.p. In mice with two tumors, one tumor was injected with immunotoxin and the other was not. The complete regression rate was 86% for the injected tumors and 53% for the uninjetced tumors. No complete regressions occurred when drugs were given separately. In regressing tumors, dying and dead tumor cells were intermingled with PMNs and surrounded by a collar of admixed eosinophils and mononuclear cells. Tumor regression was associated with increased numbers of tumor infiltrating CD8+ cells and blocked by administration of antibodies to CD8. Surviving mice were protected from tumor rechallenge by 66C14 cells not expressing mesothelin, indicating the development of anti-tumor immunity. The anti-tumor effect was abolished when a mutant non-cytotoxic variant was used instead of LMB-100, showing that the anti-tumor response is not mediated by recognition of a foreign bacterial protein. Our findings support developing a therapy composed of immunotoxins and checkpoint inhibitors for patients.

Author Info: (1) Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health. (2) Laboratory of Molecular Biology, Center for Cancer Re

Author Info: (1) Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health. (2) Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health. (3) Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health. (4) Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health. (5) Vaccine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health. (6) Vaccine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health. (7) Roche Pharmaceutical Research & Early Development, Discovery Oncology, Innovation Center Pennzberg, Roche Diagnostics GmbH. (8) Ablynx nv. (9) Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health. (10) Laboratory of Molecular Immunology, Faculty of Biology and Technion Integrated Cancer Center, Technion-Israel Institute of Technology. (11) Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health pastani@mail.nih.gov.