In a mouse OVA⁺ melanoma model, D’Anniballe et al. showed that the effects of OVA-monocyte vaccination, anti-PD-1, anti-PD-L1 or anti-CTLA-4 on s.c. tumor volume were greatest when ICB was combined with monocyte vaccination. Flt3 ligand (FltL3) treatment prior to OVA-monocyte vaccination expanded splenic DCs (>40X) and circulating OVA-specific T cells (2X). Flt3 + OVA-monocyte vaccination inhibited OVA⁺ tumor growth more than ICB alone. OVA-monocyte vaccination + Flt3L + anti-PD-1 induced the greatest increases in the frequency of circulating Ag-specific CD8⁺ T cells (including those secreting IFNγ) and reductions of OVA⁺ tumor growth.

Contributed by Paula Hochman

ABSTRACT: Undifferentiated monocytes can be loaded with tumor antigens (Ag) and administered intravenously to induce antitumor cytotoxic T lymphocyte (CTL) responses. This vaccination strategy exploits an endogenous Ag cross-presentation pathway, where Ag-loaded monocytes (monocyte vaccines) transfer their Ag to resident splenic dendritic cells (DC), which then stimulate robust CD8+ CTL responses. In this study, we investigated whether monocyte vaccination in combination with CDX-301, a DC-expanding cytokine Fms-like tyrosine kinase 3 ligand (Flt3L), could improve the antitumor efficacy of anti-programmed cell death (anti-PD-1) immune checkpoint blockade. We found that Flt3L expanded splenic DC over 40-fold in vivo and doubled the number of circulating Ag-specific T cells when administered before monocyte vaccination in C57BL/6 mice. In addition, OVA-monocyte vaccination combined with either anti-PD-1, anti-programmed cell death ligand 1 (anti-PD-L1), or anti-cytotoxic T lymphocyte antigen-4 (anti-CTLA-4) suppressed subcutaneous B16/F10-OVA tumor growth to a greater extent than checkpoint blockade alone. When administered together, OVA-monocyte vaccination improved the antitumor efficacy of Flt3L and anti-PD-1 in terms of circulating Ag-specific CD8+ T cell frequency and inhibition of subcutaneous B16/F10-OVA tumor growth. To our knowledge, this is the first demonstration that a cancer vaccine strategy and Flt3L can improve the antitumor efficacy of anti-PD-1. The findings presented here warrant further study of how monocyte vaccines can improve Flt3L and immune checkpoint blockade as they enter clinical trials.

Author Info: (1) Department of Immunology, Duke University Medical Center, Durham, NC. Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC. (2) Regeneron

Author Info: (1) Department of Immunology, Duke University Medical Center, Durham, NC. Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC. (2) Regeneron Pharmaceuticals, Tarrytown, NY. (3) Department of Immunology, Duke University Medical Center, Durham, NC. Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC. (4) Department of Dermatology, University of Utah School of Medicine, UT. (5) Department of Immunology, Duke University Medical Center, Durham, NC. Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC. (6) Department of Immunology, Duke University Medical Center, Durham, NC. Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC.