Toffoli et al. demonstrated that an off-the-shelf, clinical-stage allogeneic NK cell product (derived from ex vivo-expanded and -differentiated umbilical cord blood CD34+ hematopoietic stem cells) induced the differentiation of infiltrating monocytic cells to an activated DC-like phenotype, triggered tumor cell lysis, and controlled tumor growth efficiently in both primary and metastatic colorectal cancer single-cell suspensions. The combination of NK cells with a toll-like receptor 7/8 agonist (R848) activated CD8+ and CD4+ TlLs, reduced activated Tregs, and induced a pro-inflammatory (IFNγ, IL-2, IL-12p70, and IFNα) cytokine and chemokine release profile.

Contributed by Shishir Pant

INTRODUCTION: Natural killer (NK) cells are innate lymphocytes with a key role in the defense against tumors. Recently, allogeneic NK cell-based therapies have gained interest because of their ability to directly lyse tumor cells without inducing graft-versus-host disease. As NK cells are also able to influence the function of other immune cells (most notably dendritic cells (DC)), a better understanding of the effects of allogeneic NK cell products on the host immune system is required. In this study, we analyzed the effects of an allogeneic off-the-shelf NK cell product, on the tumor microenvironment (TME) of primary and metastatic colorectal cancer (pCRC and mCRC, respectively). Moreover, we explored if the combination of NK cells with R848, a toll-like receptors 7/8 ligand, could further enhance any pro-inflammatory effects. METHODS: Ex vivo expanded umbilical cord blood stem cell derived NK cells were co-cultured with pCRC or mCRC single-cell suspensions in the presence or absence of R848 for 5_days, during and after which flow cytometry and cytokine release profiling were performed. RESULTS: NK cells efficiently induced lysis of tumor cells in both pCRC and mCRC single-cell suspensions and thereby controlled growth rates during culture. They also induced differentiation of infiltrating monocytic cells to an activated DC phenotype. Importantly, this NK-mediated myeloid conversion was also apparent in cultures after tumor cell depletion and was further enhanced by combining NK cells with R848. Moreover, NK cells, and to a greater extent, the combination of NK cells and R848, triggered CD8(+) and CD4(+) T-cell activation as well as a reduction in activated regulatory T cell rates. Finally, the combination of NK cells and R848 induced a pro-inflammatory shift in the cytokine release profile resulting in higher levels of interferon (IFN)-_, interleukin (IL)-2, IL-12p70, and IFN-_ as well as a reduction in IL-6, in both pCRC and mCRC cultures. CONCLUSION: Allogeneic NK cells engaged in favorable myeloid crosstalk, displayed effective antitumor activity and, when combined with R848, induced a pro-inflammatory shift of the CRC TME. These findings prompt the investigation of NK cells and R848 as a combination therapy for solid tumors.

Author Info: (1) Department of Medical Oncology, Amsterdam UMC, Location Vrije Universiteit, Amsterdam, The Netherlands. Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The N

Author Info: (1) Department of Medical Oncology, Amsterdam UMC, Location Vrije Universiteit, Amsterdam, The Netherlands. Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands. Amsterdam Institute for Infection and Immunity, Amsterdam, The Netherlands. (2) Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands. Amsterdam Institute for Infection and Immunity, Amsterdam, The Netherlands. Glycostem Therapeutics, Oss, The Netherlands. Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Location Vrije Universiteit, Amsterdam, The Netherlands. (3) Department of Medical Oncology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. (4) Department of Medical Oncology, Amsterdam UMC, Location Vrije Universiteit, Amsterdam, The Netherlands. Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands. Lava Therapeutics, Utrecht, The Netherlands. (5) Department of Surgery, Amsterdam UMC, Location Vrije Universiteit, Amsterdam, The Netherlands. (6) Glycostem Therapeutics, Oss, The Netherlands. (7) Department of Medical Oncology, Amsterdam UMC, Location Vrije Universiteit, Amsterdam, The Netherlands td.degruijl@amsterdamumc.nl. Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands. Amsterdam Institute for Infection and Immunity, Amsterdam, The Netherlands.