Blockade of PD-1 on murine ovarian tumor-infiltrating dendritic cells (TIDC) led to an increased release of IL-10, which in turn increased PD-1 expression on TIDCs, creating an immune escape feedback loop. While either monotherapy was ineffective, combination of anti-PD-1 and anti-IL-10/IL-10R prolonged survival by enhancing the infiltration of activated tumor-specific T and B cells and by reducing the recruitment of myeloid-derived suppressor cells into the ascites of tumor-bearing mice.

Ligation of PD-1 in the tumor microenvironment is known to inhibit effective adaptive anti-tumor immunity. Blockade of PD-1 in humans has resulted in impressive, durable regression responses in select tumor types. However, durable responses have been elusive in ovarian cancer patients. PD-1 was recently shown to be expressed on and thereby impair the functions of tumor-infiltrating murine and human myeloid dendritic cells (TIDC) in ovarian cancer. In the present work, we characterize the regulation of PD-1 expression and the effects of PD-1 blockade on TIDC. Treatment of TIDC and bone marrow-derived DC with IL-10 led to increased PD-1 expression. Both groups of DC also responded to PD-1 blockade by increasing production of IL-10. Similarly, treatment of ovarian tumor-bearing mice with PD-1 blocking antibody resulted in an increase in IL-10 levels in both serum and ascites. While PD-1 blockade or IL-10 neutralization as monotherapies were inefficient, combination of these two led to improved survival and delayed tumor growth; this was accompanied by augmented anti-tumor T and B cell responses and decreased infiltration of immunosuppressive MDSC. Taken together, our findings implicate compensatory release of IL-10 as one of the adaptive resistance mechanisms that undermine the efficacy of anti-PD-1 (or anti-PD-L1) monotherapies and prompts further studies aimed at identifying such resistance mechanisms.

Author Info: (1) Department of Immunology, Mayo Clinic. (2) Translational Research, Iovance Biotherapeutics, Inc. (3) Immunology, Mayo Clinic. (4) Immunology, Mayo Clinic. (5) Immunology, Mayo

Author Info: (1) Department of Immunology, Mayo Clinic. (2) Translational Research, Iovance Biotherapeutics, Inc. (3) Immunology, Mayo Clinic. (4) Immunology, Mayo Clinic. (5) Immunology, Mayo Clinic. (6) Research, Mayo Clinic. (7) Medical Oncology, Mayo Clinic. (8) Department of Health Sciences Research, Mayo Clinic College of Medicine. (9) Medical Oncology, Mayo Clinic. (10) Microbiology and Immunology, University of Arkansas for Medical Sciences. (11) Immunology, Mayo Clinic knutson.keith@mayo.edu.