Pan-TGFβ inhibition by SAR439459 relieves immunosuppression and improves antitumor efficacy of PD-1 blockade
Spotlight Rita Greco (a), Hongjing Qu (a), Hui Qu (b), Joachim Theilhaber (c), Gary Shapiro (a), Richard Gregory (a), Christopher Winter (a), Natalia Malkova (b), Frank Sun (b), Julie Jaworski (d), Annie Best (d), Lily Pao (a), Andrew Hebert (e), Mikhail Levit (e), Alexei Protopopov (c), Jack Pollard (c), Ketih Bahjat (a), Dmitri Wiederschain (a) and Sharad Sharma (a).
Greco and Qu et al. investigated SAR439459, a second-generation pan-TGFβ-neutralizing antibody, in preclinical studies to elucidate its role in antitumor immunity. Comparably active in vitro to fresolimumab, SAR439459 impaired tumor growth in syngeneic tumor models. In combination with anti-PD-1, SAR439459 increased i.t. cytokines (IFNγ, TNFα, and IL-6) by inhibiting tumor TGFβ levels, and resulted in complete tumor regression and long-term immunity. ScRNA sequencing indicated the combination boosted proliferation and decreased exhaustion of CD8+ T cells in the tumor and draining LNs. Human MLR assays demonstrated comparable effects.
Contributed by Katherine Turner
Rita Greco (a), Hongjing Qu (a), Hui Qu (b), Joachim Theilhaber (c), Gary Shapiro (a), Richard Gregory (a), Christopher Winter (a), Natalia Malkova (b), Frank Sun (b), Julie Jaworski (d), Annie Best (d), Lily Pao (a), Andrew Hebert (e), Mikhail Levit (e), Alexei Protopopov (c), Jack Pollard (c), Ketih Bahjat (a), Dmitri Wiederschain (a) and Sharad Sharma (a).
Greco and Qu et al. investigated SAR439459, a second-generation pan-TGFβ-neutralizing antibody, in preclinical studies to elucidate its role in antitumor immunity. Comparably active in vitro to fresolimumab, SAR439459 impaired tumor growth in syngeneic tumor models. In combination with anti-PD-1, SAR439459 increased i.t. cytokines (IFNγ, TNFα, and IL-6) by inhibiting tumor TGFβ levels, and resulted in complete tumor regression and long-term immunity. ScRNA sequencing indicated the combination boosted proliferation and decreased exhaustion of CD8+ T cells in the tumor and draining LNs. Human MLR assays demonstrated comparable effects.
Contributed by Katherine Turner
ABSTRACT: TGFβ is a pleiotropic cytokine that may have both tumor inhibiting and tumor promoting properties, depending on tissue and cellular context. Emerging data support a role for TGFβ in suppression of antitumor immunity. Here we show that SAR439459, a pan-TGFβ neutralizing antibody, inhibits all active isoforms of human and murine TGFβ, blocks TGFβ-mediated pSMAD signaling, and TGFβ-mediated suppression of T cells and NK cells. In vitro, SAR439459 synergized with anti-PD1 to enhance T cell responsiveness. In syngeneic tumor models, SAR439459 treatment impaired tumor growth, while the combination of SAR439459 with anti–PD-1 resulted in complete tumor regression and a prolonged antitumor immunity. Mechanistically, we found that TGFβ inhibition with PD-1 blockade augmented intratumoral CD8+ T cell proliferation, reduced exhaustion, evoked proinflammatory cytokines, and promoted tumor-specific CD8+ T cell responses. Together, these data support the hypothesis that TGFβ neutralization using SAR439459 synergizes with PD-1 blockade to promote antitumor immunity and formed the basis for the ongoing clinical investigation of SAR439459 in patients with cancer (NCT03192345).
Author Info: (a) Immuno-Oncology Research, Sanofi, 640 memorial drive, Cambridge; (b) Oncology In Vivo Pharmacology, Sanofi, 640 memorial drive, Cambridge; (c) Precision Oncology, Sanofi, 270 a
Author Info: (a) Immuno-Oncology Research, Sanofi, 640 memorial drive, Cambridge; (b) Oncology In Vivo Pharmacology, Sanofi, 640 memorial drive, Cambridge; (c) Precision Oncology, Sanofi, 270 albany street, Cambridge; (d) Biologics Research, Sanofi, 49 New York Ave, Framingham; (e) Translational Sciences, Sanofi, Cambridge, MA, US.
Citation: OncoImmunology Volume 9, 2020 Issue 1