To overcome immunosuppression in solid tumors, Albershardt et al. evaluated intratumoral delivery of synthetic TLR4 agonist glucopyranosyl lipid A (G100) with either an antitumor vaccine (ZVex) or adoptive cell therapy (ACT). G100 combined with either ZVex or ACT significantly improved survival in mice with established melanomas, and G100 with ZVex caused complete remissions in orthotopic glioblastomas. Increased numbers of activated CD8+ TILs, enhanced antigen spreading, durable CD8+ T cell memory, and regression of both noninjected and injected tumors were only seen in mice receiving combination TLR4-based immunotherapy.
Contributed by Katherine Turner
ABSTRACT: Effective T cell-based immunotherapy of solid malignancies requires intratumoral activity of cytotoxic T cells and induction of protective immune memory. A major obstacle to intratumoral trafficking and activation of vaccine-primed or adoptively transferred tumor-specific T cells is the immunosuppressive tumor microenvironment (TME), which currently limits the efficacy of both anti-tumor vaccines and adoptive cell therapy (ACT). Combination treatments to overcome TME-mediated immunosuppression are therefore urgently needed. We combined intratumoral administration of the synthetic toll-like receptor 4 agonist glucopyranosyl lipid A (oil-in-water formulation, G100) with either active vaccination or adoptive transfer of tumor-specific CD8 T cells to mice bearing established melanomas or orthotopically inoculated glioblastomas. In combination with cancer vaccines or ACT, G100 significantly increased expression of innate immune genes, infiltration and expansion of activated effector T cells, antigen spreading, and durable immune responses. Complete tumor regression of both injected and non-injected tumors was observed only in mice receiving combination immunotherapy. TLR4-based intratumoral immune activation may be a viable approach to enhance the efficacy of therapeutic cancer vaccines and ACT in patients.