Heterodimeric IL-15 in Cancer Immunotherapy

NIH Pandemic-Era Grants

Pandemic Era Grants

2022

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Principal Investigator: George N. Pavlakis
Organization: DIVISION OF BASIC SCIENCES - NCI
Fiscal Year: 2022
Award: $1,137,140
Funding agency: National Cancer Institute

We explored the biology of IL-15 and showed that efficient production of IL-15 is      possible only by co-expression in the same cell with the so-called IL-15 Receptor-alpha. We      have shown that IL-15 injection accelerates the recovery of lymphocytes in mice rendered      lymphopenic after treatment with cytotoxic drugs. We also showed that hetIL-15 can replace the      need for lymphodepletion in Adoptive Cell Transfer (ACT), since the transferred cells can      survive, proliferate and enter the tumors after hetIL-15 treatment. This may have important      clinical implications for ACT protocols. We have used the previously developed technologies of      RNA optimization to optimize expression of IL-15 cytokine, and have shown that we can      over-produce bioactive cytokine after DNA delivery in mice and macaques. DNA delivery of      vectors expressing heterodimeric IL-15 leads to systemically active levels of cytokine and the      increased proliferation of NK and T cells. We have shown that hetIL-15 greatly increases      lymphocyte infiltration in several tumors in mouse models and in macaques, suggesting a      general method to increase lymphocyte infiltration, which is associated with anti-tumor      activity. On the basis of these results, we have developed first-in-human clinical trials of      hetIL-15 in metastatic cancers and also in combination with anti-PD-1 check point inhibitor      (NCT02452268; collaboration with Novartis). In addition to cancer immunotherapy, IL-15 has      generated strong interest for clinical use to treat HIV infection, especially in protocols      targeting viral eradication or a functional cure. The use of IL-15 as an immune therapeutic      agent against HIV infection is based on its effects as a growth factor and key regulator of      cytotoxic responses mediated by both the innate (NK cells) and the adaptive (CTL) arms of the      immune system. Using hetIL-15 treatment in the RM model for HIV infection, we have      demonstrated that: (i) a regimen with increasing dosing (step-dose) of hetIL-15 is well      tolerated by different routes of delivery and increases T lymphocytes (CD8, CD4 and      gamma/delta) and NK cells with high granzyme content in peripheral blood, mucosal sites and      LN. (ii) Importantly, hetIL-15 treatment promotes the entrance of cytotoxic (GrzB+) CD8+ T      cells in the B cell follicles, areas within the LN where CTL are typically excluded and where      SIV/HIV infected follicular helper CD4+ T cells reside. hetIL-15 treatment led to significant      decrease in cell-associated viral RNA within the LN as well as in plasma viremia in SHIV      infected macaques. (iii) We also showed that hetIL-15 can enhance ADCC in LN, which provides      an additional mechanism of elimination of infected cells. We have shown that hetIL-15 is      incorporated in exosomes and have produced sufficient quantities for animal experiments.      Extensive transcriptomics and proteomics analysis has revealed additional pathways affected by      hetIL-15 pharmacologically. Of note, we have studied the effects of hetIL-15 in the number and      properties of Dendritic Cells (DC) in tumors. We have demonstrated that DC in tumors increase      upon hetIL-15 treatment. DC participate in a network of cells that are induced during hetIL-15      treatment and in turn support more recruitment of effector cells in tumor sites. In      experiments that show the importance of IL-15 on the development of immune response, we      identified a systemic signature in blood of cytokines induced transiently after vaccination by      the Pfizer mRNA vaccine. This signature includes increases in IL-15, IFN-gamma, and      IP-10/CXCL10 after the 1st vaccination, which were enriched by tumor necrosis factor alpha      (TNF-alpha) and IL-6 after the 2nd vaccination. In previously COVID-19-infected individuals, a      single vaccination resulted in both strong cytokine induction and antibody titers similar to      the ones observed upon booster vaccination in antigen-naive individuals, a result with      potential implication for future public health recommendations. In an additional line of      research, we have shown in collaborative work with colleagues in Oregon, Seattle and Uppsala      that IL-15 transcriptional signature predicts protection by another viral vaccine: The      differential IL-15 gene set response to RhCMV/SIV vaccine strongly correlated with the      pre-vaccination activity of this pathway, with reduced baseline expression of IL-15 response      genes significantly correlating with higher vaccine-induced IL-15 signaling and subsequent      vaccine protection, suggesting that a robust de novo vaccine-induced IL-15 signaling response      is needed to program vaccine efficacy. The RhCMV/SIV vaccine imparts a coordinated and      persistent induction of innate and adaptive immune pathways featuring IL-15, a known regulator      of CD8+ T cell function, that support the ability of vaccine-elicited unconventionally      restricted CD8+ T cells to mediate protection against SIV challenge. We have used optimal      therapeutic vaccination, and a combination of therapeutic interventions in macaque model of      chronic controlled SIN infection under Antiretroviral therapy. We used our candidate      immunotherapy drug hetIL-15 in combinations with anti-PD-1, broadly neutralizing Antibodies      against SIV, or therapeutic vaccination. Our results provide for the first time the exciting      possibility that optimal treatment protocols can decrease virus reservoir as measured in blood      and lymph nodes. The analysis of a 56-macaque study is finalized and this should be used as      proof-of-concept for human clinical studies. We have continued to work on mouse models of      cancer to examine mode of action of our candidate immunotherapy drug, hetIL-15.      Triple-negative breast cancer (TNBC) is considered the most aggressive and difficult to treat      breast cancer type. We have tested hetIL-15 in combination with chemotherapy and surgical      removal of the primary tumor and evaluated the anti-metastatic potential of these combinations      in mice bearing orthotropic TNBC tumors. We showed that hetIL-15 exhibits its anti-metastatic      activity by both diminishing circulating tumor cells (CTCs) shed by the primary tumor and by      suppressing local metastasis formation in the lungs. Co-administration with doxorubicin      enhances the anti-metastatic effect and skews the immune landscape towards an effector over      immunosuppressive phenotype. Our findings further show that hetIL-15, alone or in combination      with Doxorubicin, eliminates metastases in lungs of tumor resected mice leading not only to      cures but also to immunological memory against the primary tumor. Thus, these      chemo-immunotherapeutic combinations may be important for improving current therapeutic      approaches against TNBC. We have also explored locoregional administration of hetIL-15 in an      orthotopic TNBC mouse models. Optimal monotherapy treatment by hetIL-15 resulted in tumor      eradication in 40% of treated mice, reduction of metastasis and induction of immunological      memory against breast cancer cells. hetIL-15 re-shaped the tumor microenvironment by promoting      the intratumoral accumulation of cytotoxic lymphocytes, conventional type 1 dendritic cells      (cDC1s) and a novel DC population expressing both CD11b and CD103 markers. These      CD103intCD11b+DCs share phenotypic and gene expression characteristics with both cDC1s and      cDC2s, have transcriptomic profiles similar to monocyte-derived DCs (moDCs) and correlate with      tumor regression. Therefore, hetIL-15, a cytokine directly affecting lymphocytes and inducing      cytotoxic cells, has also an indirect rapid and significant effect on the recruitment of      myeloid cells, initiating a cascade for tu *TRUNCATED*

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