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American Society of Hematology, Blood, Supplement_1(134), p. 624-624, 2019

DOI: 10.1182/blood-2019-128724

American Association for the Advancement of Science, Science Immunology, 39(4), 2019

DOI: 10.1126/sciimmunol.aau8943

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RIG-I activation is critical for responsiveness to checkpoint blockade

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

Achieving durable clinical responses to immune checkpoint inhibitors still remains a challenge. Here we demonstrate in preclinical models that immunotherapy with anti-CTLA-4 and its combination with anti-PD-1 rely on tumor cell-intrinsic activation of the cytosolic RNA receptor RIG-I (Fig. 1A). Mechanistically, tumor cell-intrinsic RIG-I signaling induced caspase-3-mediated tumor cell death, cross-presentation of tumor-associated antigen by CD103+ dendritic cells, subsequent expansion of tumor antigen-specific CD8+ T cells, and their accumulation within tumor tissue. Consistently, therapeutic targeting of RIG-I with 5'-triphosphorylated-RNA in both tumor and non-malignant host cells potently augmented the efficacy of CTLA-4 checkpoint blockade in several tumor models. In humans, transcriptome analysis of primary melanoma samples revealed a strong association between high expression of DDX58 (the gene encoding RIG-I), T cell receptor and antigen presentation pathway activity and prolonged overall survival (Fig. 1B). Moreover, in melanoma patients treated with anti-CTLA-4 checkpoint blockade, high RIG-I transcriptional activity significantly associated with durable clinical responses (Fig. 1C). Our preclinical data further demonstrate that tumor cell-intrinsic RIG-I signaling is also an essential pathway for the efficacy of other immunomodulating anticancer treatments including radiotherapy or hypomethylating agents such as 5-azacytidine. We thus identify aberrant tumor cell-intrinsic RIG-I signaling to be a crucial mechanism underlying cancer resistance to checkpoint inhibitor-based and other immunotherapies. These data have immediate translational potential as a RIG-I agonist for human application has been tested in phase I/II clinical trials with local administration in solid tumors and lymphomas (NCT03065023). Intratumoral RIG-I gene expression may not only serve as a biomarker to select patients that will likely benefit from anti-CTLA-4 therapy, but clinical RIG-I targeting in patients may also increase overall response rates of checkpoint inhibitor-based immunotherapy of malignancy including lymphoma. Figure 1. (A) Wild-type (WT) mice were bilaterally challenged with either WT or RIG-I-deficient (RIG-I-/-) B16.OVA melanoma cells.Recipients were repeatedly treated with anti-CTLA-4. Some mice were additionally injected with the RIG-I ligand 3pRNA into the right-sided tumor. Overall survival of treated mice bearing WT or RIG-I-/- B16.OVA tumors. (B) Overall survival in 456 TCGA melanoma patients by expression of DDX58 (RIG-I) in tumor samples. (C)DDX58 (RIG-I) expression in tumor samples from 18 patients with durable clinical response to anti-CTLA-4 treatment versus non-responders. Date give values from individual patients + geometric mean. Figure 1 Disclosures van den Brink: Seres Therapeutics: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Flagship Ventures: Consultancy, Honoraria; Novartis: Consultancy, Honoraria; Evelo: Consultancy, Honoraria; Jazz Pharmaceuticals: Consultancy, Honoraria; Therakos: Consultancy, Honoraria; Amgen: Consultancy, Honoraria; Merck & Co, Inc.: Consultancy, Honoraria; Acute Leukemia Forum (ALF): Consultancy, Honoraria; Magenta and DKMS Medical Council: Membership on an entity's Board of Directors or advisory committees; Juno Therapeutics: Other: Licensing.