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      Interferon gene therapy reprograms the leukemia microenvironment inducing protective immunity to multiple tumor antigens

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          Abstract

          Immunotherapy is emerging as a new pillar of cancer treatment with potential to cure. However, many patients still fail to respond to these therapies. Among the underlying factors, an immunosuppressive tumor microenvironment (TME) plays a major role. Here we show that monocyte-mediated gene delivery of IFNα inhibits leukemia in a mouse model. IFN gene therapy counteracts leukemia-induced expansion of immunosuppressive myeloid cells and imposes an immunostimulatory program to the TME, as shown by bulk and single-cell transcriptome analyses. This reprogramming promotes T-cell priming and effector function against multiple surrogate tumor-specific antigens, inhibiting leukemia growth in our experimental model. Durable responses are observed in a fraction of mice and are further increased combining gene therapy with checkpoint blockers. Furthermore, IFN gene therapy strongly enhances anti-tumor activity of adoptively transferred T cells engineered with tumor-specific TCR or CAR, overcoming suppressive signals in the leukemia TME. These findings warrant further investigations on the potential development of our gene therapy strategy towards clinical testing.

          Abstract

          An immune suppressive tumor microenvironment (TME) is a limitation for immunotherapy. Here the authors show that, in a B cell acute lymphoblastic leukemia mouse model, gene-based delivery of IFNα  reprograms the leukemia-induced immunosuppressive TME into immunostimulatory and enhances T-cell responses.

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          Most cited references21

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          Antitumour actions of interferons: implications for cancer therapy.

          The interferons (IFNs) are a family of cytokines that protect against disease by direct effects on target cells and by activating immune responses. The production and actions of IFNs are finely tuned to achieve maximal protection and avoid the potential toxicity associated with excessive responses. IFNs are back in the spotlight owing to mounting evidence that is reshaping how we can exploit this pathway therapeutically. As IFNs can be produced by, and act on, both tumour cells and immune cells, understanding this reciprocal interaction will enable the development of improved single-agent or combination therapies that exploit IFN pathways and new 'omics'-based biomarkers to indicate responsive patients.
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            Type I interferon responses in rhesus macaques prevent SIV infection and slow disease progression.

            Inflammation in HIV infection is predictive of non-AIDS morbidity and death, higher set point plasma virus load and virus acquisition; thus, therapeutic agents are in development to reduce its causes and consequences. However, inflammation may simultaneously confer both detrimental and beneficial effects. This dichotomy is particularly applicable to type I interferons (IFN-I) which, while contributing to innate control of infection, also provide target cells for the virus during acute infection, impair CD4 T-cell recovery, and are associated with disease progression. Here we manipulated IFN-I signalling in rhesus macaques (Macaca mulatta) during simian immunodeficiency virus (SIV) transmission and acute infection with two complementary in vivo interventions. We show that blockade of the IFN-I receptor caused reduced antiviral gene expression, increased SIV reservoir size and accelerated CD4 T-cell depletion with progression to AIDS despite decreased T-cell activation. In contrast, IFN-α2a administration initially upregulated expression of antiviral genes and prevented systemic infection. However, continued IFN-α2a treatment induced IFN-I desensitization and decreased antiviral gene expression, enabling infection with increased SIV reservoir size and accelerated CD4 T-cell loss. Thus, the timing of IFN-induced innate responses in acute SIV infection profoundly affects overall disease course and outweighs the detrimental consequences of increased immune activation. Yet, the clinical consequences of manipulation of IFN signalling are difficult to predict in vivo and therapeutic interventions in human studies should be approached with caution.
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              Neoantigen landscape dynamics during human melanoma-T cell interactions.

              Recognition of neoantigens that are formed as a consequence of DNA damage is likely to form a major driving force behind the clinical activity of cancer immunotherapies such as T-cell checkpoint blockade and adoptive T-cell therapy. Therefore, strategies to selectively enhance T-cell reactivity against genetically defined neoantigens are currently under development. In mouse models, T-cell pressure can sculpt the antigenicity of tumours, resulting in the emergence of tumours that lack defined mutant antigens. However, whether the T-cell-recognized neoantigen repertoire in human cancers is constant over time is unclear. Here we analyse the stability of neoantigen-specific T-cell responses and the antigens they recognize in two patients with stage IV melanoma treated by adoptive T-cell transfer. The T-cell-recognized neoantigens can be selectively lost from the tumour cell population, either by overall reduced expression of the genes or loss of the mutant alleles. Notably, loss of expression of T-cell-recognized neoantigens was accompanied by development of neoantigen-specific T-cell reactivity in tumour-infiltrating lymphocytes. These data demonstrate the dynamic interactions between cancer cells and T cells, which suggest that T cells mediate neoantigen immunoediting, and indicate that the therapeutic induction of broad neoantigen-specific T-cell responses should be used to avoid tumour resistance.
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                Author and article information

                Contributors
                gentner.bernhard@hsr.it
                naldini.luigi@hsr.it
                Journal
                Nat Commun
                Nat Commun
                Nature Communications
                Nature Publishing Group UK (London )
                2041-1723
                24 July 2018
                24 July 2018
                2018
                : 9
                : 2896
                Affiliations
                [1 ]GRID grid.15496.3f, Vita-Salute San Raffaele University, ; 20132 Milan, Italy
                [2 ]ISNI 0000000417581884, GRID grid.18887.3e, Targeted Cancer Gene Therapy Unit, , IRCCS San Raffaele Scientific Institute, ; 20132 Milan, Italy
                [3 ]ISNI 0000000417581884, GRID grid.18887.3e, San Raffaele Telethon Institute for Gene Therapy, ; 20132 Milan, Italy
                [4 ]ISNI 0000000417581884, GRID grid.18887.3e, Division of Immunology, Transplant and Infectious Diseases, , IRCCS San Raffaele Scientific Institute, ; 20132 Milan, Italy
                [5 ]GRID grid.15496.3f, CUSSB-University Center for Statistics in the Biomedical Sciences, , Vita-Salute San Raffaele University, ; 20132 Milan, Italy
                [6 ]ISNI 0000000417581884, GRID grid.18887.3e, Centre for Translational Genomics and Bioinformatics, , IRCCS San Raffaele Scientific Institute, ; 20132 Milan, Italy
                [7 ]ISNI 0000000417581884, GRID grid.18887.3e, Hematology and Bone Marrow Transplantation Unit, , IRCCS San Raffaele Scientific Institute, ; 20132 Milan, Italy
                Author information
                http://orcid.org/0000-0003-0384-3700
                Article
                5315
                10.1038/s41467-018-05315-0
                6057972
                30042420
                8e4edc35-7f75-4d53-a917-4a34c22f2cac
                © The Author(s) 2018

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 16 March 2018
                : 14 June 2018
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