JCI Insight (Oct 2023)

Overcoming lung cancer immunotherapy resistance by combining nontoxic variants of IL-12 and IL-2

  • Brendan L. Horton,
  • Alicia D. D’Souza,
  • Maria Zagorulya,
  • Chloe V. McCreery,
  • Gita C. Abhiraman,
  • Lora Picton,
  • Allison Sheen,
  • Yash Agarwal,
  • Noor Momin,
  • K. Dane Wittrup,
  • Forest M. White,
  • K. Christopher Garcia,
  • Stefani Spranger

Journal volume & issue
Vol. 8, no. 19

Abstract

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Engineered cytokine–based approaches for immunotherapy of cancer are poised to enter the clinic, with IL-12 being at the forefront. However, little is known about potential mechanisms of resistance to cytokine therapies. We found that orthotopic murine lung tumors were resistant to systemically delivered IL-12 fused to murine serum albumin (MSA, IL12-MSA) because of low IL-12 receptor (IL-12R) expression on tumor-reactive CD8+ T cells. IL2-MSA increased binding of IL12-MSA by tumor-reactive CD8+ T cells, and combined administration of IL12-MSA and IL2-MSA led to enhanced tumor-reactive CD8+ T cell effector differentiation, decreased numbers of tumor-infiltrating CD4+ regulatory T cells, and increased survival of lung tumor–bearing mice. Predictably, the combination of IL-2 and IL-12 at therapeutic doses led to significant dose-limiting toxicity. Administering IL-12 and IL-2 analogs with preferential binding to cells expressing Il12rb1 and CD25, respectively, led to a significant extension of survival in mice with lung tumors while abrogating dose-limiting toxicity. These findings suggest that IL-12 and IL-2 represent a rational approach to combination cytokine therapy whose dose-limiting toxicity can be overcome with engineered cytokine variants.

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