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STING agonist 8803 reprograms the immune microenvironment and increases survival in preclinical models of glioblastoma
Hinda Najem, … , Michael A. Curran, Amy B. Heimberger
Hinda Najem, … , Michael A. Curran, Amy B. Heimberger
Published June 17, 2024
Citation Information: J Clin Invest. 2024;134(12):e175033. https://doi.org/10.1172/JCI175033.
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Research Article Immunology Oncology

STING agonist 8803 reprograms the immune microenvironment and increases survival in preclinical models of glioblastoma

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Abstract

STING agonists can reprogram the tumor microenvironment to induce immunological clearance within the central nervous system. Using multiplexed sequential immunofluorescence (SeqIF) and the Ivy Glioblastoma Atlas, STING expression was found in myeloid populations and in the perivascular space. The STING agonist 8803 increased median survival in multiple preclinical models of glioblastoma, including QPP8, an immune checkpoint blockade–resistant model, where 100% of mice were cured. Ex vivo flow cytometry profiling during the therapeutic window demonstrated increases in myeloid tumor trafficking and activation, alongside enhancement of CD8+ T cell and NK effector responses. Treatment with 8803 reprogrammed microglia to express costimulatory CD80/CD86 and iNOS, while decreasing immunosuppressive CD206 and arginase. In humanized mice, where tumor cell STING is epigenetically silenced, 8803 therapeutic activity was maintained, further attesting to myeloid dependency and reprogramming. Although the combination with a STAT3 inhibitor did not further enhance STING agonist activity, the addition of anti–PD-1 antibodies to 8803 treatment enhanced survival in an immune checkpoint blockade–responsive glioma model. In summary, 8803 as a monotherapy demonstrates marked in vivo therapeutic activity, meriting consideration for clinical translation.

Authors

Hinda Najem, Spencer T. Lea, Shashwat Tripathi, Lisa Hurley, Chao-Hsien Chen, Ivana William, Moloud Sooreshjani, Michelle Bowie, Genevieve Hartley, Corey Dussold, Sebastian Pacheco, Crismita Dmello, Catalina Lee-Chang, Kathleen McCortney, Alicia Steffens, Jordain Walshon, Martina Ott, Jun Wei, Anantha Marisetty, Irina Balyasnikova, Roger Stupp, Rimas V. Lukas, Jian Hu, Charles David James, Craig M. Horbinski, Maciej S. Lesniak, David M. Ashley, Waldemar Priebe, Leonidas C. Platanias, Michael A. Curran, Amy B. Heimberger

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Figure 2

Therapeutic effect of the STING agonist 8803 in immune checkpoint blockade–resistant preclinical models of glioblastoma.

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Therapeutic effect of the STING agonist 8803 in immune checkpoint blocka...
(A) Treatment of immunocompetent C57BL/6J mice with i.c. implantation of either QPP4 or QPP8 glioma cells. The survival rate of C57BL/6J mice with i.c. implanted QPP4 treated with 8803 (5 μg) on days 14 and 28 (n = 16) significantly prolonged survival relative to vehicle control mice (n = 16; median survival [MS] = 72 days; log-rank P = 0.0003). Similarly, both 8803 and 8879 (n = 17; undefined MS) were curative in the QPP8 model (control group: n = 15; MS = 103 days) when they were administered on days 14, 21, and 28 after implantation. Agonist 8803 versus vehicle control (log-rank P < 0.0001); 8879 versus vehicle control (log-rank P = 0.0002). (B) Flow cytometric analysis of tumor-infiltrating immune cells using BD LSRFortessa X-30 prototype flow cytometry. QPP8 cells were orthotopically implanted in C57BL/6J mice and then treated with PBS or 5 μg 8803 on days 60 and 67. Tumors were isolated 48 hours after the final treatment and immune cells were collected using a Percoll gradient. The total amount of immune cells was quantified based on all live CD45+ cells and specifically on CD11b+Ly6C+ expression of mono-MDSCs. (C) Within the myeloid compartment from the tumor and cervical lymph nodes (LNs), immune cell lineages were identified based on standard surface markers (Supplemental Table 1), and then the mean fluorescence intensity (MFI) was quantified based on treatment. Each dot represents an analyzed tumor or LN. (D) Expression of immunosuppressive markers CD206 and CD163 spanning myeloid populations and as a function of treatment. (E) Myeloid PD-L1 expression on various immune lineages in tumors and LNs. (F) Conventional type 1 DCs (cDC1s) were increased in both tumor and LNs in response to 8803. (G) Immunosuppressive arginase expression spanning myeloid populations and as a function of treatment. *P < 0.05; **P < 0.01; ***P < 0.001; ****P < 0.0001 by 2-tailed Student’s t test (B–G).

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