[HTML][HTML] CTLA4 blockade and GM-CSF combination immunotherapy alters the intratumor balance of effector and regulatory T cells

SA Quezada, KS Peggs, MA Curran… - The Journal of clinical …, 2006 - Am Soc Clin Investig
The Journal of clinical investigation, 2006Am Soc Clin Investig
CTL-associated antigen 4 (CTLA4) blockade releases inhibitory controls on T cell activation
and proliferation, inducing antitumor immunity in both preclinical and early clinical trials. We
examined the mechanisms of action of anti-CTLA4 and a GM-CSF–transduced tumor cell
vaccine (Gvax) and their impact on the balance of effector T cells (Teffs) and Tregs in an in
vivo model of B16/BL6 melanoma. Tumor challenge increased the frequency of Tregs in
lymph nodes, and untreated tumors became infiltrated by CD4+ Foxp3–and CD4+ Foxp3+ T …
CTL-associated antigen 4 (CTLA4) blockade releases inhibitory controls on T cell activation and proliferation, inducing antitumor immunity in both preclinical and early clinical trials. We examined the mechanisms of action of anti-CTLA4 and a GM-CSF–transduced tumor cell vaccine (Gvax) and their impact on the balance of effector T cells (Teffs) and Tregs in an in vivo model of B16/BL6 melanoma. Tumor challenge increased the frequency of Tregs in lymph nodes, and untreated tumors became infiltrated by CD4+Foxp3 and CD4+Foxp3+ T cells but few CD8+ T cells. Anti-CTLA4 did not deplete Tregs or permanently impair their function but acted in a cell-intrinsic manner on both Tregs and Teffs, allowing them to expand, most likely in response to self antigen. While Gvax primed the tumor-reactive Teff compartment, inducing activation, tumor infiltration, and a delay in tumor growth, the combination with CTLA4 blockade induced greater infiltration and a striking change in the intratumor balance of Tregs and Teffs that directly correlated with tumor rejection. The data suggest that Tregs control both CD4+ and CD8+ T cell activity within the tumor, highlight the importance of the intratumor ratio of effectors to regulators, and demonstrate inversion of the ratio and correlation with tumor rejection during Gvax/anti-CTLA4 immunotherapy.
The Journal of Clinical Investigation