BackgroundThe coinhibitory receptor Programmed Death-1 (PD-1) inhibits effector functions of
activated T cells and prevents autoimmunity, however, cancer hijack this pathway
to escape from immune attack. The costimulatory receptor glucocorticoid-induced
TNFR related protein (GITR) is up-regulated on activated T cells and increases
their proliferation, activation and cytokine production. We hypothesize that
concomitant PD-1 blockade and GITR triggering would synergistically improve the
effector functions of tumor-infiltrating T cells and increase the antitumor
immunity. In present study, we evaluated the antitumor effects and mechanisms of
combined PD-1 blockade and GITR triggering in a clinically highly relevant murine
ID8 ovarian cancer model.MethodsMice with 7 days-established peritoneal ID8 ovarian cancer were treated
intraperitoneally (i.p.) with either control, anti-PD-1, anti-GITR or
anti-PD-1/GITR monoclonal antibody (mAb) and their survival was evaluated; the
phenotype and function of tumor-associated immune cells in peritoneal cavity of
treated mice was analyzed by flow cytometry, and systemic antigen-specific immune
response was evaluated by ELISA and cytotoxicity assay.ResultsCombined anti-PD-1/GITR mAb treatment remarkably inhibited peritoneal ID8 tumor
growth with 20% of mice tumor free 90 days after tumor challenge while treatment
with either anti-PD-1 or anti-GITR mAb alone exhibited little antitumor effect.
The durable antitumor effect was associated with a memory immune response and
conferred by CD4+ cells and CD8+ T cells. The treatment of
anti-PD-1/GITR mAb increased the frequencies of interferon-γ-producing
effector T cells and decreased immunosuppressive regulatory T cells and
myeloid-derived suppressor cells, shifting an immunosuppressive tumor milieu to an
immunostimulatory state in peritoneal cavity. In addition, combined treatment of
anti-PD-1/GITR mAb mounted an antigen-specific immune response as evidenced by
antigen-specific IFN-γ production and cytolytic activity of spleen cells from
treated mice. More importantly, combined treatment of anti-PD-1/GITR mAb and
chemotherapeutic drugs (cisplatin or paclitaxel) further increased the antitumor
efficacy with 80% of mice obtaining tumor-free long-term survival in murine ID8
ovarian cancer and 4 T1 breast cancer models.ConclusionsCombined anti-PD-1/GITR mAb treatment induces a potent antitumor immunity, which
can be further promoted by chemotherapeutic drugs. A combined strategy of
anti-PD-1/GITR mAb plus cisplatin or paclitaxel should be considered translation
into clinic.