Synergistic immunotherapy of glioblastoma by dual targeting of IL-6 and CD40

Nat Commun. 2021 Jun 8;12(1):3424. doi: 10.1038/s41467-021-23832-3.

Abstract

Immunologically-cold tumors including glioblastoma (GBM) are refractory to checkpoint blockade therapy, largely due to extensive infiltration of immunosuppressive macrophages (Mϕs). Consistent with a pro-tumor role of IL-6 in alternative Mϕs polarization, we here show that targeting IL-6 by genetic ablation or pharmacological inhibition moderately improves T-cell infiltration into GBM and enhances mouse survival; however, IL-6 inhibition does not synergize PD-1 and CTLA-4 checkpoint blockade. Interestingly, anti-IL-6 therapy reduces CD40 expression in GBM-associated Mϕs. We identify a Stat3/HIF-1α-mediated axis, through which IL-6 executes an anti-tumor role to induce CD40 expression in Mϕs. Combination of IL-6 inhibition with CD40 stimulation reverses Mϕ-mediated tumor immunosuppression, sensitizes tumors to checkpoint blockade, and extends animal survival in two syngeneic GBM models, particularly inducing complete regression of GL261 tumors after checkpoint blockade. Thus, antibody cocktail-based immunotherapy that combines checkpoint blockade with dual-targeting of IL-6 and CD40 may offer exciting opportunities for GBM and other solid tumors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Brain Neoplasms / drug therapy
  • Brain Neoplasms / immunology*
  • Brain Neoplasms / therapy*
  • CD40 Antigens / metabolism*
  • Gene Deletion
  • Glioblastoma / drug therapy
  • Glioblastoma / immunology*
  • Glioblastoma / therapy*
  • Humans
  • Hypoxia-Inducible Factor 1, alpha Subunit / metabolism
  • Immune Checkpoint Inhibitors / pharmacology
  • Immune Checkpoint Inhibitors / therapeutic use
  • Immunosuppression Therapy
  • Immunotherapy*
  • Interleukin-6 / metabolism*
  • Lymphocyte Activation / drug effects
  • Lymphocytes, Tumor-Infiltrating / drug effects
  • Lymphocytes, Tumor-Infiltrating / immunology
  • Macrophages / drug effects
  • Macrophages / metabolism
  • Mice
  • Mice, Inbred C57BL
  • Neutralization Tests
  • STAT3 Transcription Factor / metabolism
  • Survival Analysis

Substances

  • CD40 Antigens
  • Hypoxia-Inducible Factor 1, alpha Subunit
  • Immune Checkpoint Inhibitors
  • Interleukin-6
  • STAT3 Transcription Factor