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Microenvironment and Immunology

A Threshold Level of Intratumor CD8+ T-cell PD1 Expression Dictates Therapeutic Response to Anti-PD1

Shin Foong Ngiow, Arabella Young, Nicolas Jacquelot, Takahiro Yamazaki, David Enot, Laurence Zitvogel and Mark J. Smyth
Shin Foong Ngiow
1Immunology in Cancer and Infection Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
2School of Medicine, University of Queensland, Herston, Queensland, Australia.
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Arabella Young
1Immunology in Cancer and Infection Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
2School of Medicine, University of Queensland, Herston, Queensland, Australia.
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Nicolas Jacquelot
3INSERM U1015, Villejuif, France.
4Institut de Cancérologie Gustave Roussy, Villejuif, France.
5Equipe labellisée Ligue contre le Cancer, University of Paris Sud XI, Villejuif, France.
6Center of Clinical Investigations in Biotherapies of Cancer (CICBT), Villejuif, France.
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Takahiro Yamazaki
3INSERM U1015, Villejuif, France.
4Institut de Cancérologie Gustave Roussy, Villejuif, France.
5Equipe labellisée Ligue contre le Cancer, University of Paris Sud XI, Villejuif, France.
6Center of Clinical Investigations in Biotherapies of Cancer (CICBT), Villejuif, France.
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David Enot
3INSERM U1015, Villejuif, France.
4Institut de Cancérologie Gustave Roussy, Villejuif, France.
5Equipe labellisée Ligue contre le Cancer, University of Paris Sud XI, Villejuif, France.
6Center of Clinical Investigations in Biotherapies of Cancer (CICBT), Villejuif, France.
7Metabolomics and Cell Biology Platforms, Institut de Cancerologie Gustave Roussy, Villejuif, France.
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Laurence Zitvogel
3INSERM U1015, Villejuif, France.
4Institut de Cancérologie Gustave Roussy, Villejuif, France.
5Equipe labellisée Ligue contre le Cancer, University of Paris Sud XI, Villejuif, France.
6Center of Clinical Investigations in Biotherapies of Cancer (CICBT), Villejuif, France.
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Mark J. Smyth
1Immunology in Cancer and Infection Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
2School of Medicine, University of Queensland, Herston, Queensland, Australia.
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  • For correspondence: mark.smyth@qimrberghofer.edu.au
DOI: 10.1158/0008-5472.CAN-15-1082 Published September 2015
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    Figure 1.

    Anti-PD1 sensitivity correlates with reduced frequency of PD1-expressing CD8+ T cells. Groups of B6 WT mice (n = 5–8) were s.c. injected with MC38 tumor (1 × 106 cells; A, C, and E) or AT3 tumor (1 × 106 cells; B, D, and F) on day 0. A and B, tumor-bearing mice were treated with 250 μg of cIg or anti-PD1 on days 6, 10, and 14 (A) or days 15, 19, 23, and 27 (B). Tumor growth was measured using a digital caliper, and tumor sizes are presented as mean ± SEM. Statistical differences in tumor sizes between cIg- and anti-PD1–treated mice were determined by an unpaired t test (**, P < 0.01; ***, P < 0.001). Data are representative of two or more independent experiments. C–F, tumor-bearing mice were treated with 250 μg of cIg or anti-PD1 on day 10 (C and E) or day 14 (D and F), and tumors were harvested 2 or 3 days after antibody treatments for flow cytometric analyses. C and D, representative FACS plots for gating strategy to define frequencies of PD1-expressing CD4+ T cells (left) and CD8+ T cells (right) between cIg- and anti-PD1–treated mice are shown. E and F, frequencies of PD1-expressing CD4+ T cells and CD8+ T cells are shown. Statistical differences in frequencies of PD1-expressing CD4+ T cells and CD8+ T cells between cIg- and anti-PD1–treated mice were determined by an unpaired t test (****, P < 0.0001). Data shown are pooled from 12 (E) and 7 (F) independent experiments and are presented as the mean ± SD, with individual symbols representing individual mice. Data shown for frequencies of PD1-expressing CD4+ T cells, and PD1-expressing CD8+ T cells between cIg- and anti-PD1–treated mice (E and F) are the same data set as shown in Supplementary Fig. S1B and S1D.

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    Figure 2.

    Anti-PD1 mAb sensitivity correlates with intratumor T-cell inflammatory cytokines. Groups of B6 WT mice (n = 5–8) were s.c. injected with MC38 tumor (1 × 106 cells; A, B, E, and F) or AT3 tumor (1 × 106 cells; C, D, G, and H) on day 0. Tumor-bearing mice were treated with 250 μg of cIg or anti-PD1 on day 10 (A, B, E, and F) or day 14 (C, D, G, and H), and tumors were harvested 2 or 3 days after antibody treatments for flow cytometric analyses. A–D, frequencies of IFNγ- and TNF-expressing CD4+ T cells (A and C) and CD8+ T cells (B and D) between cIg- and anti-PD1–treated mice are shown. Data are presented as the mean ± SD, with individual symbols representing individual mice. Statistical differences in frequencies of IFNγ- and TNF-producing cells of CD4+; and CD8+ T-cell subsets between cIg- and anti-PD1–treated mice were determined by an unpaired t test (*, P < 0.05). Data shown are representative of three (A and B) and two (C and D) independent experiments. Tbet MFI (E and G) and Eomes MFI (F and H) of CD4+ T cells and CD8+ T cells between cIg- and anti-PD1–treated mice are shown. Data are presented as the mean ± SD, with individual symbols representing individual mice. Statistical differences in Tbet MFI (E and G) and Eomes MFI (F and H) of CD4+ and CD8+ T-cell subsets between cIg- and anti-PD1–treated mice were determined by an unpaired t test (* P < 0.05). Data shown are representative of four or more (E and F) and three (G and H) independent experiments.

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    Figure 3.

    T-cell PD1 level and frequency is independent of T-cell differentiation. Groups of B6 WT mice (n = 5–8) were s.c. injected with MC38 tumor (1 × 106 cells; A and B) or AT3 tumor (1 × 106 cells; C and D) on day 0. Tumor-bearing mice were treated with 250 μg of cIg or anti-PD1 on day 10 (A and B) or day 14 (C and D), and tumors were harvested 2 or 3 days after antibody treatments for flow cytometric analyses. Frequencies of CD44+CD62L− and CD44+CD62L+ in CD4+ T cells (A and C) and CD8+ T cells (B and D) between cIg- and anti-PD1–treated mice are shown. Data are presented as the mean ± SD of 5 mice, with individual symbols representing individual mice. Statistical differences in the frequencies of CD44+CD62L− and CD44+CD62L+ in CD4+ and CD8+ T-cell subsets between cIg- and anti-PD1–treated mice were determined by an unpaired t test (**, P < 0.01). Data shown are representative of four (A and B) and two (C and D) independent experiments.

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    Figure 4.

    Treg promotes anti-PD1–resistant PD1hi T cells. Groups of B6 WT (A and B) and Foxp3-DTR (C–F) mice (n = 5–10) were s.c. injected with MC38 tumor (1 × 106 cells; A, C, and D) or AT3 tumor (1 × 106 cells; B, E, and F) on day 0. A and B, tumor-bearing mice were treated with 250 μg of cIg or anti-PD1 on day 10 (A) or day 14 (B), and tumors were harvested 2 or 3 days after antibody treatments for flow cytometric analyses. Frequencies, numbers of Treg (CD4+Foxp3+), and CD8/Treg ratio between cIg- and anti-PD1–treated mice are shown. Data are presented as the mean ± SD, with individual symbols representing individual mice. Statistical differences in the frequencies, cell numbers, and CD8/Treg ratio between cIg- and anti-PD1–treated mice were determined by an unpaired t test (*, P < 0.05; **, P < 0.01; ***, P < 0.001; ****, P < 0.0001). Data shown are pooled from 7 (A) and 5 (B) independent experiments. C–F, tumor-bearing Foxp3-DTR mice were treated with PBS or 500 ng of DT on day 10 (C and D) or day 14 (E and F), and tumors were harvested 3 or 4 days after PBS/DT treatment for flow cytometric analyses. C and E, frequencies of PD1-expressing CD4+ and CD8+ T cells with their representative histogram plots (shaded histogram, PBS-treated; open histogram, DT-treated) from PBS- and DT-treated mice are shown. Data are presented as the mean ± SD with individual symbols representing individual mice. D and F, Tbet MFI of CD4+ and CD8+ T cells of PBS- and DT-treated mice are shown. Data are presented as the mean ± SD, with individual symbols representing individual mice. Statistical differences in frequencies of PD1-expressing T cells (C and E) and Tbet MFI (D and F) of respective cell subsets between PBS- and DT-treated mice were determined by an unpaired t test (*, P < 0.05; **, P < 0.01; ***, P < 0.001). G and H, groups of Balb/c or B6 Foxp3-DTR mice (n = 5) were s.c. injected with CT26 tumor (1 × 105 cells; G) or AT3 tumor (5 × 105 cells; H) on day 0. G, CT26-bearing mice were treated PBS or 250 ng DT on day 14 as indicated. Mice then received 250 μg of cIg or anti-PD1 on days 17, 20, and 22. H, AT3-bearing mice were treated with PBS or 100 ng DT on day 16 as indicated. Mice then received 250 μg of cIg or anti-PD1 on days 20, 24, and 28. Tumor growth was measured using a digital caliper, and tumor sizes are presented as mean ± SEM. Statistical differences in tumor growth between DT- and DT and anti-PD1–treated mice were determined by a Mann–Whitney test (*, P < 0.05).

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    Figure 5.

    Anti-PDL1 mAb suppresses anti-PD1–resistant tumor. Groups of B6 WT mice (n = 5-8) were subcutaneously injected with MC38 tumor (1 × 106 cells; A and C) or AT3 tumor (1 × 106 cells; B and D) on day 0. A and B, tumor-bearing mice were treated with 250 μg of cIg or anti-PD1 on day 10 (A) or day 14 (B), and tumors were harvested 2 or 3 days after antibody treatments for flow cytometric analyses. PDL1 MFI of CD4+ T cells, CD8+ T cells, CD11b Gr1hi cells, CD11b Gr1int cells, CD11b Gr1lo cells, CD45.2− cells (7AAD− CD45.2−) between cIg- and anti-PD1–treated mice are shown. Statistical differences in PDL1 MFI of indicated cell subsets between cIg- and anti-PD1–treated mice were determined by an unpaired t test (*, P < 0.05; **, P < 0.01; ***, P < 0.001; ****, P < 0.0001). Data shown are pooled from 5 or more (A) and three or more (B) independent experiments. C and D, tumor-bearing mice were treated with 250 μg of cIg, anti-PD1, and/or anti-PDL1 on days 8, 12, and 16 (C) or days 14, 18, 22, and 26 (D). Tumor growth was measured using a digital caliper, and tumor sizes are presented as mean ± SEM. Statistical differences in tumor sizes between cIg-, anti-PD1-, anti-PDL1-, and anti-PD1 + anti-PDL1–treated mice were determined by an unpaired t test (day 16 MC38: cIg vs. anti-PD1 P = 0.0035; cIg vs. anti-PDL1 P = 0.0010; cIg vs. anti-PD1 + PDL1, P = 0.0006; day 28 AT3: cIg vs. anti-PDL1, P = 0.0008; cIg vs. anti-PD1 + anti-PDL1, P = 0.0007). Data are representative of two independent experiments. Tumor growth data for cIg- and anti-PD1–treated mice shown in D are the same dataset as shown in Supplementary Fig. S5D.

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    Figure 6.

    PD1 MFI on CD8+ T cells predicts tumor aggressiveness and response to anti-PD1 mAb. ANCOVA was applied to test the association between the PDL1 or PD1 MFI on various TIL subsets (CD4+ T, CD8+ T, CD11b+/Gr1+, CD45.2−) and the tumor weight and the interaction between the two slopes. Plots of PD1 MFI (A–D) and PDL1 MFI (E–H) on CD4+ (left) and CD8+ T cells (right) against the weight of tumors (monitored 2 to 3 days after the first injection of mAb) from mice inoculated with MC38 (A and B; E and F) and AT3 (C and D; G and H) tumor cells and treated with cIg (solid circles) or anti-PD1 mAb (open circles). Solid (cIg) and dashed (anti-PD1 mAb) lines correspond to the slopes and associated SE as estimated by the ANCOVA model for each treatment group. All experiments described in this manuscript comprising n = 34 to 36 (AT3) and 79 to 86 (MC38) mice/group were gathered for this analysis. The analyses pertaining to the CD45.2− and myeloid cell fractions were not significant in this context and therefore not included. (*, P < 0.05; **, P < 0.01; ***, P < 0.001; ****, P < 0.0001).

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    Figure 7.

    Schematic diagram of the PD1/PDL1 axis in anti-PD1–sensitive and –resistant tumors. Left, in a tumor microenvironment with PD1lo T cells, an increased level of PDL1 expression is present that increases the probability of PD1 ligation on T cells. Right, in contrast, in a tumor microenvironment with PD1hi T cells, a low level of PDL1 expression is sufficient to ensure the ligation of PD1 on T cells.

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  • Supplementary Data

    • Supplementary Figure Legend - Supplementary Figure Legend. Legends for Supplementary Figures S1-S8.
    • Supplementary Figures S1-S8 - Supplementary Figures S1-S8. Anti-PD-1 reduces tumor weight and modulates PD-1 expressing intratumor T cells in anti-PD-1-sensitive tumor (S1); Anti-PD-1 therapy mAb does not compete for the binding of PD-1 with the anti-PD-1 flow cytometry staining mAb (S2); Anti-PD-1 mAb reduces PD-1 expression on PD-1-expressing T cells (S3); Frequency of PD-1+ CD8+ T cells maintained in anti-PD1-resistant Renca tumors (S4); Anti-Tim3 and anti-PD1 sensitivity correlates with reduced frequency of PD1 expressing CD8+ T cells (S5); Anti-PD-1/PD-L1 anti-tumor effect is FcR-independent (S6); PD-1-expressing T cells are predominantly found in the tumor microenvironment (S7); PD1 MFI on CD8+ T cells predicts tumor aggressiveness and response to anti-PD1 mAb in MC38 tumor (S8).
  • Supplementary Data

    • Supplementary Figure Legend - Supplementary Figure Legend. Legends for Supplementary Figures S1-S8.
    • Supplementary Figures S1-S8 - Supplementary Figures S1-S8. Anti-PD-1 reduces tumor weight and modulates PD-1 expressing intratumor T cells in anti-PD-1-sensitive tumor (S1); Anti-PD-1 therapy mAb does not compete for the binding of PD-1 with the anti-PD-1 flow cytometry staining mAb (S2); Anti-PD-1 mAb reduces PD-1 expression on PD-1-expressing T cells (S3); Frequency of PD-1+ CD8+ T cells maintained in anti-PD1-resistant Renca tumors (S4); Anti-Tim3 and anti-PD1 sensitivity correlates with reduced frequency of PD1 expressing CD8+ T cells (S5); Anti-PD-1/PD-L1 anti-tumor effect is FcR-independent (S6); PD-1-expressing T cells are predominantly found in the tumor microenvironment (S7); PD1 MFI on CD8+ T cells predicts tumor aggressiveness and response to anti-PD1 mAb in MC38 tumor (S8).
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Cancer Research: 75 (18)
September 2015
Volume 75, Issue 18
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A Threshold Level of Intratumor CD8+ T-cell PD1 Expression Dictates Therapeutic Response to Anti-PD1
Shin Foong Ngiow, Arabella Young, Nicolas Jacquelot, Takahiro Yamazaki, David Enot, Laurence Zitvogel and Mark J. Smyth
Cancer Res September 15 2015 (75) (18) 3800-3811; DOI: 10.1158/0008-5472.CAN-15-1082

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A Threshold Level of Intratumor CD8+ T-cell PD1 Expression Dictates Therapeutic Response to Anti-PD1
Shin Foong Ngiow, Arabella Young, Nicolas Jacquelot, Takahiro Yamazaki, David Enot, Laurence Zitvogel and Mark J. Smyth
Cancer Res September 15 2015 (75) (18) 3800-3811; DOI: 10.1158/0008-5472.CAN-15-1082
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