Generation of highly activated, antigen-specific tumor-infiltrating CD8+T cells induced by a novel T cell-targeted immunotherapy

The induction of tumor-targeted, cytotoxic T lymphocytes has been recognized as a key component to successful immunotherapy. DPX-based treatment was previously shown to effectively recruit activated CD8(+)T cells to the tumor. Herein, we analyze the unique phenotype of the CD8(+)T cells recruited into the tumor in response to DPX-based therapy, and how combination with checkpoint inhibitors impacts T cell response. C3-tumor-bearing mice were treated with cyclophosphamide (CPA) for seven continuous days every other week, followed by DPX treatment along with anti-CTLA-4 and/or anti-PD-1. Efficacy, immunogenicity, and CD8(+)T cells tumor infiltration were assessed. The expression of various markers, including checkpoint markers, peptide specificity, and proliferation and activation markers, was determined by flow cytometry. tSNE analysis of the flow data revealed a resident phenotype of CD8(+)T cells (PD-1(+)TIM-3(+)CTLA-4(+)) within untreated tumors, whereas DPX/CPA treatment induced recruitment of a novel population of CD8(+)T cells (PD-1(+)TIM-3(+)CTLA-4(-)) within tumors. Combination of anti-CTLA-4 (ipilimumab) with DPX/CPA versus DPX/CPA alone significantly increased survival and inhibition of tumor growth, without changing overall systemic immunogenicity. Addition of checkpoint inhibitors did not significantly change the phenotype of the newly recruited cells induced by DPX/CPA. Yet, anti-CTLA-4 treatment in combination with DPX/CPA enhanced a non-antigen specific response within the tumor. Finally, the tumor-recruited CD8(+)T cells induced by DPX/CPA were highly activated, antigen-specific, and proliferative, while resident phenotype CD8(+)T cells, seemingly initially exhausted, were reactivated with combination treatment. This study supports the potential of combining DPX/CPA with ipilimumab to further enhance survival clinically.