Antibodies to Costimulatory Receptor 4-1BB Enhance Anti-tumor Immunity via T Regulatory Cell Depletion and Promotion of CD8 T Cell Effector Function

The costimulatory receptor 4-1 BB is expressed on activated immune cells, including activated T cells. Antibodies targeting 4-1 BB enhance the proliferation and survival of antigen-stimulated T cells in vitro and promote CD8 T cell-dependent anti-tumor immunity in pre-clinical cancer models. We found that T regulatory (Treg) cells infiltrating human or murine tumors expressed high amounts of 4-1 BB. Intra-tumoral Treg cells were preferentially depleted by anti-41 BB mAbs in vivo. Anti-4-1 BB mAbs also promoted effector T cell agonism to promote tumor rejection. These distinct mechanisms were competitive and dependent on antibody isotype and Fc gamma R availability. Administration of anti-4-1 BB IgG2a, which preferentially depletes Treg cells, followed by either agonistic anti-4-1 BB IgG1 or anti-PD-1 mAb augmented anti-tumor responses in multiple solid tumor models. An antibody engineered to optimize both Fc gamma R-dependent Treg cell depleting capacity and Fc gamma R-independent agonism delivered enhanced anti-tumor therapy. These insights into the effector mechanisms of anti-4-1 BB mAbs lay the groundwork for translation into the clinic.