Listeria monocytogenes personalized cancer vaccines drive therapeutic immune responses to cancer derived neoantigens

Background Recent advances in the field of cancer immunotherapy have identified CD8+ T cell responses against tumor-specific mutations as a key driver of tumor regression and overall survival. ADXS-NEO is a personalized Listeria monocytogenes (Lm)-based immunotherapy designed to target a patient’s mutation-derived tumor-specific neoantigens. The objective of this study is to demonstrate the feasibility of using the ADXS-NEO platform to target tumor-specific point mutations and control tumor growth by generating neoantigen-specific T cell responses using a pre-clinical mouse tumor model. Methods Whole-exome sequencing of the MC38 mouse tumor cell line identified 2870 unique non-synonymous mutations. The netMHCcons algorithm was used to predict 137 potential neoantigens. We validated 20 immunogenic neoantigens either by peptide immunization followed by ELISPOT or by the presence of CD8+ T cells recognizing the neoantigen peptide following checkpoint inhibitor treatment. Two ADXS-NEO vectors were constructed; Lm20, targeting 20 validated immunogenic neoantigens, and Lm19, targeting most of the non-validated NSMs. Results Both Lm19 & Lm20 significantly slowed tumor growth in C57BL/6 mice compared to control. An accumulation of ADXS-NEO-specific TILs was observed in tumor bearing mice treated with either Lm19 or Lm20. Examination of the tumor microenvironment in Lm19 or Lm20 treated mice revealed a decrease in the frequency and absolute number of Tregs, TAMs, MDSCs, and PD1high exhausted CD8+ T cells as well as an increase in the frequency and absolute number of effector CD8+ T cells, relative to control. Conclusion ADXS-NEO is a potent immunotherapy capable of driving immune responses against tumor-specific mutations and leading to tumor control in mice.

[1]  T A Chan,et al.  Development of tumor mutation burden as an immunotherapy biomarker: utility for the oncology clinic , 2018, Annals of oncology : official journal of the European Society for Medical Oncology.

[2]  Gabriel N. Teku,et al.  Pan-cancer analysis of neoepitopes , 2018, Scientific Reports.

[3]  J. Flickinger,et al.  Listeria monocytogenes as a Vector for Cancer Immunotherapy: Current Understanding and Progress , 2018, Vaccines.

[4]  K. Kabashima,et al.  Anti-PD-1 and Anti-CTLA-4 Therapies in Cancer: Mechanisms of Action, Efficacy, and Limitations , 2018, Front. Oncol..

[5]  I. Melero,et al.  Antigen cross-presentation and T-cell cross-priming in cancer immunology and immunotherapy , 2017, Annals of oncology : official journal of the European Society for Medical Oncology.

[6]  A. Levine,et al.  A neoantigen fitness model predicts tumour response to checkpoint blockade immunotherapy , 2017, Nature.

[7]  F. Kühnel,et al.  CD4 and CD8 T lymphocyte interplay in controlling tumor growth , 2017, Cellular and Molecular Life Sciences.

[8]  G. Linette,et al.  Neoantigen Vaccines Pass the Immunogenicity Test. , 2017, Trends in molecular medicine.

[9]  J. Utikal,et al.  Personalized RNA mutanome vaccines mobilize poly-specific therapeutic immunity against cancer , 2017, Nature.

[10]  Charles H. Yoon,et al.  An immunogenic personal neoantigen vaccine for patients with melanoma , 2017, Nature.

[11]  C. Zahnow,et al.  Evolution of Neoantigen Landscape during Immune Checkpoint Blockade in Non-Small Cell Lung Cancer. , 2017, Cancer discovery.

[12]  N. McGranahan,et al.  Clonal Heterogeneity and Tumor Evolution: Past, Present, and the Future , 2017, Cell.

[13]  O. Ohara,et al.  Prediction and prioritization of neoantigens: integration of RNA sequencing data with whole‐exome sequencing , 2017, Cancer science.

[14]  J. Gartner,et al.  T-Cell Transfer Therapy Targeting Mutant KRAS in Cancer. , 2016, The New England journal of medicine.

[15]  Özlem Türeci,et al.  Systemic RNA delivery to dendritic cells exploits antiviral defence for cancer immunotherapy , 2016, Nature.

[16]  Nicolai J. Birkbak,et al.  Clonal neoantigens elicit T cell immunoreactivity and sensitivity to immune checkpoint blockade , 2016, Science.

[17]  I. Mellman,et al.  Neo approaches to cancer vaccines , 2015, Science.

[18]  E. Mardis,et al.  A dendritic cell vaccine increases the breadth and diversity of melanoma neoantigen-specific T cells , 2015, Science.

[19]  J. Castle,et al.  Mutant MHC class II epitopes drive therapeutic immune responses to cancer , 2015, Nature.

[20]  V. Badovinac,et al.  Listeria monocytogenes: a model pathogen to study antigen-specific memory CD8 T cell responses , 2015, Seminars in Immunopathology.

[21]  T. Schumacher,et al.  Neoantigens in cancer immunotherapy , 2015, Science.

[22]  E. Wherry,et al.  Overcoming T cell exhaustion in infection and cancer. , 2015, Trends in immunology.

[23]  Z. Modrušan,et al.  Predicting immunogenic tumour mutations by combining mass spectrometry and exome sequencing , 2014, Nature.

[24]  J. Berzofsky,et al.  Episomal Expression of Truncated Listeriolysin O in LmddA-LLO–E7 Vaccine Enhances Antitumor Efficacy by Preferentially Inducing Expansions of CD4+FoxP3− and CD8+ T Cells , 2014, Cancer Immunology Research.

[25]  L. Wood,et al.  Attenuated Listeria monocytogenes: a powerful and versatile vector for the future of tumor immunotherapy , 2014, Front. Cell. Infect. Microbiol..

[26]  S. Rosenberg,et al.  Exploiting the curative potential of adoptive T‐cell therapy for cancer , 2014, Immunological reviews.

[27]  H. Schreiber,et al.  Innate and adaptive immune cells in the tumor microenvironment , 2013, Nature Immunology.

[28]  Pia Kvistborg,et al.  The cancer antigenome , 2012, The EMBO journal.

[29]  P. Maciag,et al.  Listeria monocytogenes-Derived Listeriolysin O Has Pathogen-Associated Molecular Pattern-Like Properties Independent of Its Hemolytic Ability , 2012, Clinical and Vaccine Immunology.

[30]  J. Castle,et al.  Exploiting the mutanome for tumor vaccination. , 2012, Cancer research.

[31]  A. Oxenius,et al.  Direct activation of antigen-presenting cells is required for CD8+ T-cell priming and tumor vaccination , 2011, Proceedings of the National Academy of Sciences.

[32]  E John Wherry,et al.  T cell exhaustion , 2011 .

[33]  T. Honjo,et al.  Negative co-receptors and ligands , 2011 .

[34]  P. Maciag,et al.  Development of a live and highly attenuated Listeria monocytogenes-based vaccine for the treatment of Her2/neu-overexpressing cancers in human , 2011, Cancer Gene Therapy.

[35]  D. Schadendorf,et al.  Improved survival with ipilimumab in patients with metastatic melanoma. , 2010, The New England journal of medicine.

[36]  I. M. Belyakov,et al.  What Role Does the Route of Immunization Play in the Generation of Protective Immunity against Mucosal Pathogens? , 2009, The Journal of Immunology.

[37]  P. Maciag,et al.  Construction and Characterization of an Attenuated Listeria monocytogenes Strain for Clinical Use in Cancer Immunotherapy , 2008, Clinical and Vaccine Immunology.

[38]  B. Kyewski,et al.  Promiscuous gene expression patterns in single medullary thymic epithelial cells argue for a stochastic mechanism , 2008, Proceedings of the National Academy of Sciences.

[39]  F. Pijpers,et al.  Therapeutic cancer vaccines , 2005, Nature Reviews Drug Discovery.

[40]  D. Holdstock Past, present--and future? , 2005, Medicine, conflict, and survival.

[41]  E. Shevach Fatal attraction: tumors beckon regulatory T cells , 2004, Nature Medicine.

[42]  F. Rodríguez,et al.  Immunodominance in Virus-Induced CD8+ T-Cell Responses Is Dramatically Modified by DNA Immunization and Is Regulated by Gamma Interferon , 2002, Journal of Virology.

[43]  W. Goebel,et al.  A Novel Approach of Direct Ex Vivo Epitope Mapping Identifies Dominant and Subdominant CD4 and CD8 T Cell Epitopes from Listeria monocytogenes1 , 2001, The Journal of Immunology.

[44]  Jian-Bo Yang,et al.  Past, Present and the Future , 1998 .

[45]  P. A. Peterson,et al.  Crystal structure of an H-2Kb-ovalbumin peptide complex reveals the interplay of primary and secondary anchor positions in the major histocompatibility complex binding groove. , 1995, Proceedings of the National Academy of Sciences of the United States of America.