CAR-T cell-mediated depletion of immunosuppressive tumor-associated macrophages promotes endogenous antitumor immunity and augments adoptive immunotherapy

Nat Commun. 2021 Feb 9;12(1):877. doi: 10.1038/s41467-021-20893-2.

Abstract

The immunosuppressive tumor microenvironment (TME) represents a major barrier for effective immunotherapy. Tumor-associated macrophages (TAMs) are highly heterogeneous and plastic cell components of the TME which can either promote tumor progression (M2-like) or boost antitumor immunity (M1-like). Here, we demonstrate that a subset of TAMs that express folate receptor β (FRβ) possess an immunosuppressive M2-like profile. In syngeneic tumor mouse models, chimeric antigen receptor (CAR)-T cell-mediated selective elimination of FRβ+ TAMs in the TME results in an enrichment of pro-inflammatory monocytes, an influx of endogenous tumor-specific CD8+ T cells, delayed tumor progression, and prolonged survival. Preconditioning of the TME with FRβ-specific CAR-T cells also improves the effectiveness of tumor-directed anti-mesothelin CAR-T cells, while simultaneous co-administration of both CAR products does not. These results highlight the pro-tumor role of FRβ+ TAMs in the TME and the therapeutic implications of TAM-depleting agents as preparative adjuncts to conventional immunotherapies that directly target tumor antigens.

Publication types

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

MeSH terms

  • Animals
  • CD8-Positive T-Lymphocytes / immunology
  • Folate Receptor 2 / immunology
  • Folate Receptor 2 / metabolism
  • Humans
  • Immunosuppression Therapy
  • Immunotherapy, Adoptive / methods*
  • Mesothelin
  • Mice
  • Mice, Inbred C57BL
  • Monocytes / immunology
  • Neoplasms / immunology
  • Neoplasms / therapy*
  • Receptors, Chimeric Antigen / immunology*
  • Tumor Cells, Cultured
  • Tumor Microenvironment / immunology
  • Tumor-Associated Macrophages / immunology*
  • Tumor-Associated Macrophages / metabolism

Substances

  • Folate Receptor 2
  • Msln protein, mouse
  • Receptors, Chimeric Antigen
  • Mesothelin