In vitro transcribed mRNA constitutes a versatile platform to encode antigens
and to evoke CD8 T-cell responses. Systemic delivery of mRNA packaged
into cationic liposomes (lipoplexes) has proven particularly powerful
in achieving effective antitumor immunity in animal models. Yet, T-cell
responses to mRNA lipoplexes critically depend on the induction of
type I interferons (IFN), potent pro-inflammatory cytokines, which
inflict dose-limiting toxicities. Here, we explored an advanced hybrid
lipid polymer shell mRNA nanoparticle (lipopolyplex) endowed with
a trimannose sugar tree as an alternative delivery vehicle for systemic
mRNA vaccination. Like mRNA lipoplexes, mRNA lipopolyplexes were extremely
effective in conferring antitumor T-cell immunity upon systemic administration.
Conversely to mRNA lipoplexes, mRNA lipopolyplexes did not rely on
type I IFN for effective T-cell immunity. This differential mode of
action of mRNA lipopolyplexes enabled the incorporation of N1 methyl
pseudouridine nucleoside modified mRNA to reduce inflammatory responses
without hampering T-cell immunity. This feature was attributed to
mRNA lipopolyplexes, as the incorporation of thus modified mRNA into
lipoplexes resulted in strongly weakened T-cell immunity. Taken together,
we have identified lipopolyplexes containing N1 methyl pseudouridine
nucleoside modified mRNA as potent yet low-inflammatory alternatives
to the mRNA lipoplexes currently explored in early phase clinical
trials.
Improved understanding of cancer immunology has provided insight into the phenomenon of frequent tumor recurrence after initially successful immunotherapy. A delicate balance exists between the capacity of the immune system to control tumor growth and various resistance mechanisms that arise to avoid or even counteract the host's immune system. These resistance mechanisms include but are not limited to (i) adaptive expression of inhibitory checkpoint molecules in response to the proinflammatory environment and (ii) amplification of cancer stem cells, a small fraction of tumor cells possessing the capacity for self-renewal and mediating treatment resistance and formation of metastases after long periods of clinical remission. Several individual therapeutic agents have so far been developed to revert T-cell exhaustion or disrupt the cross-talk between cancer stem cells and the tumor-promoting microenvironment. Here, we demonstrate that a three-arm combination therapy-consisting of an mRNA-based vaccine to induce antigen-specific T-cell responses, monoclonal antibodies blocking inhibitory checkpoint molecules (PD-1, TIM-3, LAG-3), and antibodies targeting IL-6 and TGF-β-improves the therapeutic outcome in subcutaneous TC-1 tumors and significantly prolongs survival of treated mice. Our findings point to a need for a rational development of multidimensional anticancer therapies, aiming at the induction of tumor-specific immunity and simultaneously targeting multiple resistance mechanisms.
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