Many strategies for cancer treatment use combinations of immunotherapeutic agents for enhanced anti-tumor responses. However, these approaches are often complicated by a need to overcome tumor-induced immune suppression in the tumor microenvironment. In this regard, T regulatory (Treg) cells and myeloid-derived suppressor cells (MDSC) have been identified as functional suppressor cells within tumors (1, 2). The most effective immunotherapeutic regimens are likely to consist of agents that restructure, within the tumor microenvironment, the composition of tumor-infiltrating leukocytes away from these inhibitory elements in favor of effector cells, such as NK cells and CD8 ϩ T cells.Chemokine expression can regulate the polarization of immune responses (3). For example, CXCR3 and CCR5 are preferentially expressed on Th1 T cells and M1 macrophages and their respective ligands are associated with enhanced cellmediated immune responses (3-5) and favorable prognosis in human RCC (5, 6). Another chemokine, monocyte chemoattractant protein (MCP)-1 activates macrophages for enhanced anti-tumor activities (7), however MCP-1 expression is also associated with the recruitment of mononuclear cells capable of producing tumor promoting factors (8, 9), as well as MDSC that contribute to tumor progression through the inhibition of effector cell functions (8, 10).We reported previously that IL-2 and agonistic antibody to CD40 (␣CD40) synergize for the regression of metastatic tumors in mice (11). Although we identified CD8 ϩ T cells and host IFN␥ expression as critical components of this therapeutic approach (11), the specific mechanisms underlying the IL-2/␣CD40 synergistic anti-tumor responses within the microenvironment remain unclear. We demonstrate in a murine model of metastatic renal cancer that ␣CD40 may be limited by its dependency upon MCP-1 and an inability to remove Tregs and MDSC specifically from within the tumor microenvironment, allowing for eventual tumor progression. In contrast, synergistic anti-tumor responses and protection achieved by IL-2/␣CD40 are associated with the expression of Th1 chemokines that are associated with favorable prognosis in RCC (5, 6), an augmentation of effector leukocytes and concomitant removal of suppressive cells specifically within the tumor microenvironment.
Results
CCR2 Expression Is Required for ␣CD40, but Not IL-2/␣CD40 MediatedAnti-Tumor Responses. Our previous study showed that IL-2/ ␣CD40 exhibited strong synergy for treatment of established metastatic tumors in mice, as compared to IL-2 or ␣CD40 as single agents (11). Furthermore, we found that ␣CD40 treatment of Renca-bearing mice induced significant reduction in tumors in association with high levels of systemic MCP-1 levels, suggesting a possible role for MCP-1 in leukocyte recruitment into tumors and CD40-dependent anti-tumor effects (12). To determine the relative contribution of MCP-1 to the ␣CD40-and IL-2/␣CD40-mediated anti-tumor responses, we compared tumor outcomes in treated WT and mice deficient in CCR2, the rec...