Exth-58. Unraveling the Mechanisms Underlying the Therapeutic Efficacy of Tim-3 Blockade in Dipgs

Abstract

Diffuse intrinsic pontine glioma (DIPG) is an aggressive brain tumor and the leading cause of pediatric death caused by cancer. Despite great strides in the understanding of this disease, the survival is still dismal. One of the objectives of our lab is to modulate the tumor microenvironment (TME) towards a proinflammatory phenotype to render these tumors amenable to immunotherapy. TIM-3 is a member of the TIM-family of immunoregulatory proteins expressed on multiple immune cell types, including T-cells, NK, myeloid populations, and microglia, regulating adaptive and innate immunity. In silico assessment of TIM-3 expression in DIPG mRNA and single-cell datasets showed a robust expression of this gene in tumor cells and microglia uncovering this molecule as a potential target in DIPGs. In vivo studies showed that TIM-3 blockade with an antibody significantly increased the overall survival of two DIPG immunocompetent orthotopic models, led to long-term survivors (50%), and showed immune resident memory. TIM-3 inhibition resulted in a significant increase in the number and proliferative state of microglia, NK, and CD8+ cells and higher levels of IFNγ, GrzB and TNFα corresponding to NK and T-cell activate phenotypes. Interestingly, there was a decrease in the Treg population, which causes an increase in the pro-inflammatory CD8/Treg ratio. Chemokine studies demonstrated an augmentation of CCL5, CCL2 chemotactic cytokines, and CXCL10/IL-1β/IFN-γ pro-inflammatory axis in the tumor microenvironment of treated-mice. Additionally, DCs, CD4+, and CD8+ cells were increased in treated draining lymph nodes and of functional significance, expressed higher amounts of pro-inflammatory cytokines than in control mice. Interestingly, the depletion of the different immune populations did not completely abrogate the treatment efficacy indicating a residual although significant TIM-3 effect in the tumor. In conclusion, these data uncover TIM-3 as a potential target for the treatment of DIPG and its potential as an immune regulator of DIPG TME.