PD-1+ natural killer cells in human non-small cell lung cancer can be activated by PD-1/PD-L1 blockade

Abstract

Natural killer (NK) cells are critically involved in anti-tumor immunity by targeting tumor cells. In this study, we show that intratumoral NK cells from NSCLC patients expressed elevated levels of the immune checkpoint receptor PD-1 on their cell surface. In contrast to the expression of activating receptors, PD-1+ NK cells co-expressed more inhibitory receptors compared to PD-1 NK cells. Intratumoral NK cells were less functional compared to peripheral NK cells, and this dysfunction correlated with PD-1 expression. Tumor cells expressing PD-L1 inhibited the functionality of PD-1+ NK cells in ex vivo models and induced PD-1 clustering at the immunological synapse between NK cells and tumor cells. Notably, treatment with PD-1 blockade was able to reverse PD-L1-mediated inhibition of PD-1+ NK cells. Our findings highlight the therapeutic potential of PD-1+ NK cells in immune checkpoint blockade and could guide the development of NK cell-stimulating agents in combination with PD-1 blockade.

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Abbreviations

ATCC:

American type culture collection

DBM:

Department of biomedicine

HD:

Healthy donor

ICB:

Immune checkpoint blockade

KIR:

Killer immunoglobulin-like receptor

LAG-3:

Lymphocyte activation gene-3

NSCLC:

Non-small cell lung cancer

NK:

Natural killer cell

ORF:

Open reading frame

PD-1:

Programmed cell death protein 1

PD-L1:

Programmed cell death 1 ligand 1

TIGIT:

T-cell immunoreceptor with Ig and ITIM domains

TIL:

Tumor-infiltrating lymphocyte

TIM-3:

 T-cell immunoglobulin and mucin 3

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Acknowledgement

We thank the FACS Core Facility of the DBM of the University of Basel for sorting cells used in this study. Moreover, we thank Prof. Dr. Baum and Prof. Dr. Axel Schambach (Medizinische Hochschule Hannover, Germany) for providing the pRRL.PPT.SFFV.EGFP.pre expression vector. We thank Dr. Ana Luisa Pinto Correia and Priska Auf der Maur for critical input on the manuscript. We also thank all the patients that allowed the use of their material and made this work possible.

Funding

This work was supported by grants from the Swiss National Science Foundation (320030_162575 to Alfred Zippelius) and a Research Fund of the University of Basel (to Franziska Uhlenbrock).

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Contributions

FU, AZ and MPT conceived the idea for the study. FU, MPT and AZ interpreted the data, made the figures and wrote the manuscript. MPT, MK, MAS, FU and AZ planned the experiments. MPT, MK, MS and PH performed and analyzed the experiments. DL, MW and SS provided samples. HL and AZ collected the clinical data and ethical board approvals.

Corresponding authors

Correspondence to Marcel P. Trefny or Alfred Zippelius.

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Conflict of interest

Heinz Läubli and Alfred Zippelius received research funding from Bristol-Myers Squibb. Alfred Zippelius received consulting/advisor fees from Bristol-Myers Squibb, Merck Sharp& Dohme, Hoffmann–La Roche, NBE Therapeutics, Secarna, ACM Pharma and Hookipa and maintains further non-commercial research agreements with Secarna, Hookipa, Roche and Beyondsprings. The authors declare that there are no other conflicts of interest.

Ethical approval and ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Ethikkommission Nordwestschweiz, Study Approval Number EK321/10) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all individual participants included in the study for the use of their specimens in research and publication. This article does not contain any studies with animals performed by any of the authors.

Cell line authentication

K562 cells (ATCC CCL-243) and HEK293T cells (ATCC CRL-3216) were purchased from ATCC, which provided detailed cell line authentication documentation. NA8-Mel was kindly provided by Dr. Romero (University of Lausanne) and their authenticity was confirmed by HLA-A2 positivity and cell morphology. NK92 cells (ATCC CRL-2407) were kindly provided by Dr. Bentires-Alj (University of Basel, Switzerland) and authenticity was certified by ATCC.

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Trefny, M.P., Kaiser, M., Stanczak, M.A. et al. PD-1+ natural killer cells in human non-small cell lung cancer can be activated by PD-1/PD-L1 blockade. Cancer Immunol Immunother 69, 1505–1517 (2020). https://doi.org/10.1007/s00262-020-02558-z

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Keywords

  • Cancer immunotherapy
  • Immune checkpoint inhibitor
  • Inhibitory receptor
  • Resistance
  • Innate immunity