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STING agonist 8803 reprograms the immune microenvironment and increases survival in preclinical models of glioblastoma
Hinda Najem, … , Michael A. Curran, Amy B. Heimberger
Hinda Najem, … , Michael A. Curran, Amy B. Heimberger
Published June 17, 2024
Citation Information: J Clin Invest. 2024;134(12):e175033. https://doi.org/10.1172/JCI175033.
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Research Article Immunology Oncology Article has an altmetric score of 30

STING agonist 8803 reprograms the immune microenvironment and increases survival in preclinical models of glioblastoma

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Abstract

STING agonists can reprogram the tumor microenvironment to induce immunological clearance within the central nervous system. Using multiplexed sequential immunofluorescence (SeqIF) and the Ivy Glioblastoma Atlas, STING expression was found in myeloid populations and in the perivascular space. The STING agonist 8803 increased median survival in multiple preclinical models of glioblastoma, including QPP8, an immune checkpoint blockade–resistant model, where 100% of mice were cured. Ex vivo flow cytometry profiling during the therapeutic window demonstrated increases in myeloid tumor trafficking and activation, alongside enhancement of CD8+ T cell and NK effector responses. Treatment with 8803 reprogrammed microglia to express costimulatory CD80/CD86 and iNOS, while decreasing immunosuppressive CD206 and arginase. In humanized mice, where tumor cell STING is epigenetically silenced, 8803 therapeutic activity was maintained, further attesting to myeloid dependency and reprogramming. Although the combination with a STAT3 inhibitor did not further enhance STING agonist activity, the addition of anti–PD-1 antibodies to 8803 treatment enhanced survival in an immune checkpoint blockade–responsive glioma model. In summary, 8803 as a monotherapy demonstrates marked in vivo therapeutic activity, meriting consideration for clinical translation.

Authors

Hinda Najem, Spencer T. Lea, Shashwat Tripathi, Lisa Hurley, Chao-Hsien Chen, Ivana William, Moloud Sooreshjani, Michelle Bowie, Genevieve Hartley, Corey Dussold, Sebastian Pacheco, Crismita Dmello, Catalina Lee-Chang, Kathleen McCortney, Alicia Steffens, Jordain Walshon, Martina Ott, Jun Wei, Anantha Marisetty, Irina Balyasnikova, Roger Stupp, Rimas V. Lukas, Jian Hu, Charles David James, Craig M. Horbinski, Maciej S. Lesniak, David M. Ashley, Waldemar Priebe, Leonidas C. Platanias, Michael A. Curran, Amy B. Heimberger

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Figure 4

STING expression within human glioblastoma microglia and reprogramming with 8803.

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STING expression within human glioblastoma microglia and reprogramming w...
(A) Dot plot showing key gene expression from scRNA-seq of 44 tumor fragments representing 18 glioma patients, including low-grade gliomas (n = 2), newly diagnosed glioblastoma (n = 11), and recurrent glioblastoma (n = 5) analyzed from Abdelfattah et al. (56). Bubble size corresponds to the percentage of cells expressing a gene marker; colors indicate scaled mean expression. (B) Dot plot of selected gene expression within microglia subtypes. CD45– cells include both endothelial and tumor cells. (B) Immune effector functions of microglia subtypes. (C) Representative multiplexed sequential immunofluorescence (SeqIF) imaging of human glioblastoma demonstrating the expression of STING in CD163+ macrophages denoted by white arrows in proximity to the CD31 tumor vasculature (red arrow). Scale bar: 100 μm. A higher magnification image of STING+ CD163+ cells is represented at the upper right quadrant (scale bar: 20 μm). (D) Representative multiplexed SeqIF imaging of human glioblastoma, demonstrating the expression of p-IRF3 (downstream activation of STING pathway) in P2RY12+ microglia denoted by the white arrows. Scale bar: 50 μm. A higher magnification image of p-IRF3+P2RY12+ cells is represented at the upper right quadrant (scale bar: 20 μm). (E) Quantification plot showing the percentages of STING expression in the different cell populations within the human glioblastoma TME. (F) IL-4–, IL-13–, and TGF-β–polarized murine IMG microglia were treated for 48 hours with STING agonists (10 μg/mL), with increasing potency from cGAMP to MLRR-S2-CDA to 8803, and profiled based on various markers. These were quantified based on MFI fold change or percentage of cells that are positive and then presented as a heatmap.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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