B-cell non-Hodgkin lymphomas (NHL) are the sixth most common cause of cancer-related deaths in the United States. While many patients with aggressive lymphomas may be cured with cytotoxic therapy, most indolent lymphomas are incurable with current therapy. Novel effective therapies are therefore needed to treat these patients. The goal of our research is to develop novel biologic therapies for patients with B-cell NHL by utilizing strategies that augment the immune response to the malignant B-cell. During the previously funded period we evaluated whether adding IL-12, an immunostimulatory cytokine, to rituximab in patients with B-cell lymphoma would increase the antibody dependent cytotoxicity of rituximab. In the clinical trial, we found that IL-12 did not significantly increase the response rate above what would be expected with rituximab alone. In correlative studies we found that IL-12 resulted in upregulation of genes in peripheral blood cells but did not have similar effects in the tumor. In laboratory studies, we found that the lack of effector cell response to immune stimulation with IL-12 was related in part to the presence of intratumoral T-cells with suppressive function. Recent studies have suggested that CD4+CD25+ regulatory T (Treg) cells are involved in the regulation of anti-tumor immunity by inducing peripheral tolerance to tumor specific antigens. However, there are little data regarding the effect of Treg cells on tumor-specific T cell immunity in B-cell NHL and subsequently on the malignant B-cell growth. In preliminary studies, we have identified a subset of CD4+CD25+ T cells with a Treg cell phenotype that are present in B-cell NHL. In addition, we find that these Treg cells have the ability to suppress tumor-infiltrating CD4+ and CD8+ T cells in B-cell NHL and that they migrate in response to chemokines such as CCL22 produced by the malignant B-cells. Our central hypothesis is that tumor Treg cells contribute to the growth of malignant lymphoma B cells by suppressing tumor-infiltrating T cells and that malignant B-cells play an active role by selectively recruiting Treg cells to the areas of B-cell NHL. We therefore propose to firstly determine the mechanism by which these Treg cells are recruited to the malignant B-cell microenvironment in non-Hodgkin lymphoma and to discover whether they gain suppressive activity when present in the tumor microenvironment (Aim 1). Secondly, we will assess whether malignant B-cells interact directly with Treg cells in the tumor microenvironment and thereby orchestrate tolerance to their presence (Aim 2). Thirdly, we will establish whether depletion of intratumoral Treg cells, and inhibition of malignant B-cells to decrease Treg cell recruitment, will result in clinical benefit for patients with B-cell NHL (Aim 3). We anticipate that the proposed research will provide a better understanding of the Treg cell-mediated effects in B-cell malignancies. We also anticipate that the clinical use of denileukin diftitox, an interleukin-2 and diphtheria toxin fusion protein, in combination with rituximab, an anti-CD20 monoclonal antibody, will inhibit Treg cells in B-cell lymphoma patients and will also deplete lymphoma B-cells in malignant lymph nodes thereby preventing further recruitment of Treg cells into areas of B-cell lymphoma. This treatment combination will lead to a novel therapeutic approach to modulating Treg cells that will result in clinical benefit for patients with B-cell NHL.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA092104-08
Application #
8119399
Study Section
Clinical Oncology Study Section (CONC)
Program Officer
Merritt, William D
Project Start
2001-07-01
Project End
2013-04-30
Budget Start
2011-08-01
Budget End
2013-04-30
Support Year
8
Fiscal Year
2011
Total Cost
$250,979
Indirect Cost
Name
Mayo Clinic, Rochester
Department
Type
DUNS #
006471700
City
Rochester
State
MN
Country
United States
Zip Code
55905
Younes, Anas; Ansell, Stephen M (2016) Novel agents in the treatment of Hodgkin lymphoma: Biological basis and clinical results. Semin Hematol 53:186-9
Smeltzer, Jacob P; Jones, Jason M; Ziesmer, Steven C et al. (2014) Pattern of CD14+ follicular dendritic cells and PD1+ T cells independently predicts time to transformation in follicular lymphoma. Clin Cancer Res 20:2862-72
Ghesquieres, Herve; Maurer, Matthew J; Casasnovas, Olivier et al. (2013) Cytokine gene polymorphisms and progression-free survival in classical Hodgkin lymphoma by EBV status: results from two independent cohorts. Cytokine 64:523-31
Yang, Zhi-Zhang; Grote, Deanna M; Ziesmer, Steven C et al. (2013) Soluble and membrane-bound TGF-?-mediated regulation of intratumoral T cell differentiation and function in B-cell non-Hodgkin lymphoma. PLoS One 8:e59456
Monge, Jorge; Braggio, Esteban; Ansell, Stephen M (2013) Genetic factors and pathogenesis of Waldenstrom's macroglobulinemia. Curr Oncol Rep 15:450-6
Ansell, Stephen M; Maurer, Matthew J; Ziesmer, Steven C et al. (2012) Elevated pretreatment serum levels of interferon-inducible protein-10 (CXCL10) predict disease relapse and prognosis in diffuse large B-cell lymphoma patients. Am J Hematol 87:865-9
Charbonneau, Bridget; Maurer, Matthew J; Ansell, Stephen M et al. (2012) Pretreatment circulating serum cytokines associated with follicular and diffuse large B-cell lymphoma: a clinic-based case-control study. Cytokine 60:882-9
Ansell, S M; Tang, H; Kurtin, P J et al. (2012) Denileukin diftitox in combination with rituximab for previously untreated follicular B-cell non-Hodgkin's lymphoma. Leukemia 26:1046-52
Yang, Zhi-Zhang; Grote, Deanna M; Ziesmer, Steven C et al. (2012) IL-12 upregulates TIM-3 expression and induces T cell exhaustion in patients with follicular B cell non-Hodgkin lymphoma. J Clin Invest 122:1271-82
Elsawa, Sherine F; Novak, Anne J; Ziesmer, Steven C et al. (2011) Comprehensive analysis of tumor microenvironment cytokines in Waldenstrom macroglobulinemia identifies CCL5 as a novel modulator of IL-6 activity. Blood 118:5540-9

Showing the most recent 10 out of 29 publications