# Lymphocyte and inflammatory cytokine markers of response in the first-in-human combination of anti-PD-1 mAb and IL-15/IL-15Ra complexes and investigation of mediators of anti-tumor immune responses

> **NIH NIH R01** · MEDICAL UNIVERSITY OF SOUTH CAROLINA · 2022 · $389,857

## Abstract

Because PD-1 therapies only benefit approximately 1 in 5 patients with NSCLC, there is a great
need to improve immunotherapy for this disease. A distinct form of immunotherapy, IL-2, can yield complete
responses in melanoma and renal cell carcinoma. Use of IL-2 is limited due to common life-threatening toxicity.
An alternative to IL-2 is IL-15/IL-15Rα complexes. ALT-803 is a clinical grade IL-15/IL-15Rα complex and
powerful super-agonist for IL-15 responsive CD8+ lymphocytes and natural killer (NK) cells with dramatically
improved safety compared with IL-2. Preclinical studies combining ALT-803 with anti-PD-1 mAb demonstrate
remarkable anti-tumor efficacy associated with expansion of both CD8+ T cells and NK cells, and the production
of inflammatory cytokines such as IL-6 and IFNγ. We have moved this therapy into the clinic with an investigator-
initiated, first-in-human, phase Ib/II trial testing the clinical hypothesis that adding IL-15/IL-15Rα complexes (ALT-
803) to anti-PD1 mAb (nivolumab) is safe and efficacious in NSCLC (NCT02523469). To date 11 patients have
been treated with three highly active dose levels (6, 10, 15 mcg/kg SC, 15 being the highest planned dose) with
zero observed dose limiting toxicities (DLTs) and excellent activation of CD8+ T cells and NK cells and increases
in serum IL-6 and IFNγ. The goal of this application is to determine the mechanistic basis and predictors of
response for this promising combinatorial approach using our unique bank of trial-derived samples and a
powerful preclinical lung tumor model. We hypothesize that the addition of IL-15/IL-15Rα complexes to anti-PD-
1 mAb augments anti-tumor efficacy through enhanced expansion and functional activation of tumor-reactive
CD8+ lymphocytes and NK cells and that the induction of inflammatory cytokines such as IL-6 and IFNγ will be
associated with anti-tumor efficacy. We further hypothesize enhanced anti-tumor efficacy will depend on effector
lymphocytes (CD8+ and NK but not CD4+) and correlate with cytokines (IL-6 and IFNγ). Specific Aim 1: Using
state-of-art mass cytometry we will perform the high-dimension characterization of both NK and CD8+ T cell
compartments from longitudinal PBMC samples of up to 116 patients. We will perform TCR sequencing on
expanded T cells to determine if they originate from tumor. We will also perform 65-plex serum
cytokine/chemokine analysis of longitudinally acquired samples to identify novel serum biomarkers. We will
associate changes in lymphocyte and serum cytokines/chemokines parameters with clinical response. Specific
Aim 2: We will use our Lewis lung carcinoma (LLC) mouse model to inform our future clinical efforts with the
combination of anti-PD-1 mAb and IL-15/sIL-15Rα complexes. First, we will identify cellular and molecular
markers that correlate with treatment outcome using longitudinal analysis of responding and non-responding
mice. Second we will validate critical pathways using antibody-mediated depletion of lymphocy...

## Key facts

- **NIH application ID:** 10374802
- **Project number:** 5R01CA222817-04
- **Recipient organization:** MEDICAL UNIVERSITY OF SOUTH CAROLINA
- **Principal Investigator:** MARK P RUBINSTEIN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $389,857
- **Award type:** 5
- **Project period:** 2019-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10374802

## Citation

> US National Institutes of Health, RePORTER application 10374802, Lymphocyte and inflammatory cytokine markers of response in the first-in-human combination of anti-PD-1 mAb and IL-15/IL-15Ra complexes and investigation of mediators of anti-tumor immune responses (5R01CA222817-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10374802. Licensed CC0.

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