Oral Presentation Eradicate Cancer 2018

IL-18 critically drives multiple myeloma progression by generating an immunosuppressive microenvironment. (#18)

Kyohei Nakamura 1 , Sahar Kassem 2 , Alice Cleynen 3 , Marie-Lorraine Chrétien 4 , Camille Guillerey 1 5 6 , Eva Maria Putz 1 , Irmgard Forster 7 , Slavica Vuckovic 8 , Geoffrey R Hill 8 , Seth L Masters 9 10 , Marta Chesi 11 , P. Leif Bergsagel 11 , Hervé Avet-Loiseau 2 12 , Ludovic Martinet 2 , Mark Smyth 1 5
  1. Immunology in Cancer and Infection and Cancer Immunoregulation and Immunotherapy Laboratories, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
  2. Cancer Research Center of Toulouse, INSERM UMR, Toulouse, France
  3. Institut Montpelliérain Alexander Grothendieck, CNRS, Univ. Montpellier, Montpellier, France
  4. University Hospital, Dijon, France
  5. School of Medicine, University of Queensland, St Lucia, Queensland, Australia
  6. School of Medicine, University of Queensland, St Lucia, QLD, Australia
  7. LIMES Institute, Universitat Bonn, Bonn, Germany
  8. Department of Bone Marrow Transplantation, Royal Brisbane Hospital, Brisbane, Queensland, Australia
  9. Division of Inflammation, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
  10. Department of Medical Biology, The University of Melbourne, Parkville, Australia
  11. Comprehensive Cancer Center, Mayo Clinic, Scottsdale, Arizona, USA
  12. Institut Universitaire du Cancer, Toulouse, France

Although novel anti-myeloma agents have been developed, multiple myeloma (MM) is still an incurable disease. The growth of MM cells highly depends on the bone marrow (BM), where cellular components and soluble factors cooperatively orchestrate the pro-survival and immunosuppressive microenvironment. Tumor-promoting inflammation and avoiding immune destruction are hallmarks of cancer, however the molecular and cellular mechanisms of MM-associated inflammation and immunosuppression remain poorly understood. Here, we demonstrate that the pro-inflammatory cytokine IL-18 is critically involved in these hallmarks in MM.  Using Vk*MYC preclinical mouse models, a comprehensive analysis of the transcriptional landscape of the immune microenvironment in MM patients, and BM cytokine analyses, we demonstrate that dysregulated production of IL-18 is a key driving force for immunosuppression in the MM microenvironment and a potential therapeutic target.  Mice deficient for IL-18 were remarkably protected from Vk*MYC MM progression in a CD8+ T cell-dependent manner.  The MM-niche derived IL-18 drove generation of myeloid-derived suppressor cells (MDSCs), leading to accelerated disease progression. A global transcriptome analysis of the immune microenvironment in 73 MM patients strongly supported the negative impact of IL-18-driven MDSCs on T cell responses.  Strikingly, high levels of bone marrow plasma IL-18 were associated with poor overall survival in MM patients. Our results reveal the critical role of IL-18 in the MM immunopathology, which provides insight into therapeutic strategies against MM.