JAK inhibition enhances checkpoint blockade immunotherapy in patients with Hodgkin lymphoma

Science. 2024 Jun 21;384(6702):eade8520. doi: 10.1126/science.ade8520. Epub 2024 Jun 21.

Abstract

Unleashing antitumor T cell activity by checkpoint inhibitor immunotherapy is effective in cancer patients, but clinical responses are limited. Cytokine signaling through the Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway correlates with checkpoint immunotherapy resistance. We report a phase I clinical trial of the JAK inhibitor ruxolitinib with anti-PD-1 antibody nivolumab in Hodgkin lymphoma patients relapsed or refractory following checkpoint inhibitor immunotherapy. The combination yielded a best overall response rate of 53% (10/19). Ruxolitinib significantly reduced neutrophil-to-lymphocyte ratios and percentages of myeloid suppressor cells but increased numbers of cytokine-producing T cells. Ruxolitinib rescued the function of exhausted T cells and enhanced the efficacy of immune checkpoint blockade in preclinical solid tumor and lymphoma models. This synergy was characterized by a switch from suppressive to immunostimulatory myeloid cells, which enhanced T cell division.

Publication types

  • Clinical Trial, Phase I

MeSH terms

  • Adult
  • Aged
  • Animals
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Drug Synergism
  • Female
  • Hodgkin Disease* / drug therapy
  • Hodgkin Disease* / immunology
  • Hodgkin Disease* / therapy
  • Humans
  • Immune Checkpoint Inhibitors* / therapeutic use
  • Immunotherapy
  • Janus Kinase Inhibitors* / therapeutic use
  • Janus Kinases / antagonists & inhibitors
  • Janus Kinases / metabolism
  • Male
  • Mice
  • Mice, Inbred BALB C
  • Mice, Inbred C57BL
  • Middle Aged
  • Nitriles* / therapeutic use
  • Nivolumab* / therapeutic use
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors
  • Pyrazoles* / therapeutic use
  • Pyrimidines* / therapeutic use
  • T-Lymphocytes* / immunology

Substances

  • Immune Checkpoint Inhibitors
  • Janus Kinase Inhibitors
  • Janus Kinases
  • Nitriles
  • Nivolumab
  • Programmed Cell Death 1 Receptor
  • Pyrazoles
  • Pyrimidines
  • ruxolitinib