Abstract
Preclinical therapeutic assessment currently relies on the growth response of established human cell lines xenografted into immunocompromised mice, a strategy that is generally not predictive of clinical outcomes. Immunocompetent genetically engineered mouse (GEM)-derived tumor allograft models offer highly tractable preclinical alternatives and facilitate analysis of clinically promising immunomodulatory agents. Imageable reporters are essential for accurately tracking tumor growth and response, particularly for metastases. Unfortunately, reporters such as luciferase and GFP are foreign antigens in immunocompetent mice, potentially hindering tumor growth and confounding therapeutic responses. Here we assessed the value of reporter-tolerized GEMs as allograft recipients by targeting minimal expression of a luciferase-GFP fusion reporter to the anterior pituitary gland (dubbed the “Glowing Head” or GH mouse). The luciferase-GFP reporter expressed in tumor cells induced adverse immune responses in wildtype mouse, but not in GH mouse, as transplantation hosts. The antigenicity of optical reporters resulted in a decrease in both the growth and metastatic potential of the labeled tumor in wildtype mice as compared to the GH mice. Moreover, reporter expression can also alter the tumor response to chemotherapy or targeted therapy in a context-dependent manner. Thus the GH mice and experimental approaches vetted herein provide concept validation and a strategy for effective, reproducible preclinical evaluation of growth and response kinetics for traceable tumors.
Introduction
The average drug developed by major pharmaceutical companies has been estimated to cost between 4 and 11 billion dollars [1], costing the average cancer patient approximately $100,000 per year. These staggering costs are driven in part by an inability early in the developmental pipeline to reliably identify drugs that will be efficacious, and the overall approval rate for an oncological compound is currently about 5% [2]. Much of this failure can be attributed to the inadequacy of preclinical models used in therapeutic evaluation. Historically, preclinical animal studies have utilized decades-old established human cell lines, transplanted as xenografts subcutaneously into immunocompromised mice [3]. Unfortunately, these models have had limited efficacy-predictive value for drug development, yet have been deemed critical for improving pharmaceutical productivity and patient care [4].
The proficiency of preclinical cancer studies is linked to the appropriateness of the animal model itself. Paramount is the presence of a fully functional immune system, which is involved in virtually every step of disease development, and critically determines treatment responses [5]. Tumor cells interact reciprocally and dynamically with immune and other microenvironmental cells throughout the course of metastatic progression and also following therapeutic intervention [6]. This interaction is appropriately modeled both in autochthonous genetically engineered mouse (GEM) cancer models and by orthotopic transplantation of GEM-derived allografts (GDAs) into fully immunocompetent host mice [7], but not effectively in current human cancer xenograft models. Finally, therapeutic and biomarker evaluation should ideally rely on preclinical cancer models recapitulating naturally occurring metastasis, the most deadly cancer phase.
Tractable preclinical models require the ability to accurately monitor disease progression and therapeutic response, facilitating the adoption of relevant clinical endpoints [8]. Disease monitoring is essential for metastases and otherwise undetectable tumors. Optical imaging of cells expressing light-generating proteins currently dominates monitoring technologies due to their ability to measure real-time events, cost-effectiveness and time-efficiency [9]. However, most traceable marker proteins, including the popular firefly luciferase (ffLuc) and jellyfish enhanced green fluorescent protein (eGFP), are xenobiotic to mammals. Their expression naturally induces various immune responses in immunocompetent animals, resulting in inconsistent activity [10], [11], rejection of grafts [12] and suppression of metastatic activity [13], confounding the validity of preclinical conclusions. Thus, the effective use of xenobiotic reporters is restricted to either short-term studies, or fully immunocompromised animal models, limiting preclinical options [9], [13].
To overcome these problems, we have developed a GEM model that is immune-tolerant to both ffLuc and eGFP to serve as a host for transplantation of labeled syngeneic tumors. Using the rat growth hormone (rGH) promoter, expression of a ffLuc-eGFP fusion protein was targeted to the anterior pituitary, a non-immune privileged site distant from commonly monitored organs in preclinical studies, thereby creating the “Glowing Head” (GH) mouse [14]. We demonstrate that in wildtype mice immune responses induced by xenobiotic reporters substantially affect the progression and therapeutic responses of imageable transplanted tumors. Importantly, the use of pre-tolerized GH mice minimizes or eliminates these aberrations, resulting in more reliable, tractable preclinical models.
Materials and Methods
Lentiviral Vectors
The lentiviral vector that expresses the firefly luciferase-enhanced green fluorescent protein fusion protein (FerH-ffLuc-eGFP) was described previously [10]. It was here modified to remove eGFP and insert an internal ribosome binding site (IRES) and histone H2B-tagged eGFP (H2B-eGFP) to generate FerH-ffLuc-IRES-H2B-eGFP, which targets the expression of ffLuc and eGFP to the cytoplasm and nucleus, respectively. Detailed information on the vector sequence will be provided upon request to Dr. Dominic Esposito (e-mail: espositod@mail.nih.gov), Leidos Biomedical Research, Frederick, MD, USA.
Animals
To reduce bioluminescence absorption and experimental variation, albino 6- to 8-week-old inbred female mice on a C57BL/6 (C57BL/6c-brd/c-brd/Cr) or FVB/N background were used as hosts for transplantation studies. F1 mice from the breeding of C57BL/6 with 129 (B6;129) mice were used as isogenic hosts in the study of NRasQ61K/p19ARF-null melanoma, which was derived from a mixed genetic background [15], [16]. All animals used in this research project were cared for and used humanely according to the following policies: The U.S. Public Health Service Policy on Humane Care and Use of Animals (1996); the Guide for the Care and Use of Laboratory Animals (1996); and the U.S. Government Principles for Utilization and Care of Vertebrate Animals Used in Testing, Research, and Training (1985). All mouse experiments were performed in strict accordance with Animal Study Protocols approved by the Animal Care and Use Committee (ACUC), NCI, at the Frederick National Laboratory for Cancer Research, which is accredited by AAALACi and follows the Public Health Service Policy on the Care and Use of Laboratory Animals. The following protocols were approved by the ACUC for performing this study: ASP# 08–084, 11–044, and 11–058.
The mice in this study were euthanized by CO2 asphyxiation following NCI-approved ACUC guidelines: (1) Transfer the mice to a CO2 chamber right before euthanasia. (2) Turn on the CO2 at 2 liters per minute for a standard sized of chamber. (3) Within approximately two to three minutes, adult mice should be immobile and unresponsive; when this is evident, increase the flow rate to high or approximately 10 liters/min. (4) When breathing ceases for all animals seen through the cage, set the timer for 2 minutes. At the end of two minutes, the mice may be removed from the CO2-filled cage. Ensure death by making sure there are no movements of any kind for an additional 60 seconds outside the CO2-filled cage, using the timer.
Generation of the “Glowing Head” mouse
The rGH-hGH construct [17] (a gift of Dr. Rhonda Kineman, University of Illinois-Chicago, Chicago, IL) was modified by insertion of an ffLuc-eGFP fusion gene to generate the anterior pituitary gland-targeting vector, which was used to generate transgenic mice in both the C57BL/6 and FVB/N genetic backgrounds by blastocyst microinjection. Small colonies of homozygous transgenic mice were maintained for breeding purposes, and their heterozygous progeny used for all preclinical studies. All the transgenic and breeding work was performed through the Laboratory Animal Science Program, Frederick National Laboratory.
Murine tumors, cancer cell lines, and their labeling
The Lewis Lung Carcinoma (LLC) tissue was maintained only in vivo since its derivation from the original lung tumor of C57BL/6 mice [8]. The spontaneously metastasizing serial Hgf-tg/CDK4R24C melanoma skin transplant was generated from a primary melanoma induced in Hgf-tg/CDK4R24C C57BL/6 mice by epicutaneous application of the carcinogen DMBA [18]. HGF-tg/CDKN2A-/- melanoma was derived from tumors induced in HGF-tg/CDKN2A-/- FVB mice by UV irradiation [19]. These tumors were maintained only in syngeneic mice. For transplantation, the harvested tumor tissues were divided into 3 mm ×3 mm pieces and each one was inserted into a 5-mm cut on skin of a mouse. Mvt-1 murine breast cancer cells were derived from mammary tumors of the MMTV-c-Myc/MMTV-Vegf bi-transgenic mouse on an FVB/N inbred background [20]. They were established as a cell line and maintained through in vitro culture. For transplantation, 1.0×106 cells were prepared from culture and injected subcutaneously into each mouse. Mutant NRasQ61K/p19ARF-null melanoma cells were generated as described [15], [16]. In the first passage, 1.0×106 cells from in vitro culture were inoculated into C57BL/6x129 F1 mice to form tumors. In the following passages, the fragments divided from harvested tumor were used for transplantation, as described above.
To label the in vivo maintained tumors, cell suspensions prepared from in vivo-expanded tumors were infected ex vivo with lentivirus by ex vivo spinoculation [10], [21]. LLC tissue was infected with lentivirus encoding ffLuc-eGFP or ffLuc-IRES-H2B-eGFP and then subjected to in vivo cycling to obtain uniformly-labeled tumors, as described previously [8]. Cell lines were labeled with ffLuc-eGFP lentivirus in vitro, and the eGFP+ populations were isolated using the fluorescence-activated cell sorter (FACS).
Preclinical studies and pathological analysis
For preclinical studies, a cryogenically preserved labeled tumor was revived and expanded by subcutaneous transplantation into mice. These tumors were resected upon reaching 500 mm3 and expanded through passage into the requisite number of mice for the actual studies described in the text. Tumor size was measured manually and calculated by V (mm3) = 0.5×L×W2, where L is length and W is width in mm. For the preclinical modeling of primary tumors, mice were randomized into groups according to study design when their tumors reached 125 mm3. The control group received vehicle solution, and the experimental group received treatments of chemotherapeutic agents. The dose and schedule in each experiment have been specified in the Results. When tumors grew to 2000 mm3, mice had reached their endpoints and were euthanized for further study.
For preclinical models of spontaneous metastasis, primary tumors were surgically removed upon reaching 500 mm3, and the mice were randomized into groups according to the study design. Metastasis and recurrence were monitored periodically by imaging using the Xenogen IVIS system [8] to measure BL flux (photon/sec/radial degree). The control group received vehicle solution, and the experimental group received treatments of chemotherapeutic agents. The dose and schedule in each experiment have been specified in the Results. When mice showed signs of morbidity, defined by the animal study protocol (e.g. short of breathiness, difficulty in moving), they reached their endpoint and were euthanized for further study.
The drugs used in this study were obtained from the Drug Synthesis & Chemistry Branch, DTP, NCI (Bethesda, MD). Paclitaxel was dissolved at 10x the desired concentration in 100% ethanol, diluted with an equal volume of Cremaphor EL and then diluted to the 1x concentration with saline before intravenous injection into mice. Gemcitabine was dissolved in water and injected intraperitoneally into mice. Crizotinib was resuspended in 0.5% methylcellulose in 0.9% saline, and given once daily by oral gavage (PO) over a 3-week period at 10 ml/Kg. Mice carrying subcutaneous tumors were randomized into 3 groups based on tumor measurement (200–500 mm3), and treated with vehicle alone, crizotinib at 50 mg/kg, or Crizotinib at 100 mg/kg.
Harvested tissues were fixed in 10% formaldehyde and paraffin-embedded. Adjacent serial sections were stained with hematoxylin and eosin (H&E) for histological analysis, or used for GFP immunohistochemistry (ab6556, Abcam, Cambridge, MA, USA). Histopathology was performed by Dr. Miriam Anver (Pathology and Histotechnology Laboratory, Leidos Biomedical Research, Frederick, MD). For quantitative analysis, slides were scanned using the ScanScope XT system and images were analyzed by Spectrum Plus pathology analysis software (Aperio Technologies, Vista, CA).
Hormone and immunological marker analysis
Sera were prepared from the collected whole blood following conventional protocols and stored at −80°C. To analyze anti-GFP antibody in serum, ELISA plates (Nunc MaxiSorp, cat# 439454, Thermo Scientific, Waltham, MA, USA) were coated with 31.25 ng of recombinant GFP (MB-0752, Vector Laboratory, Burlingame, CA, USA) in each well overnight at 4°C. The next day, sera and control monoclonal anti-GFP antibody (11814460001, Roche Applied Science, Indianapolis, IN, USA) were subjected to serial dilution with blocking solution (3% milk in phosphate-buffered saline [PBS]) to reach the range 1∶25–1∶2000 for the former and 6.25–200 ng/ml for the latter. 50 µl of diluted sera or control antibody were added to the coated wells, followed by incubation for an hour at room temperature. After washing with PBS containing 0.05% Tween 20 (PBST). Horse reddish peroxide (HRP)-conjugated goat anti-mouse antibody (115-035-062, Jackson ImmunoResearch Laboratories) at 1∶1000 dilution in blocking solution was then added into each well, followed by the addition of peroxidase substrate (TMB 2-Component Microwell Peroxidase Substrate Kit, 50-76-00, KPL, Gaithersburg, MD, USA) for color development according to the manufacturer's instruction. The A450 absorption of the plates was measured using a microplate reader (VMax Kinetic ELISA Absorbance Microplate Reader, 97059-546, VWR Corp., Radnor, PA, USA). Mouse growth hormone levels in sera were analyzed using the Growth Hormone (GH) ELISA kit (M0934, Biotang Inc., CA, USA) according to the manufacturer's instruction as following. Sera were diluted 2-fold with RPMI1640 medium, and standard solutions were prepared for the concentration range 0.3125–100 ng/ml. The standards and samples were added into the provided ELISA plate, which was incubated at 37°C for 40 min and washed with washing buffer. Each well was then added with 50 µl of water and 50 µl of biotinylated anti-GH antibody, and incubated at 37°C for 20 min. After washing, 100 µl of streptavidin-conjugated HRP was added into each well and incubated at 37°C for 10 min. After another washing, 100 µl of HRP substrate solution was added to each well, incubated at 37°C for 15 min, followed by adding 100 µl of stop solution. The A450 absorption of the plates was measured using the VMax microplate reader.
To analyze cell surface markers, single-cell suspensions were prepared from harvested mouse spleens and incubated with 5 µl/ml of Fcγ Receptor antibody (14-0161-85, eBiosciences, San Diego, CA, USA) for blocking for 20 min. Following a wash with staining solution (PBS containing 1% bovine serum albumin [BSA]), they were incubated with 0.3 µl/ml of rat anti-mouse CD4 (550728, BD-Pharmingen, San Jose, CA, USA) or CD8α (550281, BD-Pharmingen antibody, or isotype control antibody (559073, BD-Pharmingen) at 4°C for 1 hr, followed by washing with staining solution for three times. The cells were then incubated with 4 µl/ml of Alexa 488-conjugated goat anti-rat secondary antibody (A11006, Invitrogen, Grand Island, NY, USA) at 4°C for 20 min. After washing with staining solution for three times, the cells were subjected to FACS analysis (FACSCalibur, BD Biosciences, San Jose, CA, USA) or Cell Analyzer equipped with a filter optics module for FITC detection to quantitate the expression of cell markers (Cellometer Vision, Nexcelom Bioscience, Lawrence, MA, USA). The data generated from FACS and Cellometer Vision were analyzed and quantitated with software FlowJo (TreeStar, Inc. Ashland, OR, USA) and FCS Express (De Novo Software, Los Angeles, CA, USA), respectively.
Statistical analysis
Differences in quantity distribution (e.g. tumor size, bioluminescence intensity, CD8/CD4 ratio) between study groups were analyzed using the parametric unpaired t test. For preclinical studies, the end point was overall survival, defined as the time until mouse morbidity according to the animal study protocol. Mice alive at the end of the study were censored at that date. The Kaplan-Meier method and Mantel-Cox logrank-test were performed to compare survival rates of the mouse groups. Statistical significance was established at the P-value <0.05. The median survival time was calculated as the smallest survival time for which the survivor function reached 50%. The computations were done with GraphPad Prism 6 (La Jolla, CA).
Results
Reporter activity of ffLuc-eGFP-labeled murine tumors is inconsistent in immunocompetent syngeneic mice
The subcutaneously transplanted Lewis Lung Carcinoma (LLC) is a well-characterized metastatic model that has recently been exploited in several high profile preclinical studies [22]–[24]. We recently retrieved archived LLC tissue never adapted to cell culture, and showed that following transplantation and resection metastasis occurred with very short latency in >90% of syngeneic WT C57BL/6 host mice [8]. Here we labeled LLC with an ffLuc-eGFP-encoded lentivirus ex vivo [10]. Since viral transduction results in heterogeneous cell population [25], we subject this labeled tumor to in vivo cycling to render them uniformly labeled [8], [26]. Briefly, mice bearing transplanted tumors are monitored for metastasis, and metastatic nodules will be harvested for subcutaneous transplantation to initiate next cycle. Since each nodule was derived from a single cell, the tumor derived from it is presumably clonal. Therefore, homogeneity will be enhanced through each cycle. As shown in Fig. 1A, following subcutaneously transplantation and resection of the labeled LLC in five mice, arising metastases were readily detected by in vivo bioluminescence (BL) imaging. In this passage, although tumors grew in all hosts, metastases were detected in only one (#160 in Fig. 1A, lower panel). We harvested lungs from that mouse and examined it with ex vivo imaging (Fig. 1B, upper panel). The unevenly distributed BL intensity reflected the heterogeneity of transduced cells in primary tumor (Fig. 1B, upper panel). We collected from host mice three individual well-labeled lung metastases, presumed to be clonal, dividing them into five fragments for transplantation into five C57BL/6 mice. Labeled pulmonary nodules from that mouse were collected and transplanted into another five C57BL/6 mice; however, these tumors then grew very slowly and/or exhibited no detectable reporter activity (Fig. 1B). These results demonstrate that reporter activity in labeled cells could not be consistently maintained over passages in syngeneic immunocompetent mice, even after clonal selection.
To determine if reporter consistency was dependent on tumor type, we extended our analysis to mouse melanoma. An NRasQ61K-transformed, p19ARF-deficient melanocytic cell line [15], [16] was labeled using the ffLuc-eGFP lentivirus and transplanted subcutaneously into syngeneic immunocompetent mice. Following resection one high-BL pulmonary nodule was selected for subcutaneous transplantation into two mice (Fig. S1A, left panels). Both tumors exhibited a significant reduction in normalized BL activity during subcutaneous growth (Fig. S1A, right panels). We corroborated these results in two other models. Melanoma cells harvested directly from an HGF-transgenic/CDKN2A-knockout FVB/N mouse were transduced with the ffLuc-eGFP gene ex vivo, and transplanted subcutaneously into syngeneic FVB/N mice. While all tumors grew, BL intensity was either reduced or increased more slowly (Fig. S1B), and BL intensity/size ratio, serving as the labeling retention indicator, was reduced in three of five tumors. In another model, ffLuc-eGFP-expressing mouse Mvt-1 breast cancer cells transplanted orthotopically into mammary fat pads of syngeneic FVB/N mice also demonstrated poor retention of BL signaling (see below). We conclude that ffLuc-eGFP expression in allografts in immunocompetent wildtype (WT) mice is inconsistently maintained between mice and/or passages, irrespective of tumor type, genetic background or transplantation site.
Generation of a GEM model immunologically tolerant to GFP and luciferase reporters
Our results suggested that immunogenicity of xenobiotic reporter gene products is largely responsible for their inconsistency in the context of a fully functional immune system. To circumvent this issue, we generated C57BL/6- and FVB/N-based GEM models recognizing ffLuc and eGFP proteins as self. For its high specificity, rGH gene sequences [17] (Fig. 2A) were employed to target expression of an ffLuc-eGFP fusion gene to the anterior pituitary gland of the mouse, thereby avoiding interfering signaling from the most common metastatic sites.
The anterior pituitary gland is not an immune-privileged site and is thus part of systemic circulation [27]. The transgene-encoded ffLuc and eGFP proteins expressed in the anterior pituitary gland during embryonic development therefore participate in the selection of T and B cells and are recognized as self-antigens, resulting in their tolerization. To reduce light adsorption by pigment the ffLuc-eGFP transgene was bred into the albino C57BL/6F (c-Brd) background. Founder lines were chosen from each strain that demonstrated Mendelian transgene inheritance and normal fecundity. In our previous study, we identified the detection limit of BL signal from in vivo mouse imaging was 1.5×105 photon/sec/rad [8]. To avoid possible confounding effects associated with high transgene expression, those founder lines exhibiting low but consistent BL signal above background reading (about 2–6×105 photon/sec/rad) were selected (Fig. S2A). Consistent with targeting reported for the rGH promoter [17], BL signal was evident in the head and testes of transgenic lines (Fig. 2B); modest signal could also be detected in the thyroid glands, but only by using ex vivo imaging (not shown). The BL levels in the body of GH mice are close to those in WT mice, indicating the high specificity of the transgene (Fig. S2B). Based on the site of reporter activity and rGH promoter used for targeting these GEMs were dubbed “Glowing Head” (GH) mice.
The possible impact of transgene expression on pituitary function was evaluated by comparing circulating growth hormone levels in GH and WT C57BL/6 mice. We found that serum growth hormone levels were not significantly different between transgenic and WT (Fig. 2C), irrespective of gender, indicating that expression of the ffLuc-eGFP transgene does not overtly affect anterior pituitary function in GH mice.
To assess the immunological consequences of reporter expression, cells from ffLuc-eGFP-labeled LLC tumors were transplanted subcutaneously into GH and WT C57BL/6 mice, as well as MHC-unmatched, immunocompromised non-obese diabetic/severe combined immunodeficiency (NOD/SCID) mice (BALB/c background). When tumors reached 500 mm3 blood was withdrawn and sera tested for the presence of anti-GFP antibody. While tumor-bearing WT mice possessed significant levels of circulating anti-GFP antibody (Fig. 2D and Fig. S2C), no significant difference was found between tumor-bearing GH and NOD-SCID mice, which is known incompetent to produce antibody (Fig. S2C). These data show that while immunogenic in WT mice, ffLuc-eGFP is tolerated and recognized as self in GH mice.
Growth and metastasis of tumor cells expressing imageable xenobiotic reporters are altered in WT and NOD/SCID mice compared to GH mice
To test the function of GH mice, we implanted ffLuc-EGFP-labeled tumors subcutaneously into syngeneic WT and GH mice. Although tumor size increased similarly in both types of host mice, BL increases in tumors were significantly delayed in WT mice as compared to GH mice (Fig. S3A). This result suggested that using GH mice as allograft recipients could help correct the inconsistencies observed in BL signals from labeled tumors transplanted into immunocompetent mice. To validate this point, we tested GH mouse in a larger scale study involving both primary tumor and metastasis. Metastatic Mvt-1 breast cancer cells [20], [28] were transduced with ffLuc-eGFP lentivirus and transplanted orthotopically into mammary fat pads of GH or WT syngeneic FVB/N recipient mice. Labeled Mvt-1 cells exhibited a significant enhancement in BL signaling over time when transplanted into GH mice vs. WT, which failed to retain signaling (Fig. 3A and higher panels of Fig. S4A). Since imageable reporters are essential for monitoring metastasis, responsible for the vast majority of cancer patient deaths, primary Mvt-1 tumors were resected and host mice followed over time. BL imaging showed that metastases were present after a few days and grew efficiently in GH mice (Fig. 3B and lower right panels of Fig. S4A). In contrast, metastases were first detected in a small percentage of WT mice at day 20, while most mice remained BL-free for over 2 months (Fig. 3C and lower left panel of Fig. S4A). Notably, at the experimental endpoint ex vivo imaging revealed that metastases were found at multiple sites in GH mice, but only in the lungs of WT mice (Fig. S4B). The survival of WT mice was also significantly prolonged compared to GH mice (Fig. 3D; p = 0.0025). These results indicate that immunity against xenobiotic reporters can suppress the metastatic potential of transplanted labeled cancer cells, and highlight the advantages provided by the GH mouse for monitoring cancer progression and cell tracking.
We corroborated and expanded our assessment of the GH mouse using ffLuc-eGFP-expressing LLC cells. Well-labeled LLC cells were transplanted subcutaneously into GH, WT and also NOD/SCID mice, which have residual innate immune activity, and arising tumors resected at the same size. In the first imaging after resection (day 3 in Fig. 3E to 3G and Fig. S5), metastases arose with higher BL levels in GH mice relative to those in WT and NOD/SCID mice. Subsequent monitoring revealed that metastases progressed efficiently and caused the death of all GH mice from day 9 to 15. As compared to GH mice, the overall disease progression was delayed in NOD/SCID and even more in WT mice. Accordingly, all the NOD/SCID mice died from day 13 to 18, while two of five WT mice were still alive at day 18 (Fig. S5). Importantly, the median survival time of GH mice was significantly shorter than that of either WT or NOD/SCID mice (Fig. 3H; P = 0.0037). These results demonstrate that immune responses against xenobiotic reporters can restrict the growth and metastatic potential of labeled tumors in immunocompetent and even partly immunocompromised mice, a problem that could be overcome through the use of GH host mice.
Immunogenicity associated with imageable reporter expression influences the therapeutic outcome of preclinical mouse studies
The advantages illustrated above suggest that GH mice would constitute a superior preclinical model for drug assessment. We have shown that chemotherapeutic paclitaxel has no significant effect on growth of subcutaneous LLC tumors in syngeneic C57BL/6 hosts, irrespective of doses ranging between 6.7–22 mg/kg, QDx5 (Fig. S6). In this study syngeneic GH and WT mice carrying subcutaneous ffLuc-eGFP-labeled LLC tumors were randomized to receive vehicle or paclitaxel at 7.5 mg/kg, QDx5, considered to be a dose mimicking human treatment [8], [29]. As with unlabeled LLC growing in WT mice, paclitaxel had no effect on tumors growing in GH mice (Fig. 4A); in contrast, growth of the ffLuc-eGFP-labeled tumor was significantly delayed in treated WT mice (Fig. 4B). Interestingly, the spleens of paclitaxel-treated WT mice were significantly larger relative to the other three groups (Fig. 4C), and exhibited enlarged, disrupted lymphatic follicles (Fig. S7). Accordingly, the CD8/CD4 ratio of splenocytes increased in paclitaxel-treated WT mice (Fig. 4D), correlating with spleen size in all groups (Fig. 4E). There was no difference in the growth or response to paclitaxel of unlabeled LLC cells growing in WT vs. GH mice (not shown). These data suggest that paclitaxel treatment could produce a false-positive preclinical outcome by inducing a cytotoxic T cell response against a xenobiotic tumor antigen, but only in WT mice that had not been pre-tolerized to that antigen. Taken more broadly, our results show that tumor antigens can significantly influence preclinical tumor response to chemotherapy.
To assess the effects of antigenic reporters on response to molecularly-targeted therapeutic agents, we employed the melanoma GDA model HCmel12 (derived from an HGF/CDK4R24C-transgenic mouse [18]), labeled ex vivo with ffLuc-eGFP, and transplanted subcutaneously into syngeneic GH or WT c-Brd mice. Upon reaching 125 mm3, mice were randomized to receive either vehicle or crizotinib, a drug targeting the HGF receptor (MET). Crizotinib effected insignificant or modest changes on tumor growth in GH and WT recipients, respectively (Fig. 5A). Pathological analysis revealed that in GH, but not WT, host mice crizotinib significantly reduced inflammation and tumor invasiveness at the primary site (Fig. 5B and Fig. S8). Moreover, crizotinib significantly reduced the number of pulmonary metastases in a dose-dependent manner only in GH mice (Fig. 5C). In this case, our data indicate that immunity against xenobiotic reporters can produce a false-negative response in WT mice, which can be avoided by using GH mice as hosts.
GH mice enable the ability to reliably track metastatic disease progression and therapeutic response in fully immunocompetent preclinical models
Previously, we demonstrated the feasibility of tracking cancer recurrence and progression with BL imaging in metastatic models [8]. Our initial studies using ffLuc-eGFP LLC tumors transplanted into GH mice showed that in vivo BL increases within the range of 1.5×105 to 5×107 photon/sec/rad reliably represent metastatic growth following resection of subcutaneous tumors (Fig. S9A). Encouraged by the demonstrated ability of GH mice to detect therapeutic differences in metastatic disease, we tested a first-line chemotherapeutic drug in a post-resection adjuvant setting. Tumors from ffLuc-eGFP-labeled LLC were transplanted subcutaneously into syngeneic GH mice and resected at 500 mm3, after which mice were randomized to receive vehicle or gemcitabine. BL imaging showed that metastasis progressed efficiently in mice from the control treatment group (Fig. 6A), but was greatly suppressed by gemcitabine (Fig. 6B). Accordingly, gemcitabine significantly prolonged mouse disease-free survival (P<0.0001, time median undecided vs. 11 days in control; Fig. 6C). BL signals from in vivo imaging well corresponded to the metastatic nodules identified in harvested lungs by visual observation and ex vivo imaging (Fig. 6D). At the endpoint, the metastatic burden detected by in vivo BL imaging was also validated by ex vivo imaging of the harvested lungs (Fig. S10A). To determine if fluorescence could be exploited to isolate tumor cells for molecular analyses, whole lung single cell suspensions from untreated GH mice were subjected to FACS. The eGFP+ LLC cells were readily separated from all stromal cells by FACS (Fig. 6E), and formed well-labeled tumors upon re-transplantation (Fig. S10B).
Discussion
Based on recent clinical breakthroughs in immunotherapy [30], and the ever-expanding evidence that the immune system plays numerous key roles in tumorigenesis, the need for immunocompetent preclinical mouse models has become acute. Immunocompetent GDA transplantation models offer significant advantages, allowing: incorporation of human-relevant genomic alterations and environmental insults into GEM-derived allografts; appropriate microenvironmental interactions between the transplanted tumor and host; preclinical and molecular analyses of metastatic lesions and perfectly matched sets of pre- and post-treatment samples; and industry-friendly experimental turnaround time. Immunocompromised patient-derived xenograft (PDX) models have shown promise as preclinical tools for testing chemotherapy [31], but the approach to modify host mice to bear a “humanized” immune system is prohibitively expensive and mostly untested.
The full value of any preclinical model can only be realized if cancerous lesions can be accurately monitored longitudinally. On balance optical reporters offer superior qualities and are widely used; unfortunately, their xenobiotic nature confounds their use in the context of a fully competent murine immune system. In fact, any xenobiotic gene introduced into immunocompetent animals poses a potential problem [32], [33], including other reporters [34], recombinases [35], transactivating factors [36] and viral oncogenes [37]. In this report we demonstrate that xenobiotic reporters induce problematic immune responses in immunocompetent mice, causing inconsistent activity and altered tumor behavior. We also describe a new GEM model immunologically tolerant to ffLuc and eGFP, which can serve as a transplantation host for any so-labeled syngeneic tumors. Immune responses induced by optical markers substantially affected growth, progression, and therapeutic responses of tumors transplanted into WT hosts, problems that were minimized or eliminated by using pre-tolerized GH mice. This difference was most notable with metastatic disease. GH mice enable consistent ffLuc-eGFP reporter activity, accurate monitoring throughout longitudinal studies, and tumor cell isolation for molecular analyses, all in the context of a normal immune system. Moreover, GEMs pre-tolerized to virtually any imageable marker can now be developed and exploited.
Most notably, immunity against reporter genes expressed in labeled tumors could significantly alter the outcome of preclinical therapeutic studies. Our first study showed that, relative to GH mice, paclitaxel delayed the growth of ffLuc-eGFP-expressing LLC tumors in WT hosts, where it induced a cytotoxic T cell response. Consistent with our observations, the immunogenicity of cell death induced by cytotoxic agents has been reported to be a critical determinant of chemotherapeutic efficacy [5]. However, we were surprised to observe that labeled tumors transplanted into WT mice could also be less responsive to drugs relative to those transplanted into GH hosts, indicating that the precise consequence of xenobiotic reporter expression is context-dependent (e.g. tumor type, tumor location, drug). The impact of such preclinical uncertainty on cancer patients is the possible inclusion of an ineffective drug or the exclusion of an efficacious drug in clinical trials. Therefore, results obtained from preclinical studies using labeled tumors transplanted into immunocompetent WT mice must be interpreted with great caution.
Interestingly, we found that reporter activity and growth of labeled transplanted tumors were altered not only in syngeneic WT, but also in partially immunocompromised NOD/SCID mice. Similarly, while progressing efficiently in GH mice, spontaneous metastasis was delayed or suppressed in NOD/SCID as well as WT mice. NOD/SCID mice are defective in adaptive immunity, but retain some innate immune function, including NK cell activity [38]. These findings suggest that xenobiotic reporters activate innate immunity, and indicate that immunocompromised mice with residual immunity cannot fully overcome the labeling inconsistency observed in WT mice.
The results above have demonstrated the complicated interaction between tumor antigens and immune system. The antibody reaction in WT vs. GH mice observed in Fig. 2D indicated that ffLuc-eGFP is an antigen capable of activating B cells. The results that tumor progression was delayed in NOD-SCID mice as compared to GH mice suggested that NK cells are involved, since the former still exhibits residual NK cell activity [38]. We further demonstrated that cytotoxic T cell response induced by ffLuc-eGFP induced was significantly enhanced by paclitaxel treatment (Fig. 6). Importantly, chemotherapy and targeted drug may modify the response against tumor antigen, as proposed by many studies [5]. The results above have suggested that immune system may respond to xenobiotic antigens in multiple, inter-dependent mechanisms, including adaptive (B and T cells) and innate (NK cells) immunity. In fact, a routine practice for the analysis of immune response is to compare antigenic responses between a specific mouse strain and a pre-tolerized control strain. In this regard, GH mice serve as “control” strain to study the immune response. Therefore, GH mice can also be a useful tool for immunological studies. Our complex immune system is involved to varying degrees in virtually all aspects of health and disease. Inclusion of an immune system in any preclinical model is clearly highly desirable, and of course essential when assessing highly promising immunotherapies. Preclinical cancer models become more valuable and versatile when tumor progression and drug response can be accurately and longitudinally monitored, an ability that represents an imposing challenge with the most relevant models where tumors are evaluated at orthotopic and/or metastatic sites. The Glowing Head mouse enables the consistent and reliable tracking of the progression and therapeutic response of tumors in the context of a normal immune system. We anticipate that the use of this GEM model will facilitate the assessment of metastatic and recurrent disease, permit the evaluation of immunomodulatory drugs both alone and in combination with small molecule inhibitors, and enhance the ability of preclinical models to predict clinical efficacy.
Acknowledgments
We thank Drs. Rhonda Kineman (University of Illinois-Chicago, USA) for providing the rGH-Cre vector and Richard Palmiter (University of Washington, Seattle, WA) for his permission. We also thank Drs. Dominic Esposito (Leidos Biomedical Research, Inc., Frederick, MD, USA) for lentiviral vector production and Miriam Anver (Leidos Biomedical Research, Inc., Frederick, MD, USA) for histopathology. We are also grateful to Drs. Jude Alsarraj and Kent Hunter (National Cancer Institute, Bethesda, MD, USA) for providing the ffLuc-eGFP-labeled Mvt-1 breast cancer cells for the metastatic model. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.
Supporting Information
Data Availability
The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper and its Supporting Information files.
Funding Statement
This project has been funded in whole or in part with federal funds from the National Cancer Institute, National Institutes of Health, under Contract No. HHSN261200800001E. This work was supported in part by the Developmental Therapeutics Program in the Division of Cancer Treatment and Diagnosis and Intramural Research Program of the Center for Cancer Research, NCI, NIH. Leidos Biomedical Research Inc. provided support in the form of salaries for authors John Carter, Zoe Weaver-Ohler, Carrie Bonomi, Rajaa El Meskini, Philip Martin, Cari Graff-Cherry, and Lionel Feigenbaum, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Data Availability Statement
The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper and its Supporting Information files.