RT Journal Article SR Electronic T1 Internal checkpoint regulates T cell neoantigen reactivity and susceptibility to PD1 blockade JF bioRxiv FD Cold Spring Harbor Laboratory SP 2020.09.24.306571 DO 10.1101/2020.09.24.306571 A1 Douglas C. Palmer A1 Beau R. Webber A1 Yogin Patel A1 Matthew J. Johnson A1 Christine M. Kariya A1 Walker S. Lahr A1 Maria R. Parkhurst A1 Jared J Gartner A1 Todd D Prickett A1 Frank J. Lowery A1 Rigel J. Kishton A1 Devikala Gurusamy A1 Zulmarie Franco A1 Suman K. Vodnala A1 Miechaleen D. Diers A1 Natalie K. Wolf A1 Nicholas J. Slipek A1 David H. McKenna A1 Darin Sumstad A1 Lydia Viney A1 Tom Henley A1 Tilmann Bürckstümmer A1 Oliver Baker A1 Ying Hu A1 Chunhua Yan A1 Daoud Meerzaman A1 Kartik Padhan A1 Winnie Lo A1 Parisa Malekzadeh A1 Li Jia A1 Drew C. Deniger A1 Shashank J. Patel A1 Paul F. Robbins A1 R. Scott McIvor A1 Modassir Choudhry A1 Steven A. Rosenberg A1 Branden S. Moriarity A1 Nicholas P. Restifo YR 2020 UL http://biorxiv.org/content/early/2020/09/25/2020.09.24.306571.abstract AB While neoantigen-specific tumor infiltrating lymphocytes (TIL) can be derived from in antigen-expressing tumors, their adoptive transfer fails to consistently elicit durable tumor regression. There has been much focus on the role of activation/exhaustion markers such as PD1, CD39 and TOX in TIL senescence. We found these markers were inversely expressed to Cytokine-Induced SH2 protein (CISH), a negative regulator of TCR signaling and tumor immunity in mice. To evaluate the physiological role of CISH in human TIL we developed a high-efficiency CRIPSR-based method to knock out CISH in fully mature TIL. CISH KO resulted in increased T cell receptor (TCR) avidity, tumor cytolysis and neoantigen recognition. CISH expression in the tumor resections correlated with TIL inactivity against p53 hotspot mutations and CISH KO in TIL unmasked reactivity against these universal neoantigens. While CISH KO resulted in T cell hyperactivation and expansion it did not alter maturation, perhaps by preferential PLCγ-1 and not AKT inhibition. Lastly, CISH KO in T cells increased PD1 expression and the adoptive transfer of Cish KO T cells synergistically combines with PD1 antibody blockade resulting in durable tumor regression and survival in a preclinical animal model. These data offer new insights into the regulation of neoantigen recognition, expression of activation/exhaustion markers, and functional/maturation signals in tumor-specific T cells.Competing Interest StatementM.C. is a co-founder of Intima Bioscience. B.R.W, S.A.R, and B.S.M have received sponsored research support from Intima Bioscience. D.C.P., B.R. W, M.C., S.A.R., B.S.M, and N.P.R. have patents filed based on the findings described here.