RT Journal Article SR Electronic T1 A novel antibody targeting ICOS increases intratumoural cytotoxic to regulatory T cell ratio and induces tumour regression JF bioRxiv FD Cold Spring Harbor Laboratory SP 771493 DO 10.1101/771493 A1 Richard C.A. Sainson A1 Anil K. Thotakura A1 Miha Kosmac A1 Gwenoline Borhis A1 Nahida Parveen A1 Rachael Kimber A1 Joana Carvalho A1 Simon Henderson A1 Kerstin Pryke A1 Tracey Okell A1 Siobhan O’Leary A1 Stuart Ball A1 Lauriane Gamand A1 Emma Taggart A1 Eleanor Pring A1 Hanif Ali A1 Hannah Craig A1 Vivian W. Y. Wong A1 Qi Liang A1 Robert J. Rowlands A1 Morgane Lecointre A1 Jamie Campbell A1 Ian Kirby A1 David Melvin A1 Volker Germaschewski A1 Elisabeth Oelmann A1 Sonia Quaratino A1 Matthew McCourt YR 2019 UL http://biorxiv.org/content/early/2019/09/16/771493.abstract AB The immunosuppressive tumour microenvironment constitutes a significant hurdle to the response to immune checkpoint inhibitors. Both soluble factors and specialised immune cells such as regulatory T cells (TReg) are key components of active intratumoural immunosuppression. Previous studies have shown that Inducible Co-Stimulatory receptor (ICOS) is highly expressed in the tumour microenvironment, especially on TReg, suggesting that it represents a relevant target for preferential depletion of these cells. Here, we used immune profiling of samples from tumour bearing mice and cancer patients to characterise the expression of ICOS in different tissues and solid tumours. By immunizing an Icos knockout transgenic mouse line expressing antibodies with human variable domains, we selected a fully human IgG1 antibody called KY1044 that binds ICOS from different species. Using KY1044, we demonstrated that we can exploit the differential expression of ICOS on T cell subtypes to modify the tumour microenvironment and thereby improve the anti-tumour immune response. We showed that KY1044 induces sustained depletion of ICOShigh TReg cells in mouse tumours and depletion of ICOShigh T cells in the blood of non-human primates, but was also associated with secretion of pro-inflammatory cytokines from ICOSlow TEFF cells. Altogether, KY1044 improved the intratumoural TEFF:TReg ratio and increased activation of TEFF cells, resulting in monotherapy efficacy or in synergistic combinatorial efficacy when administered with the immune checkpoint blocker anti-PD-L1. In summary, our data demonstrate that targeting ICOS with KY1044 can favourably alter the intratumoural immune contexture, promoting an anti-tumour response.