Sun, Jennifer and Corradini, Stefan and Azab, Feda and Shokeen, Monica and Muz, Barbara and Miari, Katerina E. and Maksimos, Mina and Diedrich, Camila and Asare, Obed and Alhallak, Kinan and Park, Chaelee and Lubben, Berit and Chen, Yixuan and Adebayo, Ola and Bash, Hannah and Kelley, Sarah and Fiala, Mark and Bender, Diane E. and Zhou, Haibin and Wang, Shaomeng and Vij, Ravi and Williams, Mark T. S. and Kareem Azab, Abdel (2024) IL-10R inhibition reprograms tumor-associated macrophages and reverses drug resistance in multiple myeloma. Leukemia, 38 (11). pp. 2355-2365. ISSN 0887-6924

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Abstract

Multiple myeloma (MM) is the cancer of plasma cells within the bone marrow and remains incurable. Tumor-associated macrophages (TAMs) within the tumor microenvironment often display a pro-tumor phenotype and correlate with tumor proliferation, survival, and therapy resistance. IL-10 is a key immunosuppressive cytokine that leads to recruitment and development of TAMs. In this study, we investigated the role of IL-10 in MM TAM development as well as the therapeutic application of IL-10/IL-10R/STAT3 signaling inhibition. We demonstrated that IL-10 is overexpressed in MM BM and mediates M2-like polarization of TAMs in patient BM, 3D co-cultures in vitro, and mouse models. In turn, TAMs promote MM proliferation and drug resistance, both in vitro and in vivo. Moreover, inhibition of IL-10/IL-10R/STAT3 axis using a blocking IL-10R monoclonal antibody and STAT3 protein degrader/PROTAC prevented M2 polarization of TAMs and the consequent TAM-induced proliferation of MM, and re-sensitized MM to therapy, in vitro and in vivo. Therefore, our findings suggest that inhibition of IL-10/IL-10R/STAT3 axis is a novel therapeutic strategy with monotherapy efficacy and can be further combined with current anti-MM therapy, such as immunomodulatory drugs, to overcome drug resistance. Future investigation is warranted to evaluate the potential of such therapy in MM patients.

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