<p>Despite improvements in detection and treatment, cancer is the leading cause of death worldwide. Current treatment modalities have not been able to improve the mortality rates and significant toxicities limit efficacy. Therefore there is a need for development of novel therapeutics.</p> <p>Oncolytic viruses have the ability to efficiently replicate in and destroy tumours while leaving normal tissues unharmed. These treatment platforms have been gaining momentum in recent years due to pre-clinical and clinical successes. Oncolytic viruses are extremely safe with limited toxicity observed in phase I/II clinical trials, and objective responses have been observed in some patients treated with oncolytic viruses. However, there is still room to improve on these therapeutic platforms.</p> <p>Recently, the importance of the induction of anti-tumour immunity during oncolytic virotherapy has been realized and harnessing this immune response can be used to improve current oncolytic virus platforms. To this end we have conducted numerous studies assessing our ability to improve oncolytic VSV through the addition of transgenes to enhance the immunostimulatory properties of oncolytic VSV treatment. These studies showed that only the addition of a highly secreted form of human IL-15 was able to improve VSV therapy through enhanced anti-tumour immunity. However, expressing cell-autonomous transgenes from oncolytic VSV was unable to modify the therapeutic efficacy of VSV due to limited replication, both temporally and geographically within the tumour, and the indirect vascular shutdown induced by VSV infection of tumours. We believe that the drastic vascular shutdown observed following VSV therapy is an important component to the success of VSV and we have investigated which steps in this process are critical for induction of anti-tumour immunity.</p> <p>The research presented in this thesis further enforces the requirement for induction of anti-tumour immune responses in the success of OV therapy. Our findings also indicate that manipulating the tumour as a whole, rather than the virus, will lead to improved oncolytic therapeutics.</p> / Doctor of Philosophy (PhD)

Les interférons (IFN) constituent une famille de cytokines aux propriétés antiprolifératives et antivirales. Ils activent, via la voie Jak/STAT, des gènes spécifiques dont les produits sont les médiateurs des effets biologiques des IFN. C’est le cas de PML (Promyelocytic leukemia), appelée aussi TRIM19, qui joue un rôle central dans la défense antivirale. PML appartenant à la famille des protéines Tripartite Motif (TRIM), caractérisée par la présence en N-terminal d’un motif RBCC, constitué d’un domaine RING, d’une ou de deux boites B et d’un domaine coiled-coil. PML a été identifiée dans la leucémie aiguë promyélocytaire, une pathologie causée par la translocation chromosomique t(15 ;17) qui fusionne les gènes PML et RARA, aboutissant à la synthèse d'une protéine chimère PML-RARA. Le trioxyde d'arsenic (As2O3) cible la portion PML de la protéine oncogénique, entraînant sa dégradation et la rémission complète des patients. Dans les cellules saines, les transcrits PML issus d’un gène unique génèrent par épissage alternatif 7 isoformes principales de PML, dont six sont nucléaires (PMLI à PMLVI) et une cytoplasmique (PMLVIIb). Toutes possèdent la même extrémité N-terminale mais diffèrent au niveau de leur extrémité C-terminale, conférant à chaque isoforme des fonctions spécifiques.PML est l’organisatrice d’une structure multi-protéique appelée corps nucléaires (CN), impliquée dans divers processus cellulaires tels que l’apoptose, la dégradation des protéines ou encore la défense antivirale.PML est modifiée par SUMO de façon covalente au niveau de trois sites lysines (K65, K160, K490) et de façon non covalente, via son domaine SIM (pour « SUMO Interacting Motif »). Ces modifications sont requises pour la formation de CN fonctionnels et le recrutement de protéines partenaires au sein de ceux-ci. Le but de ma thèse a été d’étudier le rôle différentiel des différentes isoformes de PML en réponse à l’As2O3 et suite à l’infection virale. Nous avons montré que le SIM de PML est nécessaire à sa dégradation en réponse à l'As2O3. Ce motif est présent dans toutes les isoformes de PML, hormis l’isoforme nucléaire PMLVI et l’isoforme cytoplasmique PMLVIIb. Le SIM de PML n’est pas requis pour sa SUMOylation et son interaction avec RNF4 (une E3 ubiquitine ligase responsable de la dégradation de PML via le protéasome). En revanche, ce motif est requis pour l’ubiquitination de PML, le recrutement des composants du protéasome et sa dégradation en réponse à l’As2O3. Concernant les propriétés antivirales de PML, l’étude que nous avons menée avec toutes les isoformes de PML a permis de montrer que seules PMLIII et PMLIV confèrent une résistance au Virus de la Stomatite Vésiculaire (VSV). L’effet antiviral de PMLIII n'est observé qu'à faible multiplicité d’infection (MOI) et est indépendant de la production d’IFN. Par contre, PMLIV exerce une puissante activité anti-VSV, y compris à forte MOI et s'exerce selon deux mécanismes distincts : (i) PMLIV inhibe la réplication du VSV par un mécanisme précoce indépendant de l’IFN, (ii) PMLIV augmente tardivement la production d’IFN-β via une plus forte activation d’IRF3 qui est due à la séquestration spécifique de Pin1 au sein des CN par PMLIV. Ces deux processus nécessitent la SUMOylation de PMLIV. Ces résultats montrent que PMLIV exerce une activité antivirale intrinsèque et est impliquée dans l’immunité innée en régulant positivement la voie de transduction conduisant à la synthèse d’IFN-β. / Interferons (IFNs) are a family of cytokines with antiproliferative and antiviral properties.They activate, via the Jak/Stat pathway, specific genes whose products are the mediators of the biological effects of IFNs. This is the case of PML (Promyelocytic leukemia), also known as TRIM19, which plays a central role in antiviral defense.PML belongs to the Tripartite Motif (TRIM) protein family, characterized by the presence of an N- terminal RBCC pattern, consisting of a RING domain, one or two B-boxes and a coiled-coil domain. PML was identified in acute promyelocytic leukemia, a disease caused by the chromosomal translocation t(15 ;17), which fuses the PML and RARA genes, leading to the synthesis of a chimeric protein PML-RARA . Arsenic trioxide (As2O3) targets the PML moiety of the oncogenic protein, resulting in its degradation and in the complete remission of patients.In healthy cells, PML transcripts derived from a single gene generate seven major isoforms of PML by alternative splicing, including six nuclear (PMLI to PMLVI) and one cytoplasmic (PMLVIIb). All share the same N-terminus but differ at their C-terminus, giving each isoform specific functions.PML is the organizer of a multi-protein structure called nuclear bodies (NBs) that are involved in various cellular processes such as apoptosis, protein degradation or antiviral defense.PML is covalently modified by SUMO at three lysine residues (K65, K160, K490) but also non-covalently via its SIM domain (for « SUMO Interacting Motif »). These modifications are required for the formation of functional NBs and the recruitment of partner proteins within them.The aim of my thesis was to study the differential role of the different PML isoforms in response to As2O3 and during viral infection.We have shown that the SIM PML SIM is necessary for its degradation in response to As2O3. This motif is present in all PML isoforms, except the nuclear PMLVI and the cytoplasmic PMLVIIb isoforms. The SIM of PML is not required for its SUMOylation and its interaction with RNF4 (the E3 ubiquitin ligase responsible for PML proteasome-dependent degradation). However, this motif is required for the ubiquitination of PML, the recruitment of proteasome components and the degradation of PML in response to As2O3.Concerning the antiviral properties of PML, the study that we conducted with all PML isoforms allowed us to show that only PMLIII and PMLIV confer resistance to Vesicular Stomatitis Virus (VSV). Whereas the antiviral activity of PMLIII is only observed at low multiplicity of infection (MOI) and is independent of IFN production, PMLIV has a potent anti-VSV activity, including at high MOI, which is mediated through two distinct mechanisms: (i) PMLIV inhibits the replication of VSV by an early and IFN-independent mechanism, (ii) PMLIV later increases the production of IFN-β via a stronger activation of IRF3, which is due to the specific sequestration of Pin1 by PMLIV within NBs. Both processes require the PMLIV SUMOylation. These results show that PMLIV has an intrinsic antiviral activity and is also involved in innate immunity by positively regulating the transduction pathway leading to IFN-β synthesis.

HIV remains an incurable viral infection and a significant global health concern. Despite the advent of antiretroviral therapy, there are 36.9 million recorded cases of HIV worldwide, with an additional 1.8 million new infections recorded in 2017 alone. An HIV cure is therefore one of several priorities within the field, and will require HIV “reservoir” cells—comprised of latently-HIV infected CD4+ T cells and productively-infected, tissue resident macrophages—to be selectively killed in vivo. HIV reservoir cells are rarely found within the peripheral circulation, residing instead within inaccessible tissue sanctuaries. Consequently, their characterization has been limited to in vitro laboratory models. To complicate matters further, a definitive cellular surface marker of HIV infected cells has yet to be identified. Impairment of the type I interferon (IFN1) response has been observed during HIV infection, however, making it a unique intracellular maker of HIV-infected cells. The recent development of oncolytic viruses (OV) designed to selectively kill IFN-defective cancer cells also suggests that these IFN1 defects possess therapeutic value. It was therefore hypothesized that the impairment of the IFN1 response in HIV-infected CD4+ cells and macrophages could serve as a target for oncolytic virus-mediated killing. The induction of several antiviral IFN-stimulated proteins, including PKR and ISG15, was inhibited in HIV-infected monocyte-derived macrophages (MDM) following stimulation with IFNα or a synthetic RNA. Consequently, HIV-infected MDM were more susceptible to infection and killing by the oncolytic Maraba virus, MG1. Importantly, MG1-mediated killing required the presence of replication-competent OV, and could not be potentiated by UV-inactivated MG1 or supernatants from MG1-infected cells. The ability of MG1 to target the HIV reservoir was further confirmed using alveolar macrophages collected from the lungs of cART-suppressed individuals living with HIV. These findings indicate that IFN1 defects are a feature of HIV infected cells, which can be exploited for selective killing by OV. This project is therefore unique in that it demonstrates that HIV reservoir cells can be eradicated in a targeted manner by exploiting an intracellular marker of HIV infection. As MG1-based cancer therapies are currently being explored in Phase I/II clinical trials, there is potential for this approach to be adapted for use within the HIV cure field.

HER2overexpression is associated with poor breast cancer prognosis and increased risk of metastasis. Current HER2targeted therapies include monoclonal antibody based strategies which work by reducing HER2 levels at the cell surface (trastuzumab), by preventing HER2 dimerization (pertuzumab), or via targeted delivery of a cytotoxic payload (trastuzumab emtansine). Although these therapies are successful in some cases, acquired and inherent resistance to these therapeutics remain a treatment hurdle. Oncolytic viruses (OVs) specifically target and lyse cancer cells while leaving normal cells unharmed. One such OV, VSVΔ51, replicates in interferon (IFN) defective cells, a characteristic of approximately 70% of tumours. We hypothesized that the combination of HER2 targeting therapies with VSVΔ51 could improve therapeutic efficacy. We found that HER2 overexpression was associated with increased virus sensitivity and that modulation of HER2 signaling through a subset of activating ligands and inhibitory drugs could influence infection. We further established that the HER2 monoclonal antibodies trastuzumab and pertuzumab mediate an anti-viral effect on VSVΔ51 spread. Finally, we demonstrate that conjugation of a microtubule targeting agent to trastuzumab can overcome the induced anti-viral state and enhance VSVΔ51 spread specifically in cancer cells. Overall, this work highlights the importance of HER2 signaling and activation on VSVΔ51 spread and shows that conjugation of microtubule destabilizing agents to monoclonal antibodies can enhance VSVΔ51 efficacy.

Le cancer est une maladie qui touche des millions de personnes et ne discrimine pas. La forme de cancer la plus répandue chez les femmes au Canada est le cancer du sein et la deuxième cause de décès par le cancer chez cette population. Les traitements dépendent de plusieurs facteurs dont le stade du cancer, la ménopause, le statut des récepteurs hormonaux et du récepteur HER2 du cancer, etc. Les traitements qui existent sont la chirurgie suivie par la radio- et/ou chimiothérapie et l’hormonothérapie. Malgré les nombreuses études et les avancées dans les traitements pour différents cancers, plusieurs patients ont des cancers du sein qui sont réfractaires aux traitements disponibles. Une alternative naissante est l’utilisation de virus oncolytiques, c’est-à-dire des virus qui ciblent spécifiquement les cellules cancéreuses et laissent intact les cellules saines. Malheureusement, certains cancers demeurent réfractaires aux traitements avec virus oncolytiques. Ceci nous amène donc à regarder plus en détail des facteurs de l’environnement tumoral qui pourraient prédire la susceptibilité virale et engendrer des résultats positifs. C’est dans cette perspective que nous avons découvert que l'estrogène, précisément l’estradiol, rend les cellules cancéreuses qui en expriment le récepteur plus sensible au virus oncolytique VSV (virus de la stomatite vésiculaire). Cependant, nous ignorons toujours si d’autres hormones peuvent également moduler l’action de VOs. Nous émettons donc l’hypothèse que, comme l’estrogène, d’autres hormones vont affecter l’efficacité des VOs et qu’il serait possible de manipuler ces interactions pour améliorer la réponse au traitement. Notre étude nous permettra de concevoir des stratégies thérapeutiques améliorées pour les patients atteints du cancer du sein. L’importance de cette étude est que jusqu’à présent l’impact des hormones sur l’efficacité des virus oncolytiques reste un sujet inexploré. Nous allons déterminer l’effet de différents niveaux d’hormones sur la réplication et l’effet oncolytique de VSV. Ceci nous donnera ainsi la possibilité et les connaissances d’améliorer la sélection des patients pour le traitement et la conception d’une nouvelle génération de virus oncolytiques perfectionnés. / Cancer is a disease that affects millions of people across the world. The most common cancer in Canadian women is breast cancer and it also represents the second cause of death by cancer in this same group. The treatment depends on multiple factors including the stage of the cancer, menopause status, hormone receptor status, HER2 receptor status, etc. The available treatments for breast cancer are surgery followed by either radiation or chemotherapy as well as endocrine therapy. Despite numerous studies and advances in the treatment of different cancers, many patients’ cancer still remains refractory to these treatments. An exciting new alternative treatment is the use of oncolytic viruses. An oncolytic virus is a virus that can specifically target cancer cells all while leaving healthy normal cells intact. However, many cancers remain refractory to treatment with oncolytic viruses. There was thus a need to investigate different factors or the tumor microenvironment that may predict viral susceptibility and obtain positive outcomes. In this vein, it was found that estrogen (specifically estradiol), a hormone found in the body, can render cancer cells that express its receptor more sensitive to oncolytic virus infection by VSV (vesicular stomatitis virus). In spite of that, we are unaware if there are other hormones capable of modulating the actions of oncolytic viruses. Our hypothesis is that, like estrogen, other hormones will affect the efficacy of oncolytic viruses and that it will be possible to manipulate these interactions with the goal to improve treatment response. Our research will allow the conception of enhanced therapeutic strategies for patients with breast cancer. The importance of this study is that as of now the interplay between hormones and oncolytic viruses remains unexplored. We will determine the effects of hormone levels on viral replication and oncolytic ability of VSV. This knowledge will allow for a greater selection of patients for which oncolytic virus treatment will have a positive outcome. Additionally, it will allow for the development of a new generation of perfected oncolytic virus platforms.

Due to the inevitable reality that most patients diagnosed with cancer will eventually relapse, modern oncology research has been forced to tackle this outcome primitively using combination therapies. Adoptive T-cell transfer with Oncolytic Virus Vaccination represents a new class of combination therapies that can facilitate the crosstalk of multiple aspects of the immune system such that they work in concert to prevent this outcome for many types of cancer. Despite this, immunosuppressive systems like those characterized in the B16F10-gp33 melanoma model pose a new problem for this approach. Typically, this model has total regression but is subsequently followed by relapse. Previous work from the Wan lab has suggested that this may be an outcome of total target gene deletion. Here we present two approaches to tackle this through the targeting of DNA repair pathways of the host cell. Our data can show that both VSV and Vaccinia infection/ propagation does lead to the generation of DNA damage but in the case of VSV this leads to incomplete cell lysis, and ultimately target gene loss via double-stranded DNA repair mechanisms. We were able to tackle the phenomenon following VSV administration by adding DNA repair inhibitors to the mix and showed that the proportion of cells that escaped after the loss of the target antigen was decreased by half when compared to the standard procedures. Additionally, this work also gave a preliminary understanding of how Vaccinia may achieve a similar outcome to this via its unique cytoplasmic replication mechanisms. / Thesis / Master of Science (MSc)

<p>We showed previously that histone deacetylase (HDAC) inhibition with MS-275 in the context of boosting oncolytic immunotherapy can drive heightened antitumor responses, leading to increased survival in mouse intracranial melanoma models. However, it is currently unclear how the co-administration of MS-275 directly impacts tumor growth. Here, we investigated the role of MS-275 in preventing the outgrowth of antigen-deficient tumor variants as a result of suboptimal treatment protocols. By adoptively transferring tumor antigen-specific memory T cells (Tm) that were expanded <em>in vivo</em> with recombinant Vesicular Stomatitis Virus (VSV-gp33), we observed complete regression of 5-day old, intradermal B16-gp33 tumors (B16-F10 overexpressing the LCMV GP33-41 epitope); however, the tumors relapsed within a month of treatment. Relapsing tumor explants were able to grow in mice that were prophylactically immunized with recombinant Adenovirus (Ad-gp33), indicating that the tumor could no longer be recognized. Strikingly however, there was zero tumor recurrence if MS-275 was co-administered with Tm and VSV-gp33, suggesting that MS-275 may prevent the emergence and/or escape of antigen loss variants. Such a benefit is lost if the administration of the drug is delayed as little as five days post VSV treatment, suggesting that its synergistic effects coincide with early immune responses and oncolytic activity. Furthermore, transplantation studies of relapsing tumor explants showed that combination treatment was unable to provide tumor protection, confirming that the mechanisms by which MS-275 prevents tumor recurrence are unlikely through direct up-regulation of antigen presentation in low- or non-antigen-expressing variants <em>in vivo</em>. Indeed, CD4 depletion in the absence of MS-275 resulted in sustained tumor regression, implying that immunoregulatory cells such as CD4+ Treg play a prominent role in sustaining tumor regression. Moreover, MS-275 modulates the phenotypic status of tumor-infiltrating MDSCs toward the differentiation of inflammatory macrophages. Taken together, the data suggests that combination therapy with HDACi with oncolytic immunotherapy mediates a synergized immune attack against the tumor through subversion of immunomodulatory mechanisms.</p> / Master of Science in Medical Sciences (MSMS)

Invariant natural killer T (iNKT) cells are a versatile subclass of T lymphocytes which recognize glycolipid antigens. iNKT cells are capable of rapidly producing a broad array of cytokines in response to stimulation; thus, they play an important role in the early regulation of a variety of immune responses. It was hypothesized that iNKT cells express functional Toll-like receptors (TLRs) and that stimulation of TLRs by their ligands modulates iNKT cells responses. In the first objective, it was revealed that upon stimulation with anti-CD3 monoclonal antibody and interferon (IFN)-α, expression of TLRs was enhanced in iNKT cells. Furthermore, stimulation of iNKT cells with TLR ligands led to a significant increase in the expression of several cytokines. In the second objective, the mechanisms behind the modulatory effects of the TLR9 ligand (CpG-ODN) on iNKT cells were determined. Altogether, these findings suggest a direct role for TLRs in iNKT cell activation. / Ontario Graduate Scholarship

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