V-domain Ig suppressor of T cell activation (VISTA) is a novel negative checkpoint ligand that is homologous to PD-L1 and suppresses T cell activation. This study demonstrates the multiple mechanisms whereby VISTA relieves negative regulation by hematopoietic cells and enhances protective anti-tumor immunity. VISTA is highly expressed on myeloid cells and Foxp3+CD4+ regulatory cells, but not on tumor cells within the tumor microenvironment (TME). VISTA monoclonal antibody (mab) treatment increased the number of tumor-specific T cells in the periphery, and enhanced the infiltration, proliferation and effector function of tumor-reactive T cells within the TME. VISTA blockade altered the suppressive feature of the TME, by decreasing the presence of monocytic myeloid-derived suppressor cells and increasing the presence of activated DCs within the TME. In addition, VISTA blockade impaired the suppressive function and reduced the emergence of tumor-specific Foxp3+CD4+ regulatory T cells. Consequently, VISTA mab administration as a monotherapy significantly suppressed the growth of both transplantable and inducible melanoma. Initial studies explored a combinatorial regimen using VISTA blockade and a peptide-based cancer vaccine with TLR agonists as adjuvants. VISTA blockade synergized with the vaccine to effectively impair the growth of established tumors.
LeMercier I, Chen W, Lines JL, et al. VISTA regulates the development of protective anti-tumor immunity. Cancer research. 2014;74(7):1933-1944.