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Supplemental Table 1. Primer sequences for transcript analysis Primer Sequence (5 3 ) Primer Sequence (5 3 ) Mmp2 Forward CCCGTGTGGCCCTC Mmp15 Forward CGGGGCTGGCT Reverse GCTCTCCCGGTTTC Reverse CCTGGTGTGCCTGCTC Mmp3 Forward TGGGTGCTCCTTTGCG β-ctin Forward CGCTTCTTTGCGCTCCTT Reverse GCCTTGGCTGGTGGTG Reverse CCGTGGGGGGTCG Mmp7 Forward CGGGTGCTCCTTTGC Timp1 Forward GCTCTGGCTCCTCTTGTT Reverse CCGGGCGGGTGC Reverse TGGGGCCCTGTTTG Mmp8 Forward CTTTCCCGGCCGGT Timp2 Forward GCGTGGCGGGGG Reverse GGCGCCCGGTGG Reverse GGGGGCCGTGTGTCT Mmp9 Forward GCGCTGCGGCTCC Timp3 Forward GTGGGGGCTGGTG Reverse TGGGCCTGTGGGGGT Reverse GGGCTTCCGTGTGTGT Mmp1 Forward CGTTGGGCCGGGC Col1a1 Forward TGGGTCCGCTGGGC Reverse TGTCCTTTCTCTCTCTCG Reverse CTCCCTGGCTCCGCTTCT Mmp11 Forward GCGCTGGGGGCGC Col1a2 Forward GGGCCCGTGGCG Reverse GTGGGGTCCTTCCTCCT Reverse TGGCGCGTTCCCGT Mmp12 Forward GCTGTCCCGTGGGG Fn Forward TTGCTCCTGCCGTGC Reverse TCCGTGGGTGCTTGG Reverse CCCCTTCTCTCCGTCTTG Mmp13 Forward TGGCCTTCTGGTCTTCTGG Ccl2 Forward GGTCCCTGTCTGCTTCTG Reverse TGGGCGCCTC Reverse TTGGGTCTCTTGCTGGT Mmp14 Forward CCGTGGTGGCCGG Reverse GGGGCCGGGGTGTTC bbreviations: Mmp, matrix metalloproteinase; Timp, tissue inhibitor of metalloproteinase; Col, collagen; Fn, fibronectin; Ccl, chemokine (C-C motif) ligand

Supplemental Figure 1 SSC- SSC- FSC- Ly6C CD45 CD19 F4/8 Ly6G Inflammatory Monocytes Ly6C Ly6C Ly6C CCR2 Ly6G CCR2 Resident Monocytes Granulocytes

Supplemental Figure 1 SSC- SSC- FSC- Ly6C CD45 CD19 F4/8 Gr-1 Inflammatory Monocytes Ly6C Ly6C Ly6C CCR2 Gr-1 CCR2 Resident Monocytes Ly6C Granulocytes CCR2 SupplementalFigure1.Gatingstrategyforidentification of monocyte subpopulations. Fluorescence-activated cell sorting (FCS) plots showing the gating strategy for identifying resident monocytes, inflammatory monocytes and granulocytes using antibodies that recognize () Ly6G or () Gr-1 in combination with antibodies that recognize CD45, CD19, F4/8, Ly6C and CCR2.

Supplemental Figure 2 72 hr bsolute number of F4/8 + macrophages (x1 6 ) analysis 5 4 3 2 1 ** *** 1 g 3 g 1 g anti-cd4 Supplemental Figure 2. CD4 agonist induces accumulation of resident macrophages in spleen. a, Wild-type C57L/6 mice were administered isotype control or anti-cd4 antibody (.1 mg) by intraperitoneal injection. b, Quantification of the absolute number of F4/8 + macrophages within spleens of mice after treatment with control or escalating doses of anti-cd4. n = 3 mice per group. **P<.1, ***P <.1, unpaired t-test.

Supplemental Figure 3 FGK45 Ly6G DPI Supplemental Figure 3. Impact of anti-cd4 treatment on Ly6G + cells within PDC tumors of KPC mice. Tumor-bearing KPC mice were treated with isotype control () or anti-cd4 antibodies. One day later, tumors were analyzed by immunofluorescence microscopy for the presence of Ly6G + cells (green). Nuclei are stained with DPI (blue). Displayed are representative images with quantification shown in Figure 1H.

Supplemental Figure 4 C Pre Day +1 post CEL Pre Day +1 post anti-gr-1 Pre Day +1 post anti-ly6c Ly6C FSC D # of cells/1µl of blood 5 4 3 2 1 IM RM Ly6C FSC IM RM E F RM IM IM 5 5 Pre Day 1 Day of CEL treatment # of cells/1µl of blood 4 3 2 1 Pre Day 1 Day of anti-gr-1 treatment # of cells/1µl of blood Ly6C FSC 4 3 2 1 IM RM Pre Day 1 Day of anti-ly6c treatment Supplemental Figure 4. Strategy for depletion of resident and inflammatory monocyte populations in vivo. FCS plots gated on CD45 + CD19 neg F4/8 + cells showing resident (RM) and inflammatory (IM) monocytes pre and one day post treatment with a, clodronate encapsulated liposomes (CEL), b, anti-gr-1 depleting antibody, R6-8C5, and c, anti-ly6c depleting antibody, Monts-1. d, Quantification of absolute number of resident monocytes in peripheral blood pre and post treatment with clodronate encapsulated liposomes. n=5 mice, P =.2, paired t-test. e, Quantification of absolute number of inflammatory monocytes in peripheral blood pre and post treatment with R6-8C5 (anti-gr-1). n=7 mice, P=.2, paired t-test. f, Quantification of inflammatory monocytes in peripheral blood pre and post treatment with Monts-1 (anti-ly6c). n=5 mice, P=.9, paired t-test.

Supplemental Figure 5 C # of cells/1µl of blood 4 3 2 1 F4/8+Ly6C lo RM Pre Day 1 # of cells/1µl of blood 1 8 6 4 2 F4/8+Ly6C hi IM Pre Day 1 # of cells/1µl of blood 6 4 2 F4/8 neg Ly6C + Ly6G + Pre Day 1 Day of CEL treatment Day of CEL treatment Day of CEL treatment Supplemental Figure 5. Effect of clodronate encapsulated liposome (CEL) treatment on peripheral blood myeloid cells. Shown are peripheral blood counts for (a) F4/8 + Ly6C lo resident monocytes (RM), (b) F4/8 + Ly6C hi inflammatory monocytes (IM) and (c) F4/8 neg Ly6C + Ly6G + cells prior to (Pre) and one day (Day 1) post treatment with CEL. The impact of CEL on F4/8 + Ly6C lo resident monocytes (RM) displayed in (a) is also shown in Supplemental Figure 4D and depicted here for comparison purposes. Significance testing was performed using a paired t-test. n=5; F4/8 + Ly6C lo RM, P=.2; F4/8 + Ly6C hi IM, P=.871; F4/8 neg Ly6C + Ly6G +, P =.113.

Supplemental Figure 6 F4/8 + Ly6C hi IM F4/8 + Ly6C lo RM F4/8 neg Ly6C + Ly6G + Cells/ L blood 2 15 1 5 *** Cells/ L blood 4 3 2 1 Cells/ L blood 2 15 1 5 Total cell number (x1 6 ) 4 3 2 1 CD3 + T cells CD19 + T cells * 1.3 * *.2 5.1 Total cell number (x1 6 ) Total cell number (x1 6 ). F4/8 + Ly6C hi IM * Total cell number (x1 6 ) 1.5 1..5. F4/8 + Ly6C lo RM Total cell number (x1 6 ) 15 1 5 F4/8 neg Ly6C + Ly6G + ** Control anti-ly6c anti-cd4 anti-cd4 + anti-ly6c Supplemental Figure 6. Specificity of Ly6C depleting antibody, Monts-1. a, Peripheral blood counts for F4/8 + Ly6C hi inflammatory monocytes (IM), F4/8 + Ly6C lo resident monocytes (RM), and F4/8 neg Ly6C + Ly6G + cells prior to (Pre) and one day after (Day +1) treatment with anti-ly6c depleting antibody, Monts-1. n=8 mice, paired t-test. b, Mice were treated with or without anti-ly6c on days -1 and with anti-cd4 administered on day. Splenocytes were harvested on day +1 and absolute number of CD3 + T cells, CD19 + cells, F4/8 + Ly6C hi IMs, F4/8 + Ly6C lo RMs, and F4/8 neg Ly6C + Ly6G + cells were quantified by flow cytometry. n = 4 mice/group, 2-tailed unpaired t-test. *P<.5, **P<.1, ***P<.1.

Supplemental Figure 7 Control anti-cd4 anti-cd4 + CEL nti-cd4 + anti-ccl2 ng CCL2/gram tissue 3 2 1 Normal pancreas SubQ tumor KPC tumor Supplemental Figure 7. CCL2 regulates CD4-dependent Ly6C + myeloid cell recruitment to PDC tumors in KPC mice. a, Representative images of immunohistochemistry to detect Ly6C + cells in PDC tumors from KPC mice one day after treatment with isotype control or anti-cd4 antibodies with or without clodronate encapsulated liposomes (CEL) or anti-ccl2 neutralizing antibodies. Quantification is shown in Figure 2C. b, CCL2 protein levels detected by cytometric bead array in pancreas of normal littermate (n=2), subcutaneously (SubQ) implanted PDC tumors (n=3), and primary PDC tumors isolated from KPC mice (n=4).

Supplemental Figure 8 pg/ml 2 15 1 5 **** IL-12 **** pg/ml 15 1 5 ** * *** *** C pg/ml 6 4 2 *** * * anti- CD4 anti- CD4 IL-12 IFN- Wild-type KPC anti-cd4 anti-cd4 + anti-ifn- Pre Day +1 Supplemental Figure 8. nti-cd4 treatment induces systemic cytokine release in mice and humans. a, Wild-type non-tumor bearing mice and KPC tumor-bearing mice were treated with isotype control () or anti-cd4 antibody. Serum was collected 24 hours after treatment for analysis. Shown are serum levels (pg/ml) of IL-12. n=17-2 mice per group for wild-type and n=1 mice per group for KPC. b, KPC tumor-bearing mice were treated with, anti-cd4 or anti-cd4 in combination with anti-ifn- neutralizing antibody. Shown are serum levels of IL-12 and IFN- detected one day after treatment. n=5-14 mice per group. For a and b, significance testing was performed using Student s 2-tailed unpaired t-test. c, Shown are plasma levels for IL-12, IP-1, and MIG in PDC patients Pre and one day post treatment with CP-87,893. For detection of plasma cytokine levels, n=13 patients at baseline; n=5 patients after CP-87,893. Significance determined using Mann-Whitney test. *, P<.5; **, P<.1; ***, P<.1; ****, P<.1.

Supplemental Figure 9 pg/ml 4 3 2 1 **** IL-12 1 2 5 12 25 Day C Day Day 1 MFI: 265 MFI: 478 pg/ml 15 1 5 ** IFN- Day 2 Day 5 MFI: 265 MFI: 254 1 2 5 12 25 Day pstt1 Supplemental Figure 9. STT1 signaling in human monocytes induced by plasma from PDC patient treated with CP-87,893. Kinetics of (a) IL-12 and (b) IFN- detected in plasma of PDC patients prior to and after treatment with the fully human CD4 agonist, CP-87,893. n=5-13 patients per time point. b, Human monocytes were incubated with plasma collected from a patient at day (prior to treatment) and on days 1, 2, and 5 post treatment with CP-87,893. Monocytes were evaluated by flow cytometry for pstt1 expression. Shown are representative histograms of monocytes obtained from one of three healthy volunteers. Quantification of results is shown in Figure 3D. MFI, mean fluorescence intensity. For panels a and b, significance testing was performed using one-way NOV with onferroni correction. **, P<.1; ****, P<.1.

Supplemental Figure 1 H&E Masson s Trichrome anti-cd4 anti-cd4 + anti-ifn- Supplemental Figure 1. nti-fibrotic activity induced with a CD4 agonist is dependent on IFN-. Representative images of tumor sections analyzed by H&E and by Masson's trichrome stain to reveal extracellular matrix (blue) one day after treatment. n=5-6 mice per group. Scale bar, 5 µm.

Supplemental Figure 11 C Ki67 FP DPI Relative transcript expression 15 1 5 anti-cd4 Col1a1 Col1a2 Fn Ki67 + FP + cells per hpf 2. 1.5 1..5 anti-cd4 Supplemental Figure 11. CD4 activation does not alter extracellular matrix production or FP + fibroblast proliferation. Syngeneic mice bearing established PDC tumors implanted subcutaneously were treated with isotype control or anti-cd4 antibodies. Tissues were harvested and analyzed one day later. a, Shown is relative transcript expression with comparison to -actin for Col1a1, Col1a2, and Fn observed within tumor homogenates. Data are shown as means + s.d. from n=5 mice for each transcript. b, Quantification of tumor sections for Ki67 + FP + cells by immunofluorescence microscopy. c, Representative immunofluorescence images of Ki67 (green) and FP (red) staining in tumor tissues. Nuclei were stained with DPI (blue). Scale bar, 1 m.

Supplemental Figure 12 H&E TIC EpCM FN EpCM H anti-cd4 anti-cd4 Supplemental Figure 12. nti-cd4 treatment selectively depletes extracellular matrix proteins within the tumor microenvironment. a, Representative images of H&E and immunofluorescence for type I collagen (TIC) and fibronectin (FN) deposition (red) among EpCM + tumor cells (green) one day after treatment with isotype control () or anti-cd4 antibodies. b, Representative images of immunohistochemistry for hyaluronan (H) one day after treatment with isotype control () or anti-cd4 antibodies.

Supplemental Figure 13 C D E F Supplemental Figure 13. Implantable tumor model of PDC that reproduces tumor microenvironment of KPC model of spontaneous PDC. Representative images of H&E (, D), Masson s trichrome staining (, E) and immunohistochemistry for F4/8 + macrophages (C, F) are shown for a spontaneously arising PDC tumor in the KPC model (-C) and a cell line derived from this tumor that was implanted subcutaneously into C57L/6 syngeneic mice (D-F).

Supplemental Figure 14 anti-cd4 IM C57L/6 2 weeks 24 hrs analysis Type I Collagen C # of IM cells per hpf 8 6 4 2 * D anti-cd4 anti-cd4 Supplemental Figure 14. Development of an implantable model of PDC for evaluating monocyte-dependent degradation of cancer fibrosis. a, Schematic showing treatment of C57L/6 mice implanted subcutaneously with a syngeneic PDC cell line derived from KPC mice. t two weeks after tumor implantation, mice were treated with isotype control or anti- CD4. The impact of treatment on the tumor microenvironment was examined 24 hours later. b, Tumors were analyzed for Ly6C + inflammatory monocyte (IM) infiltration by staining for Ly6C and for changes in extracellular matrix deposition by staining for type I collagen. One representative image out of 4 is shown per group. Scale bar, 5 m. c, Quantification of tumorinfiltrating Ly6C + inflammatory monocytes by immunohistochemistry. *, P <.5; unpaired 2-tailed t-test determined from 5-6 images per mouse. d, Quantification of type I collagen content. *, P <.5; unpaired 2-tailed t-test determined from 4 images per mouse, n=4-5 mice per group. Relative % rea 5 4 3 2 1 Type I Collagen *

Supplemental Figure 15 nti-cd4 induced expression levels relative to Control ( CT) damts dhesion Molecules Collagens ECM Proteins nti-cd4 induced expression levels relative to Control ( CT) Integrins Laminins MMPs and TIMPs Other Proteins Supplemental Figure 15. Gene expression of extracellular matrix and adhesion molecules within the tumor microenvironment in response to anti-cd4 treatment. Fold change in gene expression within tumor homogenates one day after treatment with anti-cd4 antibodies compared to isotype control.

Supplemental Figure 16 Relative transcript expression.25.2.15.1.5 Mmp1 Mmp12 Mmp13 1 1 * 8 8 Mo Mo + IFN- Relative transcript expression 6 4 2 Mo Mo + IFN- C Relative transcript expression 6 4 2 Mo Mo + IFN- Supplemental Figure 16. IFN- induces Mmp13 expression in myeloid cells. Murine bone marrow derived myeloid cells were stimulated in vitro with or without IFN- and then plated on a matrix of type I collagen containing human PDC cells. Murine-specific Mmp gene expression was detected 24 hours after addition of unstimulated myeloid cells (Mo), IFN- stimulated myeloid cells (Mo + IFN- ), and no addition of myeloid cells (). Shown is the relative transcript expression for (a) Mmp1, (b) Mmp12,and(c) Mmp13. Data are shown as means + s.d., from 3 independent experiments. *, P<.5.

Supplemental Figure 17 Control nti-cd4 Supplemental Figure 17. RN in situ hybridization (ISH) for MMP13 in PDC tumors. Representative images of RN ISH for Mmp13 in spontaneously arising PDC tumors in KPC mice one day after treatment with isotype control or anti-cd4 antibody. n=3 mice per group, 5 images per mouse.

Supplemental Figure 18 24 hours analysis MMPsense or PS % cells with active MMPs 4 3 2 1 Total CD45 + CD45 neg 5 4 3 2 1 F4/8 + Ly6C hi Ly6G + anti-cd4 Supplemental Figure 18. Detection of MMP activity in cellular subsets within the tumor microenvironment. Treatment schema for detection of MMP activity. a, C57L/6 mice were injected subcutaneously with PDC tumor cells and 14 days later mice were administered MMPsense or PS at three hours prior to treatment with or anti-cd4. t 24 hours later, tumors were evaluated by flow cytometry for presence of active MMPs. b, Flow cytometric analysis comparing cellular subsets within tumor tissue for the presence of MMP activity. n = 4-5 mice per group.

Supplemental Figure 19 MMP13 MMP13 C F4/8 FP MMP14 F4/8 T T T anti-cd4 T T Supplemental Figure 19. Protein expression of MMP13 and MMP14 within the tumor microenvironment of spontaneously arising pancreatic tumors in the KPC model. Representative immunofluorescence images with arrows indicating a, MMP13 (green) co-localization with F4/8 + (red) myeloid cells (scale bar, 1 m) and b, MMP13 (green) colocalization with FP + (red) fibroblasts (scale bar, 2 m) c, Expression of MMP14 (green) by F4/8 + (red) myeloid cells within stroma but not in tumor cells (T) of KPC mice one day after treatment with isotype control () or anti-cd4 antibody.

Supplemental Figure 2 Relative expression.7.6.5.4.3.2.1 Mmp2 Mmp14 nti-cd4 Supplemental Figure 2. Gene expression of Mmp2 and Mmp14 within the tumor microenvironment of pancreatic tumors. Shown is the relative transcript expression with comparison to -actin for Mmp2 and Mmp14 observed within tumor homogenates one day after treatment ( versus anti-cd4) of syngeneic mice bearing established PDC tumors implanted subcutaneously. Data are shown as means + s.d., from n = 9-1 mice for each transcript.

Supplemental Figure 21 FN EpCM DPI C57L/6 2 weeks 3 min 24 hrs analysis Supplemental Figure 21. nti-fibrotic activity of a CD4 agonist is dependent on MMPs. a, Schematic showing treatment of mice implanted subcutaneously with a syngeneic PDC cell line derived from KPC mice. t two weeks after tumor implantation, mice were treated with a broad spectrum MMP inhibitor (immp, ctinonin) or PS followed 3 minutes later by isotype control or anti-cd4 antibodies. b, Representative immunofluorescence images show fibronectin (FN, red) deposition among EpCM + tumor cells (green) one day after treatment. Nuclei are stained with DPI (blue). One representative image is shown out of five images per tumor section, per group. Scale bar, 1 m.

Supplemental Figure 22 anti-cd4 anti-cd4 + immp13 #1 anti-cd4 + immp13 #2 nti-cd4 + immp Masson s Trichrome Supplemental Figure 22. Impact of MMP13 specific inhibitors on CD4 agonist induced collagen degradation. Mice with an implanted PDC tumor were treated with isotype control or anti-cd4 antibodies with or without selective inhibitors of MMP13 (immp13 #1, WY-17523; immp13 #2, 544678-85-5) or a broad spectrum MMP inhibitor (immp, ctinonin). Representative images show collagen deposition (blue) by Masson s Trichrome staining one day after treatment. One representative image is shown out of five images per tumor section, n=4-8 tumors per group.

Supplemental Figure 23 Control Day 1 Ratio E leakage (tumor:kidney) 1.2 1.8.6.4.2 * 1 2 4 7 Day 2 C Day post FGK45 FGK45 (d+2) Day 4 4x Day 7 2x Supplemental Figure 23. Kinetics of anti-cd4 activity on tumor microenvironment. Mice with implanted tumors were analyzed at defined time points after treatment with isotype control or anti-cd4 antibodies. a, Gross images of bisected tumors analyzed at indicated time points after anti-cd4 treatment with comparison to isotype control. b, Shown is the ratio of Evans lue (E) leakage into tumor tissue normalized to kidney. Evans blue was administered 2 minutes prior to necropsy at defined time points after treatment with anti- CD4 or isotype control antibody. c, Representative H&E images (4x and 2x) showing hemorrhagic necrosis in tumors at day 2 after anti-cd4 treatment compared to isotype control. n=7-8 tumors per treatment group, *, P<.5.

Supplemental Figure 24 CD31 CD31 + vessels per hpf 2 15 1 5 1 2 4 7 Day post anti-cd4 anti-cd4 (d+2) Supplemental Figure 24. Impact of anti-cd4 on CD31 + blood vessel density and vascular patency. Mice with implanted tumors were analyzed on multiple days after treatment with isotype control or anti-cd4 antibodies. a, Shown is the density of CD31 + vessels per hpf. n=7-8 tumors per group, 5 images per tumor. b, Representative images showing collapsed CD31 + blood vessels within tumors.

Supplemental Figure 25 Gem C57L/6 2 weeks 2 or 5 days 24 hrs analysis anti-cd4 Gem (d+2) anti-cd4 Gem (d+5) Supplemental Figure 25. nti-cd4 treatment improves gemcitabine efficacy in vivo. a, Schematic showing treatment of mice implanted subcutaneously with a syngeneic PDC cell line derived from KPC mice. t two weeks after tumor implantation, mice were treated with anti-cd4 antibodies or control () followed by gemcitabine administered two (d+2) or five days (d+5) later. One day post treatment with gemcitabine, tumors were analyzed for the number of Ki67 + cells per hpf. b, Representative images showing detection of Ki67 + cells within tumors from indicated treatment groups. Quantification is shown in Figure 6D.

Supplemental Figure 26 Gem anti-cd4 Gem (d+2) 8 ** Ki67 Ki67 + cells per hpf 6 4 2 Gem anti-cd4 Gem (d+2) Supplemental Figure 26. nti-cd4 treatment improves gemcitabine efficacy in KPC tumor-bearing mice. KPC mice were treated with anti-cd4 antibodies or control followed two days later by gemcitabine. One day post treatment with gemcitabine, tumors were analyzed for the number of Ki67 + cells per hpf. a, Representative images showing detection of Ki67 + cells within tumors from indicated treatment groups. b, Quantification of Ki67 + cells per hpf. n=3-4 mice per group, 5 images per mouse. **, P<.1, student s ttest.

Supplemental Figure 27 % Change in tumor volume 2 1-5 -1 ** * ** Supplemental Figure 27. Impact of MMPs and Ly6C + cells on anti-tumor activity induced by gemcitabine administered two days after an agonist CD4 antibody. Mice implanted subcutaneously with a syngeneic PDC cell line derived from KPC mice were treated with anti-cd4 or control with or without inhibition of MMPs (immp, ctinonin) or depletion of Ly6C + cells. Two days after anti-cd4 treatment, mice received gemcitabine. Shown is the relative change in tumor volume from time of gemcitabine treatment to 6 days later. n=6-13 mice per group. *, P<.5, **, P<.1, Student s t test.

Supplemental Figure 28 Percent change in body weight 15 1 5-5 -1-15 Gem anti-cd4 Gem (day +2) anti-cd4 Gem (day +5) ** ** 1 2 3 4 5 6 Day post Gem treatment Supplemental Figure 28. Treatment tolerability is dependent on timing of gemcitabine administration after anti-cd4 treatment. Non-tumor-bearing mice were treated with anti-cd4 or control antibodies followed by gemcitabine administered two (day +2) or five days (day +5) later. Shown is the percent change in body weight over time. n=4-8 mice per group. Significance testing was performed using one-way nova with onferroni correction for multiple comparisons testing. Error bars represent standard error of the mean, ** P<.1.

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