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Small extracellular vesicle piR-hsa-30937 derived from pancreatic neuroendocrine neoplasms upregulates CD276 in macrophages to promote immune evasion 源自胰腺神经内分泌肿瘤的细胞外小泡 piR-hsa-30937 能上调巨噬细胞中的 CD276,从而促进免疫逃避
IF 10.1 1区 医学 Q1 Medicine Pub Date : 2024-04-04 DOI: 10.1158/2326-6066.cir-23-0825
Yuan Zhong, Ye Tian, Yan Wang, Jian'an Bai, Qin Long, Lijun Yan, Zhihui Gong, Wei Gao, Qiyun Tang
The role of PIWI-interacting RNAs (piRNAs) in small extracellular vesicles (sEV) derived from pancreatic neuroendocrine neoplasms (PNEN) in the tumor microenvironment (TME) remains unexplored. We used multiplex immunohistochemistry (mIHC) to analyze the expression of CD68, CD276 (B7H3) and CD3 on PNEN. CD276+ tumor-associated macrophages (TAMs) were more abundant in tumor tissues than nontumor tissues and negatively correlated with T-cell infiltration. Serum sEV piRNA sequencing was performed to identify piRNAs enriched in PNEN patients. We then investigated the function and mechanism of sEV piR-hsa-30937 in the crosstalk between tumor cells and macrophages in the PNEN TME. PNEN-derived sEV piR-hsa-30937 targeted PTEN to activate the AKT pathway and drive CD276 expression. CD276+ macrophages inhibited T-cell proliferation and IFN- production. piR-hsa-30937 knockdown and anti-CD276 treatment suppressed progression and metastasis in a preclinical model of PNEN by enhancing T-cell immunity. Thus, our data show that PNEN-derived sEV piR-hsa-30937 promotes CD276 expression in macrophages through the PTEN/AKT pathway and that CD276+ TAMs suppress T-cell antitumor immunity. sEV piR-hsa-30937 and CD276 are potential therapeutic targets for immunotherapy of PNEN.
胰腺神经内分泌肿瘤(PNEN)产生的小细胞外囊泡(sEV)中的PIWI-interacting RNAs(piRNAs)在肿瘤微环境(TME)中的作用仍有待探索。我们使用多重免疫组化技术(mIHC)分析了胰腺神经内分泌瘤(PNEN)上 CD68、CD276 (B7H3) 和 CD3 的表达。与非肿瘤组织相比,CD276+肿瘤相关巨噬细胞(TAMs)在肿瘤组织中更为丰富,并且与T细胞浸润呈负相关。我们对血清 sEV piRNA 进行了测序,以确定 PNEN 患者中富集的 piRNA。然后,我们研究了 sEV piR-hsa-30937 在 PNEN TME 中肿瘤细胞与巨噬细胞之间串扰的功能和机制。PNEN衍生的sEV piR-hsa-30937以PTEN为靶点,激活AKT通路并驱动CD276的表达。CD276+ 巨噬细胞抑制了 T 细胞增殖和 IFN- 的产生。piR-hsa-30937 基因敲除和抗 CD276 治疗通过增强 T 细胞免疫力,抑制了 PNEN 临床前模型的进展和转移。因此,我们的数据表明,PNEN衍生的sEV piR-hsa-30937通过PTEN/AKT途径促进巨噬细胞中CD276的表达,CD276+ TAMs抑制T细胞抗肿瘤免疫。sEV piR-hsa-30937和CD276是PNEN免疫疗法的潜在治疗靶点。
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引用次数: 0
Stressing the Role of CCL3 in Reversing the Immunosuppressive Microenvironment in Gliomas 强调 CCL3 在逆转胶质瘤免疫抑制微环境中的作用
IF 10.1 1区 医学 Q1 Medicine Pub Date : 2024-04-03 DOI: 10.1158/2326-6066.cir-24-0254
Xiaoteng Cui, Chunsheng Kang
Patients with gliomas often experience mental health problems, such as depression and anxiety, that lead to worsening tumor progression and shortened survival. In this issue, Wang and colleagues report a novel mechanism underlying this, finding that chronic stress reduces secretion of the chemokine CCL3, which leads to an immunosuppressive glioma microenvironment. CCL3 administration enhances the infiltration of antitumor immune cells, providing rationale for a potential new therapeutic approach. See related article by Wang et al.
胶质瘤患者经常会遇到抑郁和焦虑等心理健康问题,导致肿瘤恶化和生存期缩短。在本期杂志中,Wang及其同事报告了这一现象的新机制,他们发现慢性压力会减少趋化因子CCL3的分泌,从而导致免疫抑制性胶质瘤微环境。服用 CCL3 能增强抗肿瘤免疫细胞的浸润,为一种潜在的新治疗方法提供了理论依据。参见 Wang 等人的相关文章。
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引用次数: 0
Interactions between MDSCs and the Autonomic Nervous System: Opportunities and Challenges in Cancer Neuroscience MDSCs与自主神经系统之间的相互作用:癌症神经科学的机遇与挑战
IF 10.1 1区 医学 Q1 Medicine Pub Date : 2024-04-03 DOI: 10.1158/2326-6066.cir-23-0976
Lin-Zhen Shu, Yi-Dan Ding, Jin-Yao Zhang, Rui-Shan He, Li Xiao, Bing-Xing Pan, Huan Deng
Myeloid-derived suppressor cells (MDSC) are a population of heterogeneous immune cells that are involved in precancerous conditions and neoplasms. The autonomic nervous system (ANS), which is composed of the sympathetic nervous system and the parasympathetic nervous system, is an important component of the tumor microenvironment that responds to changes in the internal and external environment mainly through adrenergic and cholinergic signaling. An abnormal increase of autonomic nerve density has been associated with cancer progression. As we discuss in this review, growing evidence indicates that sympathetic and parasympathetic signals directly affect the expansion, mobilization, and redistribution of MDSCs. Dysregulated autonomic signaling recruits MDSCs to form an immunosuppressive microenvironment in chronically inflamed tissues, resulting in abnormal proliferation and differentiation of adult stem cells. The two components of the ANS may also be responsible for the seemingly contradictory behaviors of MDSCs. Elucidating the underlying mechanisms has the potential to provide more insights into the complex roles of MDSCs in tumor development and lay the foundation for the development of novel MDSC-targeted anticancer strategies.
髓源性抑制细胞(MDSC)是一种参与癌前病变和肿瘤的异质性免疫细胞群。自律神经系统(ANS)由交感神经系统和副交感神经系统组成,是肿瘤微环境的重要组成部分,主要通过肾上腺素能和胆碱能信号对内外环境的变化做出反应。自律神经密度的异常增加与癌症进展有关。正如我们在本综述中所讨论的,越来越多的证据表明,交感和副交感信号会直接影响 MDSCs 的扩增、动员和重新分布。失调的自律神经信号在慢性炎症组织中招募MDSCs形成免疫抑制微环境,导致成体干细胞异常增殖和分化。自律神经系统的两个组成部分也可能是MDSCs看似矛盾的行为的原因。阐明其潜在机制有可能让人们更深入地了解 MDSCs 在肿瘤发生发展中的复杂作用,并为开发新型 MDSC 靶向抗癌策略奠定基础。
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引用次数: 0
Tumor Burden Dictates the Neoantigen Features Required to Generate an Effective Cancer Vaccine. 肿瘤负担决定了产生有效癌症疫苗所需的新抗原特征。
IF 10.1 1区 医学 Q1 Medicine Pub Date : 2024-04-02 DOI: 10.1158/2326-6066.CIR-23-0609
Irene Garzia, Linda Nocchi, Lidia Avalle, Fulvia Troise, Guido Leoni, Laura Seclì, Laura Antonucci, Gabriella Cotugno, Simona Allocca, Giuseppina Romano, Laura Conti, Carmen Caiazza, Massimo Mallardo, Valeria Poli, Elisa Scarselli, Anna Morena D'Alise

Tumor neoantigens (nAg) represent a promising target for cancer immunotherapy. The identification of nAgs that can generate T-cell responses and have therapeutic activity has been challenging. Here, we sought to unravel the features of nAgs required to induce tumor rejection. We selected clinically validated Great Ape-derived adenoviral vectors (GAd) as a nAg delivery system for differing numbers and combinations of nAgs. We assessed their immunogenicity and efficacy in murine models of low to high disease burden, comparing multi-epitope versus mono-epitope vaccines. We demonstrated that the breadth of immune response is critical for vaccine efficacy and having multiple immunogenic nAgs encoded in a single vaccine improves efficacy. The contribution of each single neoantigen was examined, leading to the identification of 2 nAgs able to induce CD8+ T cell-mediated tumor rejection. They were both active as individual nAgs in a setting of prophylactic vaccination, although to different extents. However, the efficacy of these single nAgs was lost in a setting of therapeutic vaccination in tumor-bearing mice. The presence of CD4+ T-cell help restored the efficacy for only the most expressed of the two nAgs, demonstrating a key role for CD4+ T cells in sustaining CD8+ T-cell responses and the necessity of an efficient recognition of the targeted epitopes on cancer cells by CD8+ T cells for an effective antitumor response. This study provides insight into understanding the determinants of nAgs relevant for effective treatment and highlights features that could contribute to more effective antitumor vaccines. See related Spotlight by Slingluff Jr, p. 382.

肿瘤新抗原(nAgs)是癌症免疫疗法的一个前景广阔的靶点。鉴定能产生T细胞应答并具有治疗活性的nAgs一直是个挑战。在这里,我们试图揭示诱导肿瘤排斥反应所需的 nAgs 特征。我们选择了经过临床验证的源于大猿的腺病毒载体(GAds)作为nAg递送系统,用于递送不同数量和组合的nAg。我们在疾病负担从轻到重的小鼠模型中评估了它们的免疫原性和有效性,比较了多载体疫苗和单载体疫苗。我们证明,免疫反应的广度对疫苗的疗效至关重要,在单一疫苗中编码多种免疫原性 nAgs 可提高疗效。我们对每个新抗原的贡献进行了研究,最终确定了两种能够诱导 CD8+ T 细胞介导的肿瘤排斥反应的 nAg。在预防性疫苗接种的情况下,这两种 nAgs 作为单个 nAgs 都具有活性,只是活性程度不同。然而,在对肿瘤小鼠进行治疗性疫苗接种时,这些单个 nAgs 就失去了功效。只有两种 nAgs 中表达量最高的一种在 CD4+ T 细胞的帮助下才恢复了疗效,这表明 i) CD4+ T 细胞在维持 CD8+ T 细胞应答中起着关键作用;ii) CD8+ T 细胞必须有效识别癌细胞上的目标表位才能产生有效的抗肿瘤应答。这项研究有助于深入了解与有效治疗相关的 nAgs 的决定因素,并强调了有助于提高抗肿瘤疫苗疗效的特征。
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引用次数: 0
Optimal Neoantigen Cancer Vaccines Target CD8+ and CD4+ T Cells with Multiple Antigens. 最佳新抗原癌症疫苗靶向 CD8+ 和 CD4+ T 细胞与多种抗原。
IF 10.1 1区 医学 Q1 Medicine Pub Date : 2024-04-02 DOI: 10.1158/2326-6066.CIR-24-0165
Craig L Slingluff

Cancer vaccines targeting mutated neoantigens offer promise for prevention of cancer recurrence and for treatment of established cancers. Questions remain about whether vaccines need to target multiple neoantigens and whether they need to target both CD8+ and CD4+ T cells. In this issue, Garzia and colleagues demonstrate the importance of including multiple antigens to stimulate both CD4+ T cells and CD8+ T cells for treatment of established cancer. See related article by Garzia et al., p. 440 (4).

针对突变新抗原的癌症疫苗有望预防癌症复发和治疗已确诊的癌症。疫苗是否需要针对多种新抗原,是否需要同时针对 CD8+ 和 CD4+ T 细胞,这些问题依然存在。在本期杂志中,Garzia 及其同事证明了包含多种抗原以刺激 CD4+ T 细胞和 CD8+ T 细胞对治疗已确诊癌症的重要性。请参阅 Garzia 等人的相关文章,第 440 页(4)。
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引用次数: 0
A Sampling of Highlights from the Literature. 文献精华选集》。
IF 10.1 1区 医学 Q1 Medicine Pub Date : 2024-04-02 DOI: 10.1158/2326-6066.CIR-12-4-WWR
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引用次数: 0
Neutrophils Mediate Protection Against Colitis and Carcinogenesis by Controlling Bacterial Invasion and IL22 Production by γδ T Cells. 中性粒细胞通过控制细菌入侵和 γδ T 细胞产生 IL-22 来介导对结肠炎和癌变的防护。
IF 10.1 1区 医学 Q1 Medicine Pub Date : 2024-04-02 DOI: 10.1158/2326-6066.CIR-23-0295
Silvia Carnevale, Andrea Ponzetta, Anna Rigatelli, Roberta Carriero, Simone Puccio, Domenico Supino, Giovanna Grieco, Piera Molisso, Irene Di Ceglie, Francesco Scavello, Chiara Perucchini, Fabio Pasqualini, Camilla Recordati, Claudio Tripodo, Beatrice Belmonte, Andrea Mariancini, Paolo Kunderfranco, Giuseppe Sciumè, Enrico Lugli, Eduardo Bonavita, Elena Magrini, Cecilia Garlanda, Alberto Mantovani, Sebastien Jaillon

Neutrophils are the most abundant leukocytes in human blood and play a primary role in resistance against invading microorganisms and in the acute inflammatory response. However, their role in colitis and colitis-associated colorectal cancer is still under debate. This study aims to dissect the role of neutrophils in these pathologic contexts by using a rigorous genetic approach. Neutrophil-deficient mice (Csf3r-/- mice) were used in classic models of colitis and colitis-associated colorectal cancer and the role of neutrophils was assessed by histologic, cellular, and molecular analyses coupled with adoptive cell transfer. We also performed correlative analyses using human datasets. Csf3r-/- mice showed increased susceptibility to colitis and colitis-associated colorectal cancer compared with control Csf3r+/+ mice and adoptive transfer of neutrophils in Csf3r-/- mice reverted the phenotype. In colitis, Csf3r-/- mice showed increased bacterial invasion and a reduced number of healing ulcers in the colon, indicating a compromised regenerative capacity of epithelial cells. Neutrophils were essential for γδ T-cell polarization and IL22 production. In patients with ulcerative colitis, expression of CSF3R was positively correlated with IL22 and IL23 expression. Moreover, gene signatures associated with epithelial-cell development, proliferation, and antimicrobial response were enriched in CSF3Rhigh patients. Our data support a model where neutrophils mediate protection against intestinal inflammation and colitis-associated colorectal cancer by controlling the intestinal microbiota and driving the activation of an IL22-dependent tissue repair pathway.

中性粒细胞是人体血液中含量最高的白细胞,在抵抗入侵微生物和急性炎症反应中发挥着主要作用。然而,它们在结肠炎和结肠炎相关结肠直肠癌中的作用仍存在争议。本研究旨在通过严谨的遗传学方法剖析中性粒细胞在这些病理环境中的作用。中性粒细胞缺陷小鼠(Csf3r-/-小鼠)被用于结肠炎和结肠炎相关性结直肠癌的经典模型,并通过组织学、细胞和分子分析以及收养性细胞转移评估了中性粒细胞的作用。我们还利用人类数据集进行了相关分析。与对照组 Csf3r+/+ 小鼠相比,Csf3r-/- 小鼠对结肠炎和结肠炎相关性结肠直肠癌的易感性增加,而在 Csf3r-/- 小鼠体内进行中性粒细胞的收养性转移可逆转这种表型。在结肠炎中,Csf3r-/-小鼠显示细菌入侵增加,结肠溃疡愈合数量减少,表明上皮细胞再生能力受损。中性粒细胞对 γδ T 细胞极化和 IL-22 的产生至关重要。在溃疡性结肠炎患者中,CSF3R的表达与IL22和IL23的表达呈正相关。此外,在 CSF3R 高的患者中,与上皮细胞发育、增殖和抗菌反应相关的基因特征也很丰富。我们的数据支持这样一个模型,即中性粒细胞通过控制肠道微生物群和驱动IL-22依赖性组织修复途径的激活,介导对肠道炎症和结肠炎相关结直肠癌的保护。
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引用次数: 0
High-Specificity CRISPR-Mediated Genome Engineering in Anti-BCMA Allogeneic CAR T Cells Suppresses Allograft Rejection in Preclinical Models. 高特异性 CRISPR 介导的抗 BCMA 异体 CAR T 细胞基因组工程可抑制临床前模型中的异体移植排斥反应。
IF 10.1 1区 医学 Q1 Medicine Pub Date : 2024-04-02 DOI: 10.1158/2326-6066.CIR-23-0679
Émilie Degagné, Paul D Donohoue, Suparna Roy, Jessica Scherer, Tristan W Fowler, Ryan T Davis, Gustavo A Reyes, George Kwong, Morena Stanaway, Vanina Larroca Vicena, Devin Mutha, Raymond Guo, Leslie Edwards, Benjamin Schilling, McKay Shaw, Stephen C Smith, Bryan Kohrs, Heinrich J Kufeldt, Glen Churchward, Finey Ruan, David B Nyer, Kyle McSweeney, Matthew J Irby, Christopher K Fuller, Lynda Banh, Mckenzi S Toh, Matthew Thompson, Arthur L G Owen, Zili An, Scott Gradia, Justin Skoble, Mara Bryan, Elizabeth Garner, Steven B Kanner

Allogeneic chimeric antigen receptor (CAR) T cell therapies hold the potential to overcome many of the challenges associated with patient-derived (autologous) CAR T cells. Key considerations in the development of allogeneic CAR T cell therapies include prevention of graft-vs-host disease (GvHD) and suppression of allograft rejection. Here, we describe preclinical data supporting the ongoing first-in-human clinical study, the CaMMouflage trial (NCT05722418), evaluating CB-011 in patients with relapsed/refractory multiple myeloma. CB-011 is a hypoimmunogenic, allogeneic anti-B-cell maturation antigen (BCMA) CAR T cell therapy candidate. CB-011 cells feature 4 genomic alterations and were engineered from healthy donor-derived T cells using a Cas12a CRISPR hybrid RNA-DNA (chRDNA) genome-editing technology platform. To address allograft rejection, CAR T cells were engineered to prevent endogenous HLA class I complex expression and overexpress a single-chain polyprotein complex composed of beta-2 microglobulin (B2M) tethered to HLA-E. In addition, T-cell receptor (TCR) expression was disrupted at the TCR alpha constant locus in combination with the site-specific insertion of a humanized BCMA-specific CAR. CB-011 cells exhibited robust plasmablast cytotoxicity in vitro in a mixed lymphocyte reaction in cell cocultures derived from patients with multiple myeloma. In addition, CB-011 cells demonstrated suppressed recognition by and cytotoxicity from HLA-mismatched T cells. CB-011 cells were protected from natural killer cell-mediated cytotoxicity in vitro and in vivo due to endogenous promoter-driven expression of B2M-HLA-E. Potent antitumor efficacy, when combined with an immune-cloaking armoring strategy to dampen allograft rejection, offers optimized therapeutic potential in multiple myeloma. See related Spotlight by Caimi and Melenhorst, p. 385.

异体嵌合抗原受体(CAR)T细胞疗法有可能克服与患者来源(自体)CAR T细胞相关的许多挑战。开发异体 CAR T 细胞疗法的主要考虑因素包括预防 GvHD 和抑制异体移植排斥反应。在此,我们描述了支持正在进行的首个人体临床研究--CaMMouflage 试验(NCT05722418)的临床前数据,该试验评估了 CB-011 在复发/难治性多发性骨髓瘤患者中的应用。CB-011 是一种低免疫原性异基因抗 B 细胞成熟抗原(BCMA)CAR T 细胞候选疗法。CB-011细胞具有4个基因组改变,是利用Cas12a CRISPR杂交RNA-DNA(chRDNA)基因组编辑技术平台从健康供体来源的T细胞中设计出来的。为了解决异体移植排斥反应,CAR T细胞被设计成阻止内源性人类白细胞抗原(HLA)I类复合物的表达,并过度表达由与HLA-E相连的β-2微球蛋白(B2M)组成的单链多聚蛋白复合物。此外,结合人源化 BCMA 特异性 CAR 的位点特异性插入,TCR α 常数位点的 T 细胞受体(TCR)表达被破坏。在多发性骨髓瘤患者的细胞共培养体外混合淋巴细胞反应中,CB-011 细胞表现出强大的浆细胞毒性。此外,CB-011 细胞还抑制了 HLA 不匹配 T 细胞的识别和细胞毒性。由于内源性启动子驱动 B2M-HLA-E 的表达,CB-011 细胞在体外和体内均可免受自然杀伤(NK)细胞介导的细胞毒性的影响。CB-011细胞具有强大的抗肿瘤功效,与抑制异体移植排斥反应的免疫铠装策略相结合,为多发性骨髓瘤提供了优化的治疗潜力。
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引用次数: 0
Gut Mycobiota Dysbiosis Is Associated with Melanoma and Response to Anti-PD-1 Therapy. 肠道菌群失调与黑色素瘤和抗PD-1疗法反应有关。
IF 10.1 1区 医学 Q1 Medicine Pub Date : 2024-04-02 DOI: 10.1158/2326-6066.CIR-23-0592
Natalia Szóstak, Luiza Handschuh, Anna Samelak-Czajka, Katarzyna Tomela, Bernadeta Pietrzak, Marcin Schmidt, Łukasz Galus, Jacek Mackiewicz, Andrzej Mackiewicz, Piotr Kozlowski, Anna Philips

Recent research indicates that gut microbiota may be vital in the advancement of melanoma. In this study, we found that melanoma patients exhibited a distinct gut mycobiota structure compared with healthy participants. Candida albicans, Candida dubliniensis, and Neurospora crassa were more abundant in samples from patients with melanoma, whereas Saccharomyces cerevisiae and Debaryomyces hansenii were less abundant. During anti-PD-1 treatment, the relative amount of Malassezia restricta and C. albicans increased. A higher level of Saccharomyces paradoxus was associated with a positive response to anti-PD-1 treatment, whereas a higher level of Tetrapisispora blattae was associated with a lack of clinical benefits. High levels of M. restricta and C. albicans, elevated serum lactate dehydrogenase, and being overweight were linked to increased risk of melanoma progression and poorer response to anti-PD-1 treatment. Thus, this study has revealed melanoma-associated mycobiome dysbiosis, characterized by altered fungal composition and fungi species associated with a higher risk of melanoma progression, identifying a role for the gut mycobiome in melanoma progression.

最近的研究表明,肠道微生物群可能对黑色素瘤的发展至关重要。在这项研究中,我们发现与健康参与者相比,黑色素瘤患者的肠道微生物群结构截然不同。在黑色素瘤患者的样本中,白色念珠菌、杜布林念珠菌和蟋蟀神经孢子菌的含量较高,而酿酒酵母菌和汉逊德巴里酵母菌的含量较低。在抗PD-1治疗过程中,限制马拉色菌和白癣菌的相对数量有所增加。较高水平的矛盾酵母菌与抗-PD-1治疗的阳性反应有关,而较高水平的白葡萄孢酵母菌与缺乏临床益处有关。高水平的限制酵母菌和白僵菌、血清低密度脂蛋白胆固醇(LDH)升高以及超重与黑色素瘤进展风险增加以及对抗PD-1治疗反应较差有关。因此,这项研究揭示了与黑色素瘤相关的真菌生物群失调,其特点是真菌组成和真菌种类的改变与黑色素瘤进展的高风险相关,从而确定了肠道真菌生物群在黑色素瘤进展中的作用。
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引用次数: 0
Reprogramming the Intrahepatic Cholangiocarcinoma Immune Microenvironment by Chemotherapy and CTLA-4 Blockade Enhances Anti-PD-1 Therapy. 通过化疗和CTLA-4阻断剂重编程肝内胆管癌免疫微环境可增强抗PD1疗法的效果
IF 10.1 1区 医学 Q1 Medicine Pub Date : 2024-04-02 DOI: 10.1158/2326-6066.CIR-23-0486
Jiang Chen, Zohreh Amoozgar, Xin Liu, Shuichi Aoki, Zelong Liu, Sarah M Shin, Aya Matsui, Alexei Hernandez, Zhangya Pu, Stefan Halvorsen, Pin-Ji Lei, Meenal Datta, Lingling Zhu, Zhiping Ruan, Lei Shi, Daniel Staiculescu, Koetsu Inoue, Lance L Munn, Dai Fukumura, Peigen Huang, Slim Sassi, Nabeel Bardeesy, Won Jin Ho, Rakesh K Jain, Dan G Duda

Intrahepatic cholangiocarcinoma (ICC) has limited therapeutic options and a dismal prognosis. Adding blockade of the anti-programmed cell death protein (PD)-1 pathway to gemcitabine/cisplatin chemotherapy has recently shown efficacy in biliary tract cancers but with low response rates. Here, we studied the effects of anti-cytotoxic T lymphocyte antigen (CTLA)-4 when combined with anti-PD-1 and gemcitabine/cisplatin in orthotopic murine models of ICC. This combination therapy led to substantial survival benefits and reduction of morbidity in two aggressive ICC models that were resistant to immunotherapy alone. Gemcitabine/cisplatin treatment increased tumor-infiltrating lymphocytes and normalized the ICC vessels and, when combined with dual CTLA-4/PD-1 blockade, increased the number of activated CD8+Cxcr3+IFNγ+ T cells. CD8+ T cells were necessary for the therapeutic benefit because the efficacy was compromised when CD8+ T cells were depleted. Expression of Cxcr3 on CD8+ T cells is necessary and sufficient because CD8+ T cells from Cxcr3+/+ but not Cxcr3-/- mice rescued efficacy in T cell‒deficient mice. Finally, rational scheduling of anti-CTLA-4 "priming" with chemotherapy followed by anti-PD-1 therapy achieved equivalent efficacy with reduced overall drug exposure. These data suggest that this combination approach should be clinically tested to overcome resistance to current therapies in ICC patients.

肝内胆管癌(ICC)的治疗方案有限,预后不佳。最近,在吉西他滨/顺铂化疗中加入 PD1 通路阻断治疗对胆道癌有疗效,但反应率较低。在这里,我们研究了抗CTLA-4与抗PD1和吉西他滨/顺铂联合用于ICC正位小鼠模型的效果。在两种对单独免疫疗法耐药的侵袭性 ICC 模型中,这种联合疗法带来了显著的生存获益并降低了发病率。吉西他滨/顺铂治疗增加了肿瘤浸润淋巴细胞,使ICC血管正常化,当与CTLA-4/PD1双重阻断联合使用时,增加了活化CD8+Cxcr3+IFNγ+ T细胞的数量。CD8+ T细胞是获得疗效的必要条件,因为当CD8+ T细胞被耗尽时,疗效就会受到影响。Cxcr3 在 CD8+ T 细胞上的表达是必要且充分的,因为来自 Cxcr3+/+ 而非 Cxcr3-/- 小鼠的 CD8+ T 细胞能挽救 T 细胞缺陷小鼠的疗效。最后,合理安排抗CTLA-4 "引物 "与化疗的时间,然后再进行抗PD1治疗,可在减少总体药物暴露的情况下获得同等疗效。这些数据表明,应该对这种联合疗法进行临床试验,以克服ICC患者对目前疗法的耐药性。
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引用次数: 0
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Cancer immunology research
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