Mukherjee Pinku, Basu Gargi D, Tinder Teresa L, Subramani Durai B, Bradley Judy M, Arefayene Million, Skaar Todd, De Petris Giovanni
Department of Immunology, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA.
J Immunol. 2009 Jan 1;182(1):216-24.
With a 5-year survival rate of <5%, pancreatic cancer is one of the most rapidly fatal malignancies. Current protocols for the treatment of pancreas cancer are not as effective as we desire. In this study, we show that a novel Mucin-1 (MUC1)-based vaccine in combination with a cyclooxygenase-2 inhibitor (celecoxib), and low-dose chemotherapy (gemcitabine) was effective in preventing the progression of preneoplastic intraepithelial lesions to invasive pancreatic ductal adenocarcinomas. The study was conducted in an appropriate triple transgenic model of spontaneous pancreatic cancer induced by the KRAS(G12D) mutation and that expresses human MUC1 as a self molecule. The combination treatment elicited robust antitumor cellular and humoral immune responses and was associated with increased apoptosis in the tumor. The mechanism for the increased immune response was attributed to the down-regulation of circulating prostaglandin E(2) and indoleamine 2, 3,-dioxygenase enzymatic activity, as well as decreased levels of T regulatory and myeloid suppressor cells within the tumor microenvironment. The preclinical data provide the rationale to design clinical trials with a combination of MUC1-based vaccine, celecoxib, and gemcitabine for the treatment of pancreatic cancer.
胰腺癌的5年生存率低于5%,是致死率上升最快的恶性肿瘤之一。目前的胰腺癌治疗方案并不如我们期望的那样有效。在本研究中,我们发现一种新型的基于黏蛋白-1(MUC1)的疫苗,联合环氧化酶-2抑制剂(塞来昔布)及低剂量化疗药物(吉西他滨),可有效预防癌前上皮内病变进展为浸润性胰腺导管腺癌。本研究在一种合适的三联转基因模型中开展,该模型由KRAS(G12D)突变诱导产生自发性胰腺癌,并将人MUC1作为自身分子表达。联合治疗引发了强烈的抗肿瘤细胞免疫和体液免疫反应,并与肿瘤细胞凋亡增加有关。免疫反应增强的机制归因于循环前列腺素E2和吲哚胺2,3-双加氧酶活性的下调,以及肿瘤微环境中调节性T细胞和髓系抑制细胞水平的降低。临床前数据为设计基于MUC1的疫苗、塞来昔布和吉西他滨联合治疗胰腺癌的临床试验提供了理论依据。