Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Blood. 2012 Nov 29;120(23):4533-43. doi: 10.1182/blood-2012-02-407163. Epub 2012 Aug 30.
Targeted and immune-based therapies are thought to eradicate cancer cells by different mechanisms, and these approaches could possibly complement each other when used in combination. In this study, we report that the in vivo antitumor effects of the c-KIT inhibitor, dasatinib, on the c-KIT mutant P815 mastocytoma tumor were substantially dependent on T cell-mediated immunity. We found that dasatinib treatment significantly decreased levels of Tregs while specifically enhancing tumor antigen-specific T-cell responses. We sought to further enhance this therapy with the addition of anti-OX40 antibody, which is known to provide a potent costimulatory signal to T cells. The combination of dasatinib and anti-OX40 antibody resulted in substantially better therapeutic efficacy compared with either drug alone, and this was associated with enhanced accumulation of tumor antigen-specific T cells in the tumor microenvironment. Furthermore, the combination regimen inhibited the function of Tregs and also resulted in significantly up-regulated expression of the IFN-γ-induced chemokines CXCL9, 10, and 11 in the tumor microenvironment, which provides a feasible mechanism for the enhanced intratumoral CTL infiltration. These studies delineate a strategy by which targeted therapy and immunotherapy may be combined to achieve superior antitumor responses in cancer patients.
靶向和免疫治疗被认为通过不同的机制来消灭癌细胞,当这些方法联合使用时,它们可能会相互补充。在这项研究中,我们报告了 c-KIT 抑制剂达沙替尼对 c-KIT 突变的 P815 肥大细胞瘤肿瘤的体内抗肿瘤作用在很大程度上依赖于 T 细胞介导的免疫。我们发现达沙替尼治疗显著降低了 Tregs 的水平,同时特异性增强了肿瘤抗原特异性 T 细胞反应。我们试图通过添加抗 OX40 抗体进一步增强这种治疗,因为已知抗 OX40 抗体可以向 T 细胞提供有效的共刺激信号。与单独使用任何一种药物相比,达沙替尼和抗 OX40 抗体的联合治疗具有显著更好的治疗效果,这与肿瘤微环境中肿瘤抗原特异性 T 细胞的积累增加有关。此外,联合方案抑制了 Tregs 的功能,还导致肿瘤微环境中 IFN-γ 诱导的趋化因子 CXCL9、10 和 11 的表达显著上调,这为增强肿瘤内 CTL 浸润提供了一种可行的机制。这些研究描绘了一种策略,通过这种策略,靶向治疗和免疫治疗可以结合起来,为癌症患者实现更好的抗肿瘤反应。