Mahvi David A, Meyers Justin V, Tatar Andrew J, Contreras Amanda, Suresh Marulasiddappa, Leverson Glen E, Sen Siddhartha, Cho Clifford S
*Section of Surgical Oncology, University of Wisconsin School of Medicine and Public Health †Department of Pathobiological Sciences, University of Wisconsin School of Veterinary Medicine ‡Surgical Service, William S. Middleton Memorial VA Hospital, Madison, WI.
J Immunother. 2015 Feb-Mar;38(2):54-61. doi: 10.1097/CJI.0000000000000064.
Immunotherapeutic approaches to the treatment of advanced melanoma have relied on strategies that augment the responsiveness of endogenous tumor-specific T-cell populations [eg, cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) blockade-mediated checkpoint inhibition] or introduce exogenously prepared tumor-specific T-cell populations [eg, adoptive cell transfer (ACT)]. Although both approaches have shown considerable promise, response rates to these therapies remain suboptimal. We hypothesized that a combinatorial approach to immunotherapy using both CTLA-4 blockade and nonlymphodepletional ACT could offer additive therapeutic benefit. C57BL/6 mice were inoculated with syngeneic B16F10 melanoma tumors transfected to express low levels of the lymphocytic choriomeningitis virus peptide GP33 (B16GP33), and treated with no immunotherapy, CTLA-4 blockade, ACT, or combination immunotherapy of CTLA-4 blockade with ACT. Combination immunotherapy resulted in optimal control of B16GP33 melanoma tumors. Combination immunotherapy promoted a stronger local immune response reflected by enhanced tumor-infiltrating lymphocyte populations, and a stronger systemic immune responses reflected by more potent tumor antigen-specific T-cell activity in splenocytes. In addition, whereas both CTLA-4 blockade and combination immunotherapy were able to promote long-term immunity against B16GP33 tumors, only combination immunotherapy was capable of promoting immunity against parental B16F10 tumors as well. Our findings suggest that a combinatorial approach using CTLA-4 blockade with nonlymphodepletional ACT may promote additive endogenous and exogenous T-cell activities that enable greater therapeutic efficacy in the treatment of melanoma.
治疗晚期黑色素瘤的免疫治疗方法依赖于增强内源性肿瘤特异性T细胞群体反应性的策略[例如,细胞毒性T淋巴细胞相关抗原4(CTLA-4)阻断介导的检查点抑制]或引入外源性制备的肿瘤特异性T细胞群体[例如,过继性细胞转移(ACT)]。尽管这两种方法都显示出了相当大的前景,但这些疗法的缓解率仍然不尽人意。我们推测,将CTLA-4阻断与非淋巴细胞清除性ACT相结合的免疫治疗方法可能会带来额外的治疗益处。将C57BL/6小鼠接种同基因的转染后表达低水平淋巴细胞性脉络丛脑膜炎病毒肽GP33的B16F10黑色素瘤肿瘤(B16GP33),并分别给予无免疫治疗、CTLA-4阻断、ACT或CTLA-4阻断与ACT联合免疫治疗。联合免疫治疗导致对B16GP33黑色素瘤肿瘤的最佳控制。联合免疫治疗促进了更强的局部免疫反应,表现为肿瘤浸润淋巴细胞群体增加,以及更强的全身免疫反应,表现为脾细胞中更有效的肿瘤抗原特异性T细胞活性。此外,虽然CTLA-4阻断和联合免疫治疗都能够促进对B16GP33肿瘤的长期免疫,但只有联合免疫治疗也能够促进对亲本B16F10肿瘤的免疫。我们的数据表明,将CTLA-4阻断与非淋巴细胞清除性ACT相结合的方法可能会促进内源性和外源性T细胞活性的叠加,从而在黑色素瘤治疗中实现更大的治疗效果。