Sagiv-Barfi Idit, Kohrt Holbrook E K, Czerwinski Debra K, Ng Patrick P, Chang Betty Y, Levy Ronald
Division of Oncology, Department of Medicine, Stanford University, Stanford, CA 94305-5151; and.
Department of Research, Pharmacyclics, Inc., Sunnyvale, CA 94085-4521.
Proc Natl Acad Sci U S A. 2015 Mar 3;112(9):E966-72. doi: 10.1073/pnas.1500712112. Epub 2015 Feb 17.
Monoclonal antibodies can block cellular interactions that negatively regulate T-cell immune responses, such as CD80/CTLA-4 and PD-1/PD1-L, amplifying preexisting immunity and thereby evoking antitumor immune responses. Ibrutinib, an approved therapy for B-cell malignancies, is a covalent inhibitor of BTK, a member of the B-cell receptor (BCR) signaling pathway, which is critical to the survival of malignant B cells. Interestingly this drug also inhibits ITK, an essential enzyme in Th2 T cells and by doing so it can shift the balance between Th1 and Th2 T cells and potentially enhance antitumor immune responses. Here we report that the combination of anti-PD-L1 antibody and ibrutinib suppresses tumor growth in mouse models of lymphoma that are intrinsically insensitive to ibrutinib. The combined effect of these two agents was also documented for models of solid tumors, such as triple negative breast cancer and colon cancer. The enhanced therapeutic activity of PD-L1 blockade by ibrutinib was accompanied by enhanced antitumor T-cell immune responses. These preclinical results suggest that the combination of PD1/PD1-L blockade and ibrutinib should be tested in the clinic for the therapy not only of lymphoma but also in other hematologic malignancies and solid tumors that do not even express BTK.
单克隆抗体可阻断对T细胞免疫反应产生负调节作用的细胞间相互作用,如CD80/细胞毒性T淋巴细胞相关蛋白4(CTLA-4)和程序性死亡受体1(PD-1)/程序性死亡受体配体1(PD-L1),增强已有的免疫力,从而引发抗肿瘤免疫反应。伊布替尼是一种已获批准用于治疗B细胞恶性肿瘤的药物,它是B细胞受体(BCR)信号通路成员布鲁顿酪氨酸激酶(BTK)的共价抑制剂,对恶性B细胞的存活至关重要。有趣的是,这种药物还能抑制Th2 T细胞中的一种关键酶——白细胞介素-2诱导激酶(ITK),通过这种方式,它可以改变Th1和Th2 T细胞之间的平衡,并有可能增强抗肿瘤免疫反应。在此,我们报告抗PD-L1抗体与伊布替尼联合使用可抑制淋巴瘤小鼠模型中的肿瘤生长,这些模型对伊布替尼本身不敏感。在三阴性乳腺癌和结肠癌等实体瘤模型中也证实了这两种药物的联合效果。伊布替尼增强了PD-L1阻断的治疗活性,并伴有增强的抗肿瘤T细胞免疫反应。这些临床前结果表明,PD1/PD-L1阻断与伊布替尼联合使用应在临床上进行测试,不仅用于治疗淋巴瘤,还用于治疗其他血液系统恶性肿瘤以及甚至不表达BTK的实体瘤。