Moynihan Kelly D, Opel Cary F, Szeto Gregory L, Tzeng Alice, Zhu Eric F, Engreitz Jesse M, Williams Robert T, Rakhra Kavya, Zhang Michael H, Rothschilds Adrienne M, Kumari Sudha, Kelly Ryan L, Kwan Byron H, Abraham Wuhbet, Hu Kevin, Mehta Naveen K, Kauke Monique J, Suh Heikyung, Cochran Jennifer R, Lauffenburger Douglas A, Wittrup K Dane, Irvine Darrell J
Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts, USA.
Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.
Nat Med. 2016 Dec;22(12):1402-1410. doi: 10.1038/nm.4200. Epub 2016 Oct 24.
Checkpoint blockade with antibodies specific for cytotoxic T lymphocyte-associated protein (CTLA)-4 or programmed cell death 1 (PDCD1; also known as PD-1) elicits durable tumor regression in metastatic cancer, but these dramatic responses are confined to a minority of patients. This suboptimal outcome is probably due in part to the complex network of immunosuppressive pathways present in advanced tumors, which are unlikely to be overcome by intervention at a single signaling checkpoint. Here we describe a combination immunotherapy that recruits a variety of innate and adaptive immune cells to eliminate large tumor burdens in syngeneic tumor models and a genetically engineered mouse model of melanoma; to our knowledge tumors of this size have not previously been curable by treatments relying on endogenous immunity. Maximal antitumor efficacy required four components: a tumor-antigen-targeting antibody, a recombinant interleukin-2 with an extended half-life, anti-PD-1 and a powerful T cell vaccine. Depletion experiments revealed that CD8 T cells, cross-presenting dendritic cells and several other innate immune cell subsets were required for tumor regression. Effective treatment induced infiltration of immune cells and production of inflammatory cytokines in the tumor, enhanced antibody-mediated tumor antigen uptake and promoted antigen spreading. These results demonstrate the capacity of an elicited endogenous immune response to destroy large, established tumors and elucidate essential characteristics of combination immunotherapies that are capable of curing a majority of tumors in experimental settings typically viewed as intractable.
使用针对细胞毒性T淋巴细胞相关蛋白(CTLA)-4或程序性细胞死亡1(PDCD1,也称为PD-1)的特异性抗体进行检查点阻断,可在转移性癌症中引发持久的肿瘤消退,但这些显著反应仅限于少数患者。这种不理想的结果可能部分归因于晚期肿瘤中存在的复杂免疫抑制途径网络,仅通过干预单一信号检查点不太可能克服这些途径。在此,我们描述了一种联合免疫疗法,该疗法可募集多种先天性和适应性免疫细胞,以消除同基因肿瘤模型和黑色素瘤基因工程小鼠模型中的巨大肿瘤负荷;据我们所知,以前依靠内源性免疫的治疗方法无法治愈如此大小的肿瘤。最大抗肿瘤疗效需要四个组成部分:肿瘤抗原靶向抗体、半衰期延长的重组白细胞介素-2、抗PD-1和强大的T细胞疫苗。清除实验表明,肿瘤消退需要CD8 T细胞、交叉呈递树突状细胞和其他几个先天性免疫细胞亚群。有效的治疗诱导免疫细胞浸润并在肿瘤中产生炎性细胞因子,增强抗体介导的肿瘤抗原摄取并促进抗原扩散。这些结果证明了内源性免疫反应破坏大型已形成肿瘤的能力,并阐明了联合免疫疗法的基本特征,这些联合免疫疗法能够在通常被视为棘手的实验环境中治愈大多数肿瘤。