Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Sci Transl Med. 2016 Dec 21;8(370):370ra180. doi: 10.1126/scitranslmed.aag2942.
The immunosuppressive effects of chemotherapy present a challenge for designing effective cancer immunotherapy strategies. We hypothesized that although systemic chemotherapy (SC) exhibits negative immunologic effects, local chemotherapy (LC) can potentiate an antitumor immune response. We show that LC combined with anti-programmed cell death protein 1 (PD-1) facilitates an antitumor immune response and improves survival (P < 0.001) in glioblastoma. LC-treated mice had increased infiltration of tumor-associated dendritic cells and clonal expansion of antigen-specific T effector cells. In comparison, SC resulted in systemic and intratumoral lymphodepletion, with decreased immune memory in long-term survivors. Furthermore, adoptive transfer of CD8 cells from LC-treated mice partially rescued SC-treated mice after tumor rechallenge. Last, the timing of chemo- and immunotherapy had differential effects on anti-PD-1 efficacy. This study suggests that both mode of delivery and timing have distinct effects on the efficacy of anti-PD-1. The results of this work could help guide the selection and scheduling of combination treatment for patients with glioblastoma and other tumor types.
化疗的免疫抑制作用给设计有效的癌症免疫治疗策略带来了挑战。我们假设,虽然全身化疗(systemic chemotherapy,SC)表现出负性免疫效应,但局部化疗(local chemotherapy,LC)可以增强抗肿瘤免疫反应。我们发现,LC 联合抗程序性细胞死亡蛋白 1(programmed cell death protein 1,PD-1)治疗促进了胶质母细胞瘤的抗肿瘤免疫反应并提高了生存率(P<0.001)。LC 治疗的小鼠肿瘤相关树突状细胞浸润增加,抗原特异性 T 效应细胞克隆扩增。相比之下,SC 导致全身和肿瘤内淋巴细胞耗竭,长期幸存者的免疫记忆减少。此外,在肿瘤再挑战后,从 LC 治疗的小鼠中过继转移 CD8 细胞部分挽救了 SC 治疗的小鼠。最后,化疗和免疫治疗的时机对抗 PD-1 的疗效有不同的影响。这项研究表明,给药方式和时机对抗 PD-1 的疗效有明显影响。这项工作的结果可以帮助指导胶质母细胞瘤和其他肿瘤类型患者联合治疗的选择和安排。