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联合抗血管生成和抗PD-L1疗法通过形成高内皮微静脉刺激肿瘤免疫。

Combined antiangiogenic and anti-PD-L1 therapy stimulates tumor immunity through HEV formation.

作者信息

Allen Elizabeth, Jabouille Arnaud, Rivera Lee B, Lodewijckx Inge, Missiaen Rindert, Steri Veronica, Feyen Kevin, Tawney Jaime, Hanahan Douglas, Michael Iacovos P, Bergers Gabriele

机构信息

Laboratory of Tumor Microenvironment and Therapeutic Resistance, VIB-Center for Cancer Biology, Department of Oncology, Katholieke Universiteit Leuven, 3000 Leuven, Belgium.

Brain Tumor Research Center, Department of Neurological Surgery, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA 94158, USA.

出版信息

Sci Transl Med. 2017 Apr 12;9(385). doi: 10.1126/scitranslmed.aak9679.

Abstract

Inhibitors of VEGF (vascular endothelial growth factor)/VEGFR2 (vascular endothelial growth factor receptor 2) are commonly used in the clinic, but their beneficial effects are only observed in a subset of patients and limited by induction of diverse relapse mechanisms. We describe the up-regulation of an adaptive immunosuppressive pathway during antiangiogenic therapy, by which PD-L1 (programmed cell death ligand 1), the ligand of the negative immune checkpoint regulator PD-1 (programmed cell death protein 1), is enhanced by interferon-γ-expressing T cells in distinct intratumoral cell types in refractory pancreatic, breast, and brain tumor mouse models. Successful treatment with a combination of anti-VEGFR2 and anti-PD-L1 antibodies induced high endothelial venules (HEVs) in PyMT (polyoma middle T oncoprotein) breast cancer and RT2-PNET (Rip1-Tag2 pancreatic neuroendocrine tumors), but not in glioblastoma (GBM). These HEVs promoted lymphocyte infiltration and activity through activation of lymphotoxin β receptor (LTβR) signaling. Further activation of LTβR signaling in tumor vessels using an agonistic antibody enhanced HEV formation, immunity, and subsequent apoptosis and necrosis in pancreatic and mammary tumors. Finally, LTβR agonists induced HEVs in recalcitrant GBM, enhanced cytotoxic T cell (CTL) activity, and thereby sensitized tumors to antiangiogenic/anti-PD-L1 therapy. Together, our preclinical studies provide evidence that anti-PD-L1 therapy can sensitize tumors to antiangiogenic therapy and prolong its efficacy, and conversely, antiangiogenic therapy can improve anti-PD-L1 treatment specifically when it generates intratumoral HEVs that facilitate enhanced CTL infiltration, activity, and tumor cell destruction.

摘要

血管内皮生长因子(VEGF)/血管内皮生长因子受体2(VEGFR2)抑制剂在临床上常用,但仅在部分患者中观察到其有益效果,且受多种复发机制诱导的限制。我们描述了抗血管生成治疗期间一种适应性免疫抑制途径的上调,通过该途径,在难治性胰腺癌、乳腺癌和脑肿瘤小鼠模型的不同肿瘤内细胞类型中,表达干扰素-γ的T细胞增强了负性免疫检查点调节因子程序性死亡蛋白1(PD-1)的配体程序性死亡配体1(PD-L1)。抗VEGFR2和抗PD-L1抗体联合成功治疗在PyMT(多瘤病毒中间T癌蛋白)乳腺癌和RT2-PNET(Rip1-Tag2胰腺神经内分泌肿瘤)中诱导了高内皮微静脉(HEV),但在胶质母细胞瘤(GBM)中未诱导。这些HEV通过激活淋巴毒素β受体(LTβR)信号促进淋巴细胞浸润和活性。使用激动剂抗体进一步激活肿瘤血管中的LTβR信号增强了胰腺和乳腺肿瘤中的HEV形成、免疫以及随后的凋亡和坏死。最后,LTβR激动剂在难治性GBM中诱导HEV,增强细胞毒性T细胞(CTL)活性,从而使肿瘤对抗血管生成/抗PD-L1治疗敏感。总之,我们的临床前研究提供了证据,表明抗PD-L1治疗可使肿瘤对抗血管生成治疗敏感并延长其疗效,反之,抗血管生成治疗可在产生促进CTL浸润、活性增强和肿瘤细胞破坏的肿瘤内HEV时特异性改善抗PD-L1治疗。

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