胆囊收缩素受体拮抗剂改变胰腺癌微环境并提高免疫检查点抗体治疗在小鼠中的疗效。

Cholecystokinin receptor antagonist alters pancreatic cancer microenvironment and increases efficacy of immune checkpoint antibody therapy in mice.

机构信息

Department of Medicine, Georgetown University, Building D, Room 338, 4000 Reservoir Rd, Washington DC, NW, 20007, USA.

Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC, USA.

出版信息

Cancer Immunol Immunother. 2018 Feb;67(2):195-207. doi: 10.1007/s00262-017-2077-9. Epub 2017 Oct 17.

Abstract

Advanced pancreatic ductal adenocarcinoma (PDAC) has typically been resistant to chemotherapy and immunotherapy; therefore, novel strategies are needed to enhance therapeutic response. Cholecystokinin (CCK) has been shown to stimulate growth of pancreatic cancer. CCK receptors (CCKRs) are present on pancreatic cancer cells, fibroblasts, and lymphocytes. We hypothesized that CCKR blockade would improve response to immune checkpoint antibodies by promoting influx of tumor-infiltrating lymphocytes (TILs) and reducing fibrosis. We examined the effects of CCKR antagonists or immune checkpoint blockade antibodies alone or in combination in murine models of PDAC. Monotherapy with CCKR blockade significantly decreased tumor size and metastases in SCID mice with orthotopic PDAC, and in C57BL/6 mice, it reduced fibrosis and induced the influx of TILs. Immune-competent mice bearing syngeneic pancreatic cancer (Panc02 and mT3-2D) that were treated with the combination of CCK receptor antagonists and immune checkpoint blockade antibodies survived significantly longer with smaller tumors. Tumor immunohistochemical staining and flow cytometry demonstrated that the tumors of mice treated with the combination regimen had a significant reduction in Foxp3+ T-regulatory cells and an increase in CD4+ and CD8+ lymphocytes. Masson's trichrome stain analysis revealed 50% less fibrosis in the tumors of mice treated with CCKR antagonist compared to controls and compared to checkpoint antibody therapy. CCKR antagonists given with immune checkpoint antibody therapy represent a novel approach for improving survival of PDAC. The mechanism by which this combination therapy improves the survival of PDAC may be related to the decreased fibrosis and immune cells of the tumor microenvironment.

摘要

晚期胰腺导管腺癌(PDAC)通常对化疗和免疫疗法有抵抗力;因此,需要新的策略来增强治疗反应。胆囊收缩素(CCK)已被证明可刺激胰腺癌的生长。胆囊收缩素受体(CCKR)存在于胰腺癌细胞、成纤维细胞和淋巴细胞上。我们假设 CCKR 阻断将通过促进肿瘤浸润淋巴细胞(TIL)的流入和减少纤维化来改善对免疫检查点抗体的反应。我们研究了 CCKR 拮抗剂或免疫检查点阻断抗体单独或联合在 PDAC 小鼠模型中的作用。CCKR 阻断的单药治疗可显著减少 SCID 小鼠原位 PDAC 中的肿瘤大小和转移,在 C57BL/6 小鼠中,它可减少纤维化并诱导 TIL 流入。用 CCK 受体拮抗剂和免疫检查点阻断抗体联合治疗的携带同源胰腺癌细胞(Panc02 和 mT3-2D)的免疫活性小鼠存活时间显著延长,肿瘤更小。肿瘤免疫组织化学染色和流式细胞术表明,联合治疗方案治疗的小鼠肿瘤中 Foxp3+调节性 T 细胞显著减少,CD4+和 CD8+淋巴细胞增加。Masson 三色染色分析显示,与对照组和检查点抗体治疗相比,CCKR 拮抗剂治疗的小鼠肿瘤中的纤维化减少了 50%。CCKR 拮抗剂与免疫检查点抗体治疗联合使用代表了改善 PDAC 生存率的一种新方法。这种联合治疗改善 PDAC 生存率的机制可能与肿瘤微环境中纤维化和免疫细胞的减少有关。

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