School of Graduate Studies, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.
Section of Surgical Oncology Research, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.
Sci Transl Med. 2018 Dec 12;10(471). doi: 10.1126/scitranslmed.aau0417.
Melanoma is an aggressive cutaneous malignancy, but advances over the past decade have resulted in multiple new therapeutic options, including molecularly targeted therapy, immunotherapy, and oncolytic virus therapy. Talimogene laherparepvec (T-VEC) is a herpes simplex type 1 oncolytic virus, and trametinib is a MEK inhibitor approved for treatment of melanoma. Therapeutic responses with T-VEC are often limited, and BRAF/MEK inhibition is complicated by drug resistance. We observed that the combination of T-VEC and trametinib resulted in enhanced melanoma cell death in vitro. Further, combination treatment resulted in delayed tumor growth and improved survival in mouse models. Tumor regression was dependent on activated CD8 T cells and Batf3 dendritic cells. We also observed antigen spreading and induction of an inflammatory gene signature, including increased expression of PD-L1. Triple therapy with the combination of T-VEC, MEK inhibition, and anti-PD-1 antibody further augmented responses. These data support clinical development of combination oncolytic viruses, MEK inhibitors, and checkpoint blockade in patients with melanoma.
黑色素瘤是一种侵袭性皮肤恶性肿瘤,但在过去十年中的进展带来了多种新的治疗选择,包括分子靶向治疗、免疫治疗和溶瘤病毒治疗。Talimogene laherparepvec(T-VEC)是一种单纯疱疹病毒 1 溶瘤病毒,曲美替尼是一种已被批准用于治疗黑色素瘤的 MEK 抑制剂。T-VEC 的治疗反应往往有限,而 BRAF/MEK 抑制因耐药性而变得复杂。我们观察到 T-VEC 和 trametinib 的联合使用导致体外黑色素瘤细胞死亡增加。此外,联合治疗导致小鼠模型中的肿瘤生长延迟和生存改善。肿瘤消退依赖于激活的 CD8 T 细胞和 Batf3 树突状细胞。我们还观察到抗原扩散和炎症基因特征的诱导,包括 PD-L1 的表达增加。T-VEC、MEK 抑制和抗 PD-1 抗体的三联疗法进一步增强了反应。这些数据支持黑色素瘤患者联合溶瘤病毒、MEK 抑制剂和检查点阻断的临床开发。