Roche Innovation Center Munich, Roche Pharma Research and Early Development, Penzberg, Germany.
Institute for Experimental Molecular Imaging, University Clinic and Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany.
Hepatology. 2019 Oct;70(4):1280-1297. doi: 10.1002/hep.30666. Epub 2019 May 21.
Antiangiogenic and cytotoxic effects are considered the principal mechanisms of action of sorafenib, a multitarget kinase inhibitor approved for the treatment of hepatocellular carcinoma (HCC). We report that sorafenib also acts through direct immune modulation, indispensable for its antitumor activity. In vivo cell depletion experiments in two orthotopic HCC mouse models as well as in vitro analysis identified macrophages (MΦ) as the key mediators of the antitumoral effect and demonstrate a strong interdependency of MΦ and natural killer (NK) cells for efficient tumor cell killing. Caspase 1 analysis in sorafenib-treated MΦ revealed an induction of pyroptosis. As a result, cytotoxic NK cells become activated when cocultured with sorafenib-treated MΦ, leading to tumor cell death. In addition, sorafenib was found to down-regulate major histocompatibility complex class I expression of tumor cells, which may reduce the tumor responsiveness to immune checkpoint therapies and favor NK-cell response. In vivo cytokine blocking revealed that sorafenib efficacy is abrogated after inhibition of interleukins 1B and 18. Conclusion: We report an immunomodulatory mechanism of sorafenib involving MΦ pyroptosis and unleashing of an NK-cell response that sets it apart from other spectrum kinase inhibitors as a promising immunotherapy combination partner for the treatment of HCC.
索拉非尼是一种多靶点激酶抑制剂,被批准用于治疗肝细胞癌(HCC),其被认为具有抗血管生成和细胞毒性作用,这是其主要作用机制。我们报告称,索拉非尼还通过直接免疫调节起作用,这对于其抗肿瘤活性是必不可少的。在两种原位 HCC 小鼠模型中的体内细胞耗竭实验以及体外分析中,鉴定出巨噬细胞(MΦ)是抗肿瘤作用的关键介质,并证明 MΦ 和自然杀伤(NK)细胞之间存在强烈的相互依存关系,这对于有效的肿瘤细胞杀伤至关重要。对索拉非尼处理的 MΦ 中的半胱天冬酶 1 的分析显示发生了细胞焦亡。结果,当与索拉非尼处理的 MΦ 共培养时,细胞毒性 NK 细胞被激活,导致肿瘤细胞死亡。此外,还发现索拉非尼下调了肿瘤细胞的主要组织相容性复合体 I 类表达,这可能降低了肿瘤对免疫检查点疗法的反应性,并有利于 NK 细胞的反应。体内细胞因子阻断实验表明,白介素 1B 和 18 的抑制会使索拉非尼的疗效丧失。结论:我们报告了索拉非尼的一种免疫调节作用机制,涉及 MΦ 的细胞焦亡和 NK 细胞的释放,使其有别于其他谱激酶抑制剂,成为治疗 HCC 的一种有前途的免疫治疗联合伙伴。
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