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4-1BB 激动剂可避免 TIL 耗竭并在胶质母细胞瘤和其他颅内癌中许可 PD-1 阻断。

4-1BB Agonism Averts TIL Exhaustion and Licenses PD-1 Blockade in Glioblastoma and Other Intracranial Cancers.

机构信息

Department of Pathology, Duke University Medical Center, Durham, North Carolina.

Duke University School of Medicine, Durham, North Carolina.

出版信息

Clin Cancer Res. 2020 Mar 15;26(6):1349-1358. doi: 10.1158/1078-0432.CCR-19-1068. Epub 2019 Dec 23.


DOI:10.1158/1078-0432.CCR-19-1068
PMID:31871298
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7073290/
Abstract

PURPOSE: The success of checkpoint blockade against glioblastoma (GBM) has been disappointing. Anti-PD-1 strategies may be hampered by severe T-cell exhaustion. We sought to develop a strategy that might license new efficacy for checkpoint blockade in GBM. EXPERIMENTAL DESIGN: We characterized 4-1BB expression in tumor-infiltrating lymphocytes (TIL) from human GBM. We implanted murine tumor models including glioma (CT2A), melanoma (B16), breast (E0771), and lung carcinomas intracranially and subcutaneously, characterized 4-1BB expression, and tested checkpoint blockade strategies . RESULTS: Our data reveal that 4-1BB is frequently present on nonexhausted CD8 TILs in human and murine GBM. In murine gliomas, 4-1BB agonism and PD-1 blockade demonstrate a synergistic survival benefit in a CD8 T-cell-dependent manner. The combination decreases TIL exhaustion and improves TIL functionality. This strategy proves most successful against intracranial CT2A gliomas. Efficacy in all instances correlates with the levels of 4-1BB expression on CD8 TILs, rather than with histology or with intracranial versus subcutaneous tumor location. Proffering 4-1BB expression to T cells licenses combination 4-1BB agonism and PD-1 blockade in models where TIL 4-1BB levels had previously been low and the treatment ineffective. CONCLUSIONS: Although poor T-cell activation and severe T-cell exhaustion appear to be limiting factors for checkpoint blockade in GBM, 4-1BB agonism obviates these limitations and produces long-term survival when combined with anti-PD-1 therapy. Furthermore, this combination therapy is limited by TIL 4-1BB expression, but not by the intracranial compartment, and therefore may be particularly well-suited to GBM.

摘要

目的:针对胶质母细胞瘤(GBM)的检查点阻断取得的成功令人失望。抗 PD-1 策略可能会受到严重 T 细胞耗竭的阻碍。我们试图开发一种策略,为 GBM 中的检查点阻断提供新的疗效。

实验设计:我们对来自人类 GBM 的肿瘤浸润淋巴细胞(TIL)中的 4-1BB 表达进行了特征分析。我们将包括神经胶质瘤(CT2A)、黑色素瘤(B16)、乳腺癌(E0771)和肺癌在内的小鼠肿瘤模型颅内和皮下植入,对 4-1BB 表达进行特征分析,并测试了检查点阻断策略。

结果:我们的数据表明,4-1BB 在人类和小鼠 GBM 的非耗竭性 CD8 TIL 上经常存在。在小鼠神经胶质瘤中,4-1BB 激动剂和 PD-1 阻断以 CD8 T 细胞依赖性的方式表现出协同的生存获益。该组合降低了 TIL 的耗竭并改善了 TIL 的功能。这种策略在针对颅内 CT2A 神经胶质瘤时最为成功。所有情况下的疗效均与 CD8 TIL 上的 4-1BB 表达水平相关,而与组织学或颅内与皮下肿瘤位置无关。为 T 细胞提供 4-1BB 表达,使得在 TIL 4-1BB 水平先前较低且治疗无效的模型中,组合 4-1BB 激动剂和 PD-1 阻断具有组合效应。

结论:尽管 T 细胞激活不良和严重的 T 细胞耗竭似乎是 GBM 中检查点阻断的限制因素,但 4-1BB 激动剂消除了这些限制,并与抗 PD-1 治疗联合使用时可产生长期生存。此外,这种联合治疗受到 TIL 4-1BB 表达的限制,而不受颅内环境的限制,因此可能特别适合 GBM。

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