Cancer Biophysics Laboratory, Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus.
Department of Life Sciences, Program in Biological Sciences, European University Cyprus, Nicosia, Cyprus.
Theranostics. 2020 Jan 12;10(4):1910-1922. doi: 10.7150/thno.36936. eCollection 2020.
Tumor normalization strategies aim to improve tumor blood vessel functionality (i.e., perfusion) by reducing the hyper-permeability of tumor vessels or restoring compressed vessels. Despite progress in strategies to normalize the tumor microenvironment (TME), their combinatorial antitumor effects with nanomedicine and immunotherapy remain unexplored. : Here, we re-purposed the TGF-β inhibitor tranilast, an approved anti-fibrotic and antihistamine drug, and combined it with Doxil nanomedicine to normalize the TME, increase perfusion and oxygenation, and enhance anti-tumor immunity. Specifically, we employed two triple-negative breast cancer (TNBC) mouse models to primarily evaluate the therapeutic and normalization effects of tranilast combined with doxorubicin and Doxil. We demonstrated the optimized normalization effects of tranilast combined with Doxil and extended our analysis to investigate the effect of TME normalization to the efficacy of immune checkpoint inhibitors. : Combination of tranilast with Doxil caused a pronounced reduction in extracellular matrix components and an increase in the intratumoral vessel diameter and pericyte coverage, indicators of TME normalization. These modifications resulted in a significant increase in tumor perfusion and oxygenation and enhanced treatment efficacy as indicated by the notable reduction in tumor size. Tranilast further normalized the immune TME by restoring the infiltration of T cells and increasing the fraction of T cells that migrate away from immunosuppressive cancer-associated fibroblasts. Furthermore, we found that combining tranilast with Doxil nanomedicine, significantly improved immunostimulatory M1 macrophage content in the tumorigenic tissue and improved the efficacy of the immune checkpoint blocking antibodies anti-PD-1/anti-CTLA-4. : Combinatorial treatment of tranilast with Doxil optimizes TME normalization, improves immunostimulation and enhances the efficacy of immunotherapy.
肿瘤血管正常化策略旨在通过降低肿瘤血管的高通透性或恢复受压血管来改善肿瘤血管功能(即灌注)。尽管在肿瘤微环境(TME)正常化策略方面取得了进展,但它们与纳米医学和免疫疗法联合的抗肿瘤综合效果仍未得到探索。在这里,我们重新利用了 TGF-β抑制剂曲尼司特,一种已批准的抗纤维化和抗组胺药物,并将其与 Doxil 纳米药物结合,以正常化 TME,增加灌注和氧合,并增强抗肿瘤免疫。具体来说,我们采用了两种三阴性乳腺癌(TNBC)小鼠模型,主要评估曲尼司特联合多柔比星和 Doxil 的治疗和正常化效果。我们证明了曲尼司特联合 Doxil 的最佳正常化效果,并扩展了我们的分析,以研究 TME 正常化对免疫检查点抑制剂疗效的影响。曲尼司特与 Doxil 的联合使用导致细胞外基质成分明显减少,肿瘤内血管直径和周细胞覆盖率增加,这是 TME 正常化的指标。这些变化导致肿瘤灌注和氧合显著增加,治疗效果显著提高,肿瘤体积明显缩小。曲尼司特通过恢复 T 细胞浸润和增加从免疫抑制性癌症相关成纤维细胞迁移的 T 细胞比例,进一步正常化免疫 TME。此外,我们发现,曲尼司特与 Doxil 纳米药物联合使用,显著增加了肿瘤组织中免疫刺激 M1 巨噬细胞的含量,并提高了免疫检查点阻断抗体抗 PD-1/抗 CTLA-4 的疗效。曲尼司特与 Doxil 的联合治疗优化了 TME 正常化,改善了免疫刺激作用,并增强了免疫疗法的疗效。
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