Novartis Institutes for BioMedical Research, Cambridge, Massachusetts.
Novartis Institutes for BioMedical Research, Basel, Switzerland.
Cancer Res. 2021 Jun 1;81(11):3079-3091. doi: 10.1158/0008-5472.CAN-20-0189. Epub 2021 Jan 27.
p53 is a transcription factor that plays a central role in guarding the genomic stability of cells through cell-cycle arrest or induction of apoptosis. However, the effects of p53 in antitumor immunity are poorly understood. To investigate the role of p53 in controlling tumor-immune cell cross-talk, we studied murine syngeneic models treated with HDM201, a potent and selective second-generation MDM2 inhibitor. In response to HDM201 treatment, the percentage of dendritic cells increased, including the CD103 antigen cross-presenting subset. Furthermore, HDM201 increased the percentage of TbetEomes CD8 T cells and the CD8/Treg ratio within the tumor. These immunophenotypic changes were eliminated with the knockout of p53 in tumor cells. Enhanced expression of CD80 on tumor cells was observed and , which coincided with T-cell-mediated tumor cell killing. Combining HDM201 with PD-1 or PD-L1 blockade increased the number of complete tumor regressions. Responding mice developed durable, antigen-specific memory T cells and rejected subsequent tumor implantation. Importantly, antitumor activity of HDM201 in combination with PD-1/PD-L1 blockade was abrogated in p53-mutated and knockout syngeneic tumor models, indicating the effect of HDM201 on the tumor is required for triggering antitumor immunity. Taken together, these results demonstrate that MDM2 inhibition triggers adaptive immunity, which is further enhanced by blockade of PD-1/PD-L1 pathway, thereby providing a rationale for combining MDM2 inhibitors and checkpoint blocking antibodies in patients with wild-type p53 tumors. SIGNIFICANCE: This study provides a mechanistic rationale for combining checkpoint blockade immunotherapy with MDM2 inhibitors in patients with wild-type p53 tumors.
p53 是一种转录因子,通过细胞周期阻滞或诱导细胞凋亡,在维持细胞基因组稳定性方面发挥核心作用。然而,p53 在抗肿瘤免疫中的作用仍知之甚少。为了研究 p53 控制肿瘤免疫细胞相互作用的作用,我们研究了用强效和选择性的第二代 MDM2 抑制剂 HDM201 处理的小鼠同基因模型。在对 HDM201 治疗的反应中,树突状细胞的百分比增加,包括 CD103 抗原交叉呈递亚群。此外,HDM201 增加了肿瘤内 TbetEomes CD8 T 细胞和 CD8/Treg 比值。这些免疫表型变化在肿瘤细胞中敲除 p53 后被消除。观察到肿瘤细胞上 CD80 的表达增强,与 T 细胞介导的肿瘤细胞杀伤一致。将 HDM201 与 PD-1 或 PD-L1 阻断联合使用增加了完全肿瘤消退的数量。应答小鼠产生了持久的、抗原特异性的记忆 T 细胞,并拒绝随后的肿瘤植入。重要的是,在 p53 突变和敲除同基因肿瘤模型中,HDM201 与 PD-1/PD-L1 阻断联合的抗肿瘤活性被阻断,表明 HDM201 对肿瘤的作用是触发抗肿瘤免疫所必需的。综上所述,这些结果表明,MDM2 抑制触发适应性免疫,进一步增强 PD-1/PD-L1 通路阻断,从而为在野生型 p53 肿瘤患者中联合 MDM2 抑制剂和检查点阻断抗体提供了依据。意义:这项研究为在野生型 p53 肿瘤患者中联合检查点阻断免疫疗法和 MDM2 抑制剂提供了机制依据。
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