Department of Radiotherapy, The Second Hospital of Jilin University, Changchun 130041, P. R. China.
Department of Thyroid, The Second Hospital of Jilin University, Changchun, 130041, P. R. China.
Theranostics. 2021 Apr 3;11(12):5955-5969. doi: 10.7150/thno.58164. eCollection 2021.
Anti-programmed cell death protein 1 (PD-1) therapy has shown promising efficacy in hepatocellular carcinoma (HCC), but its response rates in advanced HCC are lower than 20%. A critical reason for this is the imbalance between CD8 T cells and tumor burden. Here, a novel concept of vascular disruption and normalization dependent on a polymeric vascular disrupting agent (VDA) poly (-glutamic acid)--methoxy poly (ethylene glycol)/combretastatin A4 (CA4-NPs) + a vascular endothelial growth factor (VEGF)/VEGF receptor 2 (VEGFR2) inhibitor DC101 is applied to improve anti-PD-1 therapy, wherein CA4-NPs reduce tumor burden and DC101 simultaneously increases the number of intratumoral CD8 T cells, successfully regulating the abovementioned imbalance in an H22 tumor model. Blood vessel density, tumor cell proliferation, and necrosis were evaluated to reveal the effects on reducing tumor burden by CA4-NP treatment. Pericyte coverage of blood vessels, tumor blood vessel perfusion, tumor hypoxia, and intratumoral immune cells were examined to verify their role in vascular normalization and immune cell homing of DC101. Furthermore, the effects of CA4-NPs + DC101 on reducing tumor burden and increasing the number of immune cells were studied. Finally, tumor suppression, intratumoral CD8 T cell activation, and the synergistic effects of anti-PD-1 combined with CA4-NPs + DC101 were verified. The tumor inhibition rate of anti-PD-1 antibody combined with CA4-NPs + DC101 reached 86.4%, which was significantly higher than that of anti-PD-1 (16.8%) alone. Importantly, the Q value reflecting the synergy between CA4-NPs + DC101 and anti-PD-1 was 1.24, demonstrating a strong synergistic effect. Furthermore, CA4-NPs + DC101 improved anti-PD-1 therapy by increasing the number of intratumoral CD8 T cells (anti-PD-1, 0.31% vs triple drug combination, 1.18%). These results reveal a novel approach to enhance anti-PD-1 therapy with VDAs + VEGF/VEGFR2 inhibitors in HCC.
抗程序性细胞死亡蛋白 1(PD-1)治疗在肝细胞癌(HCC)中显示出了有希望的疗效,但在晚期 HCC 中的反应率低于 20%。这一现象的一个关键原因是 CD8 T 细胞与肿瘤负担之间的不平衡。在这里,一种新的概念,即基于聚合物血管破坏剂(VDA)聚(谷氨酸)-甲氧基聚(乙二醇)/康普瑞汀 A4(CA4-NPs)和血管内皮生长因子(VEGF)/血管内皮生长因子受体 2(VEGFR2)抑制剂 DC101 的血管破坏和正常化,被应用于改善抗 PD-1 治疗,其中 CA4-NPs 降低肿瘤负担,而 DC101 同时增加肿瘤内 CD8 T 细胞的数量,成功地调节了 H22 肿瘤模型中的上述失衡。通过 CA4-NP 治疗来评估血管密度、肿瘤细胞增殖和坏死,以揭示其对降低肿瘤负担的影响。检查血管周细胞覆盖、肿瘤血管灌注、肿瘤缺氧和肿瘤内免疫细胞,以验证其在 DC101 的血管正常化和免疫细胞归巢中的作用。此外,还研究了 CA4-NPs+DC101 对降低肿瘤负担和增加免疫细胞数量的作用。最后,验证了 CA4-NPs+DC101 对降低肿瘤负担和增加免疫细胞数量的协同作用。抗 PD-1 抗体联合 CA4-NPs+DC101 的肿瘤抑制率达到 86.4%,明显高于单独使用抗 PD-1(16.8%)。重要的是,反映 CA4-NPs+DC101 与抗 PD-1 之间协同作用的 Q 值为 1.24,表明具有很强的协同作用。此外,CA4-NPs+DC101 通过增加肿瘤内 CD8 T 细胞的数量(抗 PD-1,0.31%比三药联合治疗,1.18%)来改善抗 PD-1 治疗。这些结果揭示了一种利用 VDAs+VEGF/VEGFR2 抑制剂增强 HCC 中抗 PD-1 治疗的新方法。
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