Department of Radiation Oncology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado.
Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, Colorado.
Clin Cancer Res. 2022 Mar 1;28(5):1013-1026. doi: 10.1158/1078-0432.CCR-21-2767.
PURPOSE: Metastasis remains a major hurdle in treating aggressive malignancies such as pancreatic ductal adenocarcinoma (PDAC). Improving response to treatment, therefore, requires a more detailed characterization of the cellular populations involved in controlling metastatic burden. EXPERIMENTAL DESIGN: PDAC patient tissue samples were subjected to RNA sequencing analysis to identify changes in immune infiltration following radiotherapy. Genetically engineered mouse strains in combination with orthotopic tumor models of PDAC were used to characterize disease progression. Flow cytometry was used to analyze tumor infiltrating, circulating, and nodal immune populations. RESULTS: We demonstrate that although radiotherapy increases the infiltration and activation of dendritic cells (DC), it also increases the infiltration of regulatory T cells (Treg) while failing to recruit natural killer (NK) and CD8 T cells in PDAC patient tissue samples. In murine orthotopic tumor models, we show that genetic and pharmacologic depletion of Tregs and NK cells enhances and attenuates response to radiotherapy, respectively. We further demonstrate that targeted inhibition of STAT3 on Tregs results in improved control of local and distant disease progression and enhanced NK-mediated immunosurveillance of metastasis. Moreover, combination treatment of STAT3 antisense oligonucleotide (ASO) and radiotherapy invigorated systemic immune activation and conferred a survival advantage in orthotopic and metastatic tumor models. Finally, we show the response to STAT3 ASO + radiotherapy treatment is dependent on NK and DC subsets. CONCLUSIONS: Our results suggest targeting Treg-mediated immunosuppression is a critical step in mediating a response to treatment, and identifying NK cells as not only a prognostic marker of improved survival, but also as an effector population that functions to combat metastasis.
目的:转移仍然是治疗胰腺导管腺癌 (PDAC) 等侵袭性恶性肿瘤的主要障碍。因此,提高治疗反应需要更详细地描述参与控制转移负担的细胞群体。 实验设计:对 PDAC 患者组织样本进行 RNA 测序分析,以确定放疗后免疫浸润的变化。结合 PDAC 原位肿瘤模型,使用基因工程小鼠品系来描述疾病进展。流式细胞术用于分析肿瘤浸润、循环和淋巴结免疫群体。 结果:我们证明,尽管放疗增加了树突状细胞 (DC) 的浸润和激活,但它也增加了调节性 T 细胞 (Treg) 的浸润,同时未能在 PDAC 患者组织样本中招募自然杀伤 (NK) 和 CD8 T 细胞。在小鼠原位肿瘤模型中,我们表明 Treg 和 NK 细胞的遗传和药理学耗竭分别增强和减弱了对放疗的反应。我们进一步证明,Treg 上 STAT3 的靶向抑制可改善局部和远处疾病进展的控制,并增强 NK 介导的转移免疫监视。此外,STAT3 反义寡核苷酸 (ASO) 和放疗的联合治疗增强了全身免疫激活,并在原位和转移性肿瘤模型中赋予了生存优势。最后,我们表明 STAT3 ASO + 放疗治疗的反应取决于 NK 和 DC 亚群。 结论:我们的结果表明,靶向 Treg 介导的免疫抑制是介导治疗反应的关键步骤,并将 NK 细胞确定为不仅是改善生存的预后标志物,而且是发挥作用以对抗转移的效应细胞群体。
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