帕博利珠单抗联合贝伐珠单抗治疗有效抑制非小细胞肺癌生长并预防人源化小鼠模型术后复发和转移。

Combined pembrolizumab and bevacizumab therapy effectively inhibits non-small-cell lung cancer growth and prevents postoperative recurrence and metastasis in humanized mouse model.

机构信息

Department of Thoracic Surgery, Air Force Specialty Medical Center, Fourth Military Medical University, Xi'an, 710032, China.

Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710032, China.

出版信息

Cancer Immunol Immunother. 2023 May;72(5):1169-1181. doi: 10.1007/s00262-022-03318-x. Epub 2022 Nov 10.

Abstract

Antibodies targeting the programmed cell death protein 1/programmed cell death ligand-1 (PD-1/PD-L1) pathway have dramatically changed the treatment landscape of advanced non-small cell lung cancer (NSCLC). However, combination approaches are required to extend this benefit beyond a subset of patients. In addition, it is of equal interest whether these combination therapy can be applied to neoadjuvant therapy of early-stage NSCLC. In this study, we hypothesized that combining immunotherapy with anti-angiogenic therapy may have a synergistic effect in local tumor control and neoadjuvant therapy. To this end, the effect of combination of bevacizumab and pembrolizumab in humanized mouse models was evaluated. Furthermore, we innovatively constructed a neoadjuvant mouse model that can simulate postoperative recurrence and metastasis of NSCLC to perform neoadjuvant study. Tumor growth and changes in the tumor vasculature, along with the frequency and phenotype of tumor-infiltrating lymphocytes, were examined. Additionally, in vivo imaging system (IVIS) was used to observe the effect of neoadjuvant therapy. Results showed that combination therapy could inhibited tumor growth by transforming tumor with low immunoreactivity into inflamed ('hot') tumor, as demonstrated by increased CD8granzyme B cytotoxic T cell infiltration. Subsequent studies revealed that this process is mediated by vascular normalization and endothelial cell activation. IVIS results showed that neoadjuvant therapy can effectively prevent postoperative recurrence and metastasis. Taken together, these preclinical studies demonstrated that the combination of bevacizumab and pembrolizumab had a synergistic effect in both advanced tumor therapy and neoadjuvant setting and therefore provide a theoretical basis for translating this basic research into clinical applications.

摘要

针对细胞程序性死亡蛋白 1/细胞程序性死亡配体 1(PD-1/PD-L1)通路的抗体显著改变了晚期非小细胞肺癌(NSCLC)的治疗格局。然而,需要联合治疗方法才能将这种获益扩展到一部分患者之外。此外,这些联合治疗方法是否可应用于早期 NSCLC 的新辅助治疗也同样具有研究意义。在这项研究中,我们假设免疫疗法联合抗血管生成治疗可能在局部肿瘤控制和新辅助治疗方面具有协同作用。为此,我们评估了贝伐珠单抗和帕博利珠单抗联合在人源化小鼠模型中的效果。此外,我们创新性地构建了一种新辅助小鼠模型,可以模拟 NSCLC 的术后复发和转移,以进行新辅助研究。我们检测了肿瘤生长和肿瘤血管变化,以及肿瘤浸润淋巴细胞的频率和表型。此外,还使用体内成像系统(IVIS)观察新辅助治疗的效果。结果表明,联合治疗可通过将低免疫反应性肿瘤转化为炎症(“热”)肿瘤来抑制肿瘤生长,这表现为 CD8+granzyme B 细胞毒性 T 细胞浸润增加。后续研究表明,这个过程是由血管正常化和内皮细胞激活介导的。IVIS 结果表明,新辅助治疗可有效预防术后复发和转移。综上所述,这些临床前研究表明,贝伐珠单抗和帕博利珠单抗联合应用在晚期肿瘤治疗和新辅助治疗中具有协同作用,为将这一基础研究转化为临床应用提供了理论依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd3a/10992452/7d7b8c4a3d51/262_2022_3318_Fig1_HTML.jpg

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