Center for Functional Cancer Epigenetics, Dana-Farber Cancer Institute, Boston, Massachusetts.
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
Cancer Res. 2023 Oct 2;83(19):3284-3304. doi: 10.1158/0008-5472.CAN-23-1711.
UNLABELLED: Immunotherapies have yet to demonstrate significant efficacy in the treatment of hormone receptor-positive (HR+) breast cancer. Given that endocrine therapy (ET) is the primary approach for treating HR+ breast cancer, we investigated the effects of ET on the tumor immune microenvironment (TME) in HR+ breast cancer. Spatial proteomics of primary HR+ breast cancer samples obtained at baseline and after ET from patients enrolled in a neoadjuvant clinical trial (NCT02764541) indicated that ET upregulated β2-microglobulin and influenced the TME in a manner that promotes enhanced immunogenicity. To gain a deeper understanding of the underlying mechanisms, the intrinsic effects of ET on cancer cells were explored, which revealed that ET plays a crucial role in facilitating the chromatin binding of RelA, a key component of the NF-κB complex. Consequently, heightened NF-κB signaling enhanced the response to interferon-gamma, leading to the upregulation of β2-microglobulin and other antigen presentation-related genes. Further, modulation of NF-κB signaling using a SMAC mimetic in conjunction with ET augmented T-cell migration and enhanced MHC-I-specific T-cell-mediated cytotoxicity. Remarkably, the combination of ET and SMAC mimetics, which also blocks prosurvival effects of NF-κB signaling through the degradation of inhibitors of apoptosis proteins, elicited tumor regression through cell autonomous mechanisms, providing additional support for their combined use in HR+ breast cancer. SIGNIFICANCE: Adding SMAC mimetics to endocrine therapy enhances tumor regression in a cell autonomous manner while increasing tumor immunogenicity, indicating that this combination could be an effective treatment for HR+ patients with breast cancer.
未标记:免疫疗法在治疗激素受体阳性(HR+)乳腺癌方面尚未显示出显著疗效。鉴于内分泌治疗(ET)是治疗 HR+乳腺癌的主要方法,我们研究了 ET 对 HR+乳腺癌肿瘤免疫微环境(TME)的影响。从参加新辅助临床试验(NCT02764541)的患者中获得的基线时和 ET 后 HR+原发性乳腺癌样本的空间蛋白质组学表明,ET 上调了β2-微球蛋白,并以促进增强免疫原性的方式影响 TME。为了更深入地了解潜在机制,探索了 ET 对癌细胞的内在影响,结果表明 ET 在促进 NF-κB 复合物关键组成部分 RelA 与染色质结合方面发挥着关键作用。因此,增强的 NF-κB 信号增强了对干扰素-γ的反应,导致β2-微球蛋白和其他抗原呈递相关基因的上调。此外,使用 SMAC 模拟物联合 ET 调节 NF-κB 信号可增强 T 细胞迁移并增强 MHC-I 特异性 T 细胞介导的细胞毒性。值得注意的是,ET 和 SMAC 模拟物的联合使用,通过降解凋亡抑制蛋白阻断 NF-κB 信号的生存促进作用,通过细胞自主机制引发肿瘤消退,为它们在 HR+乳腺癌中的联合使用提供了额外的支持。 意义:在内分泌治疗中添加 SMAC 模拟物以细胞自主的方式增强肿瘤消退,同时增加肿瘤免疫原性,表明这种联合治疗可能是 HR+乳腺癌患者的有效治疗方法。
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