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内分泌治疗与 SMAC 模拟物协同作用,增强激素受体阳性乳腺癌的抗原呈递和肿瘤消退。

Endocrine Therapy Synergizes with SMAC Mimetics to Potentiate Antigen Presentation and Tumor Regression in Hormone Receptor-Positive Breast Cancer.

机构信息

Center for Functional Cancer Epigenetics, Dana-Farber Cancer Institute, Boston, Massachusetts.

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.

出版信息

Cancer Res. 2023 Oct 2;83(19):3284-3304. doi: 10.1158/0008-5472.CAN-23-1711.


DOI:10.1158/0008-5472.CAN-23-1711
PMID:37450351
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10543960/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/238883da7f59/3284fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/cf03c05ac812/overview_graphic_can-23-1711.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/ed59d1cf2875/3284fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/7c7e339755ce/3284fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/ce1d97f23cf5/3284fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/00c5e7e05cef/3284fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/b6fed8a7b5d8/3284fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/1109fe5a325a/3284fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/238883da7f59/3284fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/cf03c05ac812/overview_graphic_can-23-1711.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/ed59d1cf2875/3284fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/7c7e339755ce/3284fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/ce1d97f23cf5/3284fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/00c5e7e05cef/3284fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/b6fed8a7b5d8/3284fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/1109fe5a325a/3284fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510f/10543960/238883da7f59/3284fig7.jpg

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本文引用的文献

[1]
Use of Immune Checkpoint Inhibitor Pembrolizumab in the Treatment of High-Risk, Early-Stage Triple-Negative Breast Cancer: ASCO Guideline Rapid Recommendation Update.

J Clin Oncol. 2022-5-20

[2]
A human breast cancer-derived xenograft and organoid platform for drug discovery and precision oncology.

Nat Cancer. 2022-2

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Curr Oncol Rep. 2022-5

[4]
Impact of Duration of Neoadjuvant Aromatase Inhibitors on Molecular Expression Profiles in Estrogen Receptor-positive Breast Cancers.

Clin Cancer Res. 2022-3-15

[5]
Inhibition of estrogen signaling in myeloid cells increases tumor immunity in melanoma.

J Clin Invest. 2021-12-1

[6]
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Nat Commun. 2021-9-21

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Front Pharmacol. 2021-5-6

[9]
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[10]
Integrin αvβ6-TGFβ-SOX4 Pathway Drives Immune Evasion in Triple-Negative Breast Cancer.

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