Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China.
Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Zhejiang Provincial Clinical Research Center for CANCER, China; Cancer Center of Zhejiang University, Hangzhou, Zhejiang, 310058, China; Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education, China.
Cancer Lett. 2024 Apr 28;588:216798. doi: 10.1016/j.canlet.2024.216798. Epub 2024 Mar 11.
Immune checkpoint inhibitors (ICIs) offer new options for the treatment of patients with solid cancers worldwide. The majority of colorectal cancers (CRC) are proficient in mismatch-repair (pMMR) genes, harboring fewer tumor antigens and are insensitive to ICIs. These tumors are often found to be immune-deserted. We hypothesized that forcing immune cell infiltration into the tumor microenvironment followed by immune ignition by PD1 blockade may initiate a positive immune cycle that can boost antitumor immunity. Bioinformatics using a public database suggested that IFNγ was a key indicator of immune status and prognosis in CRC. Intratumoral administration of IFNγ increased immune cells infiltration into the tumor, but induced PD-L1 expression. A combined treatment strategy using IFNγ and anti-PD-1 antibody significantly increased T cell killing of tumor cells in vitro and showed synergistic inhibition of tumor growth in a mouse model of CRC. CyTOF found drastic changes in the immune microenvironment upon combined immunotherapy. Treatment with IFNγ and anti-PD1 antibody in CT26 tumors significantly increased infiltration of polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs). IFNγ had a more pronounced effect in decreasing intratumoral M2-like macrophages, while PD1 blockade increased the population of CD8+Ly6C + T cells in the tumor microenvironment, creating a more pro-inflammatory microenvironment. Additionally, PD1 induced increased expression of lymphocyte activating 3 (LAG3) in a significant fraction of CD8 T cells and Treg cells, indicating potential drug resistance and feedback mechanisms. In conclusion, our work provides preclinical data for the Combined immunotherapy of CRC using intratumoral delivery of IFNγ and systemic anti-PD1 monoclonoal antibody.
免疫检查点抑制剂(ICIs)为全球实体瘤患者的治疗提供了新的选择。大多数结直肠癌(CRC)对错配修复(pMMR)基因具有很高的修复能力,其肿瘤抗原较少,对 ICI 不敏感。这些肿瘤通常被认为是免疫荒漠型。我们假设,通过 PD1 阻断免疫激发,迫使免疫细胞浸润肿瘤微环境,可能会引发一个正向免疫循环,从而增强抗肿瘤免疫。使用公共数据库的生物信息学表明,IFNγ是 CRC 中免疫状态和预后的关键指标。IFNγ瘤内给药可增加免疫细胞浸润肿瘤,但诱导 PD-L1 表达。IFNγ联合抗 PD-1 抗体的联合治疗策略显著增加了体外 T 细胞对肿瘤细胞的杀伤作用,并在 CRC 小鼠模型中显示出协同抑制肿瘤生长的作用。CyTOF 发现联合免疫治疗后免疫微环境发生了巨大变化。IFNγ和抗 PD1 抗体治疗 CT26 肿瘤可显著增加多形核髓源性抑制细胞(PMN-MDSCs)浸润。IFNγ在减少肿瘤内 M2 样巨噬细胞方面的作用更为显著,而 PD1 阻断增加了肿瘤微环境中 CD8+Ly6C+T 细胞的数量,从而创造了一个更具促炎的微环境。此外,PD1 诱导肿瘤微环境中 CD8 T 细胞和 Treg 细胞中淋巴细胞激活 3(LAG3)的表达显著增加,表明存在潜在的药物耐药性和反馈机制。总之,我们的工作为使用 IFNγ瘤内给药和系统抗 PD1 单克隆抗体联合治疗 CRC 提供了临床前数据。
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