Department of Radiology, Huaxi MR Research Center (HMRRC), Frontiers Science Center for Disease-Related Molecular Network, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China.
Functional and Molecular Imaging Key Laboratory of Sichuan Province, and Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, 610041, China.
Adv Mater. 2024 Jun;36(25):e2401304. doi: 10.1002/adma.202401304. Epub 2024 Mar 22.
The dense extracellular matrix (ECM) in solid tumors, contributed by cancer-associated fibroblasts (CAFs), hinders penetration of drugs and diminishes their therapeutic outcomes. A sequential treatment strategy of remodeling the ECM via a CAF modifier (dasatinib, DAS) is proposed to promote penetration of an immunogenic cell death (ICD) inducer (epirubicin, Epi) via apoptotic vesicles, ultimately enhancing the treatment efficacy against breast cancer. Dendritic poly(oligo(ethylene glycol) methyl ether methacrylate) (POEGMA)-based nanomedicines (poly[OEGMA-Dendron(G2)-Gly-Phe-Leu-Gly-DAS] (P-DAS) and poly[OEGMA-Dendron(G2)-hydrazone-Epi] (P-Epi)) are developed for sequential delivery of DAS and Epi, respectively. P-DAS reprograms CAFs to reduce collagen by downregulating collagen anabolism and energy metabolism, thereby reducing the ECM deposition. The regulated ECM can enhance tumor penetration of P-Epi to strengthen its ICD effect, leading to an amplified antitumor immune response. In breast cancer-bearing mice, this approach alleviates the ECM barrier, resulting in reduced tumor burden and increased cytotoxic T lymphocyte infiltration, and more encouragingly, synergizes effectively with anti-programmed cell death 1 (PD-1) therapy, significantly inhibiting tumor growth and preventing lung metastasis. Furthermore, systemic toxicity is barely detectable after sequential treatment with P-DAS and P-Epi. This approach opens a new avenue for treating desmoplastic tumors by metabolically targeting CAFs to overcome the ECM barrier.
实体肿瘤中致密的细胞外基质(ECM)由癌相关成纤维细胞(CAFs)贡献,阻碍了药物的渗透,降低了它们的治疗效果。提出了一种通过 CAF 调节剂(达沙替尼,DAS)重塑 ECM 的序贯治疗策略,以促进凋亡小体中免疫原性细胞死亡(ICD)诱导剂(表柔比星,Epi)的渗透,最终增强针对乳腺癌的治疗效果。基于树枝状聚(聚乙二醇甲基醚甲基丙烯酸酯)(POEGMA)的纳米药物(聚[OEGMA-树枝状(G2)-甘氨酸-苯丙氨酸-甘氨酸-DAS](P-DAS)和聚[OEGMA-树枝状(G2)-腙-Epi](P-Epi))分别用于顺序递达 DAS 和 Epi。P-DAS 重新编程 CAFs 以通过下调胶原合成代谢和能量代谢来减少胶原,从而减少 ECM 沉积。调节后的 ECM 可以增强 P-Epi 对肿瘤的渗透,以增强其 ICD 作用,从而引发放大的抗肿瘤免疫反应。在患有乳腺癌的小鼠中,这种方法减轻了 ECM 屏障,导致肿瘤负担减轻和细胞毒性 T 淋巴细胞浸润增加,更令人鼓舞的是,与抗程序性细胞死亡 1(PD-1)治疗协同有效,显著抑制肿瘤生长并防止肺转移。此外,序贯使用 P-DAS 和 P-Epi 后几乎检测不到全身毒性。这种方法通过代谢靶向 CAFs 来克服 ECM 屏障,为治疗纤维母细胞瘤开辟了新途径。
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