Ding Dongbing, Liang Rongpu, Li Tan, Lan Tianyun, Li Yiquan, Huang Shengxin, He Guanhui, Ren Jiannan, Li Weibo, Zheng Zongheng, Chen Tufeng, Fang Jiafeng, Huang Lijun, Shuai Xintao, Wei Bo
Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
Nanomedicine Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
J Control Release. 2024 May;369:309-324. doi: 10.1016/j.jconrel.2024.03.052. Epub 2024 Apr 3.
Immunotherapy based on the PD-1/PD-L1 axis blockade has no benefit for patients diagnosed with colon cancer liver metastasis (CCLM) for the microsatellite stable/proficient mismatch repair (MSS/pMMR)) subtype, which is known as an immune-desert cancer featuring poor immunogenicity and insufficient CD8 T cell infiltration in the tumor microenvironment. Here, a multifunctional nanodrug carrying a cyclin-dependent kinase (CDK)1/2/5/9 inhibitor and PD-L1 antibody is prepared to boost the immune checkpoint blockade (ICB)-based immunotherapy against MSS/pMMR CCLM via reversing the immunosuppressive tumor microenvironment. To enhance the MSS/pMMR CCLM-targeting efficacy, we modify the nanodrug with PD-L1 knockout cell membrane of this colon cancer subtype. First, CDKs inhibitor delivered by nanodrug down-regulates phosphorylated retinoblastoma and phosphorylated RNA polymerase II and meanwhile arrests the G2/M cell cycle in CCLM to promote immunogenic signal release, stimulate dendritic cell maturation, and enhance CD8 T cell infiltration. Moreover, CDKi suppresses the secretion of immunosuppressive cytokines in tumor-associated myeloid cells sensitizing ICB therapy in CCLM. Notably, the great efficacy to activate immune responses is demonstrated in the patient-derived xenograft model and the patient-derived organoid model as well, revealing a clinical application potential. Overall, our study represents a promising therapeutic approach for targeting liver metastasis, remolding the tumor immune microenvironment (TIME), and enhancing the response of MSS/pMMR CCLM to boost ICB immunotherapy.
基于PD-1/PD-L1轴阻断的免疫疗法对诊断为微卫星稳定/错配修复功能正常(MSS/pMMR)亚型的结肠癌肝转移(CCLM)患者没有益处,该亚型被称为免疫沙漠癌,其免疫原性差,肿瘤微环境中CD8 T细胞浸润不足。在此,制备了一种携带细胞周期蛋白依赖性激酶(CDK)1/2/5/9抑制剂和PD-L1抗体的多功能纳米药物,通过逆转免疫抑制性肿瘤微环境来增强基于免疫检查点阻断(ICB)的针对MSS/pMMR CCLM的免疫疗法。为了提高对MSS/pMMR CCLM的靶向疗效,我们用这种结肠癌亚型的PD-L1基因敲除细胞膜对纳米药物进行修饰。首先,纳米药物递送的CDK抑制剂下调磷酸化视网膜母细胞瘤和磷酸化RNA聚合酶II,同时使CCLM中的G2/M细胞周期停滞,以促进免疫原性信号释放,刺激树突状细胞成熟,并增强CD8 T细胞浸润。此外,CDKi抑制肿瘤相关髓系细胞中免疫抑制细胞因子的分泌,使CCLM中的ICB治疗敏感化。值得注意的是,在患者来源的异种移植模型和患者来源的类器官模型中也证明了激活免疫反应的巨大疗效,揭示了临床应用潜力。总体而言,我们的研究代表了一种有前景的治疗方法,用于靶向肝转移、重塑肿瘤免疫微环境(TIME),并增强MSS/pMMR CCLM对增强ICB免疫疗法的反应。