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局部放疗联合 TIM-3 适体可改善弥漫性中线胶质瘤模型的存活率。

Combination of locoregional radiotherapy with a TIM-3 aptamer improves survival in diffuse midline glioma models.

机构信息

Health Research Institute of Navarra (IdiSNA), Pamplona, Navarra, Spain.

Solid Tumor Program, Center for the Applied Medical Research, Pamplona, Navarra, Spain.

出版信息

JCI Insight. 2024 Aug 15;9(18):e175257. doi: 10.1172/jci.insight.175257.

Abstract

Pediatric diffuse midline gliomas (DMG) with altered H3-K27M are aggressive brain tumors that arise during childhood. Despite advances in genomic knowledge and the significant number of clinical trials testing new targeted therapies, patient outcomes are still poor. Immune checkpoint blockades with small molecules, such as aptamers, are opening new therapeutic options that represent hope for this orphan disease. Here, we demonstrated that a TIM-3 aptamer (TIM-3 Apt) as monotherapy increased the immune infiltration and elicited a strong specific immune response with a tendency to improve the overall survival of treated DMG-bearing mice. Importantly, combining TIM-3 Apt with radiotherapy increased the overall median survival and led to long-term survivor mice in 2 pediatric DMG orthotopic murine models. Interestingly, TIM-3 Apt administration increased the number of myeloid populations and the proinflammatory CD8-to-Tregs ratios in the tumor microenvironment as compared with nontreated groups after radiotherapy. Importantly, the depletion of T cells led to a major loss of the therapeutic effect achieved by the combination. This work uncovers TIM-3 targeting as an immunotherapy approach to improve the radiotherapy outcome in DMGs and offers a strong foundation for propelling a phase I clinical trial using radiotherapy and TIM-3 blockade combination as a treatment for these tumors.

摘要

小儿弥漫性中线脑胶质瘤(DMG)伴 H3-K27M 改变是一种侵袭性脑肿瘤,发生于儿童时期。尽管在基因组学知识方面取得了进展,并且有大量临床试验测试新的靶向治疗方法,但患者的预后仍然很差。免疫检查点封锁小分子,如适体,正在开辟新的治疗选择,为这种孤儿病带来了希望。在这里,我们证明了 TIM-3 适体(TIM-3 Apt)作为单一疗法可增加免疫浸润,并引起强烈的特异性免疫反应,有改善接受治疗的 DMG 荷瘤小鼠总生存率的趋势。重要的是,TIM-3 Apt 与放射治疗联合使用可提高总中位生存期,并在 2 种小儿 DMG 原位小鼠模型中导致长期存活的小鼠。有趣的是,与未治疗组相比,TIM-3 Apt 给药后可增加放射治疗后肿瘤微环境中髓样细胞群和促炎 CD8-to-Tregs 比值。重要的是,T 细胞耗竭导致联合治疗的疗效显著丧失。这项工作揭示了 TIM-3 靶向作为一种免疫疗法,可改善 DMG 的放射治疗效果,并为推动使用放射治疗和 TIM-3 阻断联合作为这些肿瘤的治疗方法的 I 期临床试验提供了坚实的基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19df/11457855/ef34f2964452/jciinsight-9-175257-g265.jpg

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