曲美替尼增强了在由化疗预处理的胰腺癌细胞建立的肿瘤中抗PD-1的疗效。

Trametinib Potentiates Anti-PD-1 Efficacy in Tumors Established from Chemotherapy-Primed Pancreatic Cancer Cells.

作者信息

Pham Thao D, Metropulos Anastasia E, Mubin Nida, Becker Jeffrey H, Shah Dhavan, Spaulding Christina, Shields Mario A, Bentrem David J, Munshi Hidayatullah G

机构信息

Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

The Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois.

出版信息

Mol Cancer Ther. 2024 Dec 3;23(12):1854-1865. doi: 10.1158/1535-7163.MCT-23-0833.

Abstract

Despite advances in immune checkpoint inhibitors, chemotherapy remains the standard therapy for patients with pancreatic ductal adenocarcinoma (PDAC). As the combinations of chemotherapy, including the FOLFIRINOX [5-fluorouracil, F; irinotecan, I; and oxaliplatin, O (FIO)] regimen, and immune checkpoint inhibitors have failed to demonstrate clinical benefit in patients with metastatic PDAC tumors, there is increasing interest in identifying therapeutic approaches to potentiate ICI efficacy in patients with PDAC. In this study, we report that neoadjuvant FOLFIRINOX-treated human PDAC tumors exhibit increased MEK/ERK activation. We also show elevated MEK/ERK signaling in ex vivo PDAC slice cultures and cell lines treated with a combination of FIO. In addition, we find that the KPC-FIO cells, established from repeated treatment of mouse PDAC cell lines with six to eight cycles of FIO, display enhanced ERK phosphorylation and demonstrate increased sensitivity to MEK inhibition in vitro and in vivo. Significantly, the KPC-FIO cells develop tumors with a proinflammatory immune profile similar to human PDAC tumors after neoadjuvant FOLFIRINOX treatment. Furthermore, we found that the MEK inhibitor trametinib enables additional infiltration of highly functional CD8+ T cells into the KPC-FIO tumors and potentiates the efficacy of anti-PD-1 antibody in syngeneic mouse models. Our findings provide a rationale for combining trametinib and anti-PD-1 antibodies in patients with PDAC after neoadjuvant or short-term FOLFIRINOX treatment to achieve effective antitumor responses.

摘要

尽管免疫检查点抑制剂取得了进展,但化疗仍然是胰腺导管腺癌(PDAC)患者的标准治疗方法。由于包括FOLFIRINOX [5-氟尿嘧啶,F;伊立替康,I;奥沙利铂,O(FIO)]方案在内的化疗与免疫检查点抑制剂的联合应用未能在转移性PDAC肿瘤患者中显示出临床益处,因此人们越来越有兴趣寻找增强ICI在PDAC患者中疗效的治疗方法。在本研究中,我们报告新辅助FOLFIRINOX治疗的人PDAC肿瘤表现出MEK/ERK激活增加。我们还显示,在用FIO组合处理的离体PDAC切片培养物和细胞系中,MEK/ERK信号升高。此外,我们发现,通过用六至八个周期的FIO重复处理小鼠PDAC细胞系建立的KPC-FIO细胞,显示出增强的ERK磷酸化,并在体外和体内对MEK抑制表现出更高的敏感性。重要的是,新辅助FOLFIRINOX治疗后,KPC-FIO细胞形成具有与人类PDAC肿瘤相似的促炎免疫特征的肿瘤。此外,我们发现MEK抑制剂曲美替尼能够使高功能CD8 + T细胞更多地浸润到KPC-FIO肿瘤中,并增强同基因小鼠模型中抗PD-1抗体的疗效。我们的研究结果为在新辅助或短期FOLFIRINOX治疗后的PDAC患者中联合使用曲美替尼和抗PD-1抗体以实现有效的抗肿瘤反应提供了理论依据。

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