Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China.
Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, 750002, China.
Theranostics. 2024 Sep 16;14(15):5984-5998. doi: 10.7150/thno.98272. eCollection 2024.
Neoadjuvant chemotherapy (NAC) has been recognized as an indispensable strategy for advanced malignancies. Nevertheless, the enhancement of overall patient survival in NAC recipients has encountered challenges due to the limited sustainability of its efficacy and the inability to prevent postoperative tumor recurrence and metastasis. We devise a hierarchically unlocking nanoSTING stimulant liposome (AUG) as a neoadjuvant chemoimmunotherapy agent in the debulking of tumors prior to surgery and prevention of postoperative tumor recurrence and metastasis by simultaneously activating innate and adaptive antitumor immune responses. In the weakly acidic tumor microenvironment, the hydrazone bond within AUG is initially cleaved, leading to the release of a cyclic seven-membered ring containing tertiary amine that serve to activate the stimulator of interferon genes (STING) pathway. Following this, AUG undergoes degradation within lysosomes, facilitating the release of doxorubicin and ultimately inducing immunogenic cell death along with leakage of double-stranded DNA into the cytoplasm. The hierarchically acidity-unlocking pattern enables cascaded STING activation, achieving over 90% tumor growth inhibition in subcutaneous xenograft model and preventing 75% of mice from postsurgical metastasis or recurrence when combined with immune checkpoint inhibitors. Our strategy highlights the potency of AUG as a neoadjuvant paradigm for presurgical tumor debulking and as a preventive measure against postoperative tumor recurrence and metastasis.
新辅助化疗 (NAC) 已被认为是治疗晚期恶性肿瘤不可或缺的策略。然而,由于其疗效的可持续性有限,并且无法预防术后肿瘤复发和转移,接受 NAC 的患者的总体生存得到提高遇到了挑战。我们设计了一种分级解锁的纳米 STING 刺激脂质体 (AUG),作为手术前肿瘤减瘤的新辅助化疗免疫治疗药物,并通过同时激活先天和适应性抗肿瘤免疫反应来预防术后肿瘤复发和转移。在弱酸性肿瘤微环境中,AUG 内的腙键首先被切断,导致释放含有叔胺的七元环,激活干扰素基因刺激物 (STING) 途径。在此之后,AUG 在溶酶体中降解,促进阿霉素的释放,并最终诱导免疫原性细胞死亡以及双链 DNA 泄漏到细胞质中。这种分级酸解锁模式可实现级联 STING 激活,在皮下异种移植模型中实现超过 90%的肿瘤生长抑制,并与免疫检查点抑制剂联合使用时可防止 75%的小鼠术后转移或复发。我们的策略强调了 AUG 作为术前肿瘤减瘤新辅助范例的效力,以及作为预防术后肿瘤复发和转移的措施。