Lin Wei, Wang Yingying, Li Minghao, Feng Jingjing, Yue Ying, Yu Jing, Hu Yanjiang, Suo Yuanzhen
Department of Rheumatology and Autoimmunology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China.
School of Clinical and Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China.
BMC Cancer. 2025 Mar 17;25(1):489. doi: 10.1186/s12885-025-13859-w.
BACKGROUND: Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. Tumor treating fields (TTFields) combined with anti-PD immunotherapy offers a promising strategy to address this issue. Nevertheless, the mechanism of action (MOA) of TTFields therapy combined with anti-PD immunotherapy in NSCLC has not been thoroughly investigated. This study aims to elucidate the MOA of the combined therapy from the aspect of improving the tumor immune microenvironment (TIME). METHODS: Using a mouse model of NSCLC, we tested the efficacy of TTFields therapy with anti-PD-1 and anti-PD-L1 immunotherapy. By RNA-seq, the differential genes and signaling pathways between combination therapy and anti-PD therapy groups were studied. In-vitro experiments validated the effects of TTFields on tumor cells for CD4 T cell and CD8 T cell infiltration, as well as the expression of tumor immunogenic death related genes and chemokines. RESULTS: Combining TTFields with anti-PD-1 reduced tumor weight and volume, respectively, compared to controls (p < 0.05). RNA-seq analysis revealed 1,745 differentially expressed genes (DEGs) in the combination therapy group versus controls, including upregulated immune pathways and immunogenic cell death (ICD) associated genes. Further study showed that the combination therapy resulted in increased T cell infiltration compared to anti-PD immunotherapy alone, and TTFields induced higher level expression of ATP, HMGB1, CCL2, CCL8, CXCL9, and CXCL10 and inflammatory cytokines than control group. These effects collectively contributed to the altered TIME, and finally potentiated the efficacy of anti-PD therapy. CONCLUSIONS: TTFields enhance the effectiveness of anti-PD immunotherapy by improving CD4 T cells and CD8 T infiltration via inducing ICD to increase CCL2/8 and CXCL9/CXCL10 expression of tumor cells. This study provides theoretical basis and new insights for evaluating the effectiveness of TTFields combined with anti-PD therapy for NSCLC.
背景:非小细胞肺癌(NSCLC)是最常见的肺癌类型。肿瘤治疗电场(TTFields)联合抗PD免疫疗法为解决这一问题提供了一种有前景的策略。然而,TTFields疗法联合抗PD免疫疗法在NSCLC中的作用机制(MOA)尚未得到充分研究。本研究旨在从改善肿瘤免疫微环境(TIME)方面阐明联合疗法的作用机制。 方法:使用NSCLC小鼠模型,我们测试了TTFields疗法联合抗PD-1和抗PD-L1免疫疗法的疗效。通过RNA测序,研究了联合治疗组和抗PD治疗组之间的差异基因和信号通路。体外实验验证了TTFields对肿瘤细胞中CD4 T细胞和CD8 T细胞浸润的影响,以及肿瘤免疫原性死亡相关基因和趋化因子的表达。 结果:与对照组相比,TTFields联合抗PD-1分别降低了肿瘤重量和体积(p < 0.05)。RNA测序分析显示,联合治疗组与对照组相比有1745个差异表达基因(DEG),包括上调的免疫通路和免疫原性细胞死亡(ICD)相关基因。进一步研究表明,与单独的抗PD免疫疗法相比,联合疗法导致T细胞浸润增加,并且TTFields诱导的ATP、HMGB1、CCL2、CCL8、CXCL9和CXCL10以及炎性细胞因子的表达水平高于对照组。这些作用共同导致了TIME的改变,并最终增强了抗PD疗法的疗效。 结论:TTFields通过诱导ICD增加肿瘤细胞的CCL2/8和CXCL9/CXCL10表达,改善CD4 T细胞和CD8 T细胞浸润,从而增强抗PD免疫疗法的有效性。本研究为评估TTFields联合抗PD疗法治疗NSCLC的有效性提供了理论依据和新见解。
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