Lam Casey, Lanchoney Olivia, Maddipatla Vishnu, Markosyan Nune, Joshi Nikhil, Fofana Courtney Ray, Zeng Shan, DeMatteo Ronald P, Vonderheide Robert H, Zhang Jennifer Q
University of Pennsylvania.
Res Sq. 2025 Jun 16:rs.3.rs-6823527. doi: 10.21203/rs.3.rs-6823527/v1.
There has been marked improvement in the clinical outcome of triple-negative breast cancer (TNBC) with the use of immune checkpoint blockade (ICB) although serious immune-related adverse effects are not uncommon. Unlike TNBC, ERα + breast tumors are largely unresponsive to ICB. Here we demonstrate defective priming by cross-presenting conventional dendritic cells (cDCs) and a blunted response to ICB in ERα + mouse mammary tumors compared to TNBC. Systemic administration of an agonistic CD40 antibody (aCD40) induced T cell proliferation and activation in tumor-draining lymph nodes and attracted effector T cells to the tumor bed from the periphery. This effect was largely due to activation, maturation and migration of type 1 conventional dendritic cells (cDC1s). aCD40 alone slowed tumor growth in ERα + tumors but its combination with ICB cured tumor-bearing mice, accomplishing a "vaccine effect" and the immune-mediated rejection of tumor rechallenge. The anti-tumor effect of aCD40 effect was cDC1 and CD8 + T cell-dependent, whereas the rejection of secondary tumor rechallenge in cured mice required CD4 + T cells. Importantly, intra-tumoral administration of aCD40 combined with systemic or intra-tumoral ICB - to mimic neoadjuvant therapeutic approaches-induced complete regressions of both treated and distant tumors. These findings indicate that aCD40 achieves DC activation required for the response to immunotherapy in ERα + tumors and further supports intra-tumoral administration of both aCD40 and ICB as an effective treatment that might limit systemic exposure and lower risk of immune-related toxicity.
尽管严重的免疫相关不良反应并不罕见,但使用免疫检查点阻断(ICB)后三阴性乳腺癌(TNBC)的临床结局有了显著改善。与TNBC不同,ERα + 乳腺肿瘤对ICB基本无反应。在这里,我们证明与TNBC相比,ERα + 小鼠乳腺肿瘤中交叉呈递的传统树突状细胞(cDC)启动存在缺陷,对ICB的反应减弱。全身性给予激动性CD40抗体(aCD40)可诱导肿瘤引流淋巴结中的T细胞增殖和活化,并从外周吸引效应T细胞至肿瘤床。这种效应主要归因于1型传统树突状细胞(cDC1)的活化、成熟和迁移。单独使用aCD40可减缓ERα + 肿瘤的生长,但其与ICB联合使用可治愈荷瘤小鼠,实现“疫苗效应”以及免疫介导的肿瘤再挑战排斥。aCD40的抗肿瘤作用依赖于cDC1和CD8 + T细胞,而治愈小鼠中对二次肿瘤再挑战的排斥需要CD4 + T细胞。重要的是,瘤内给予aCD40联合全身或瘤内ICB(以模拟新辅助治疗方法)可诱导治疗肿瘤和远处肿瘤完全消退。这些发现表明,aCD40可实现ERα + 肿瘤对免疫治疗反应所需的DC活化,并进一步支持瘤内给予aCD40和ICB作为一种有效治疗方法,这可能会限制全身暴露并降低免疫相关毒性风险。