靶向巨噬细胞的癌症治疗策略
Macrophage-directed therapeutic strategies in cancer.
肿瘤相关巨噬细胞(TAMs)是肿瘤微环境的主要组成部分,具有显著的功能可塑性,根据所处的微环境信号,既可表现为促进肿瘤进展的免疫抑制细胞,也可表现为支持抗肿瘤免疫的免疫刺激细胞。
英文原题:An Fc-inert PD-L1×4-1BB bispecific antibody mediates potent anti-tumor immunity in mice by combining checkpoint inhibition and conditional 4-1BB co-stimulation.
靶向 PD-1/PD-L1 轴的免疫检查点抑制剂(ICI)已改变晚期实体瘤的治疗格局;然而,许多患者出现治疗耐药。
靶向PD-1/PD-L1轴的免疫检查点抑制剂(ICI)改变了晚期实体瘤的治疗模式,但许多患者仍会产生耐药。临床前模型显示,4-1BB共刺激可通过活化细胞毒性T细胞和NK细胞介导的抗肿瘤免疫,与ICI产生协同作用。本研究阐明一种可作用于小鼠、Fc效应失活的PD-L1×4-1BB双特异性抗体(mbsAb-PD-L1×4-1BB)的作用机制,并提供其增强抗肿瘤活性的概念验证。在报告基因实验中,mbsAb-PD-L1×4-1BB表现出条件性4-1BB激动活性,须同时结合PD-L1才能发挥作用。该抗体还可独立于4-1BB结合而阻断PD-L1/PD-1相互作用。结合这两种机制后,mbsAb-PD-L1×4-1BB在体外使用小鼠原代细胞时显著增强T细胞增殖、细胞因子生成和抗原特异性细胞毒作用。此外,该抗体在CT26和MC38体内模型中表现出强抗肿瘤活性,并使单独PD-L1阻断无效的CT26肿瘤发生排斥。抗肿瘤活性伴随肿瘤微环境和肿瘤引流淋巴结中肿瘤特异性CD8阳性T细胞增加、调节性T细胞减少。在无肿瘤的免疫健全小鼠中,mbsAb-PD-L1×4-1BB治疗既未诱导T细胞浸润肝脏,也未升高血液肝酶。因此,双特异性抗体同时靶向PD-L1和4-1BB,可能克服第一代4-1BB激动性抗体的关键局限,并为提高PD-1/PD-L1免疫检查点阻断疗效提供新策略。
Immune checkpoint inhibitors (ICI) targeting the PD-1/PD-L1 axis have changed the treatment paradigm for advanced solid tumors; however, many patients experience treatment resistance. In preclinical models 4-1BB co-stimulation synergizes with ICI by activating cytotoxic T- and NK-cell-mediated anti-tumor immunity. Here we characterize the mechanism of action of a mouse-reactive Fc-inert PD-L1 4-1BB bispecific antibody (mbsAb-PD-L1 4-1BB) and provide proof-of-concept for enhanced anti-tumor activity. In reporter assays mbsAb-PD-L1 4-1BB exhibited conditional 4-1BB agonist activity that was dependent on simultaneous binding to PD-L1. mbsAb-PD-L1 4-1BB further blocked the PD-L1/PD-1 interaction independently of 4-1BB binding. By combining both mechanisms, mbsAb-PD-L1 4-1BB strongly enhanced T-cell proliferation, cytokine production and antigen-specific cytotoxicity using primary mouse cells in vitro . Furthermore, mbsAb-PD-L1 4-1BB exhibited potent anti-tumor activity in the CT26 and MC38 models in vivo , leading to the rejection of CT26 tumors that were unresponsive to PD-L1 blockade alone. Anti-tumor activity was associated with increased tumor-specific CD8 + T cells and reduced regulatory T cells within the tumor microenvironment and tumor-draining lymph nodes. In immunocompetent tumor-free mice, mbsAb-PD-L1 4-1BB treatment neither induced T-cell infiltration into the liver nor elevated liver enzymes in the blood. Dual targeting of PD-L1 and 4-1BB with a bispecific antibody may therefore address key limitations of first generation 4-1BB-agonistic antibodies, and may provide a novel approach to improve PD-1/PD-L1 checkpoint blockade.
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