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Tsarovsky N, Felder M, Heck M, Slowinski J, Rasmussen K, VandenHeuvel S, Zaborek J, Morris ZS, Erbe AK, Sondel PM, Rakhmilevich AL. Cyclophosphamide augments the efficacy of in situ vaccination in a mouse melanoma model. Front Oncol 2023; 13:1200436. [PMID: 37746303 PMCID: PMC10516537 DOI: 10.3389/fonc.2023.1200436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction We have previously shown that an intratumoral (IT) injection of the hu14.18-IL2 immunocytokine (IC), an anti-GD2 antibody linked to interleukin 2, can serve as an in situ vaccine and synergize with local radiotherapy (RT) to induce T cell-mediated antitumor effects. We hypothesized that cyclophosphamide (CY), a chemotherapeutic agent capable of depleting T regulatory cells (Tregs), would augment in situ vaccination. GD2+ B78 mouse melanoma cells were injected intradermally in syngeneic C57BL/6 mice. Methods Treatments with RT (12Gy) and/or CY (100 mg/kg i.p.) started when tumors reached 100-300 mm3 (day 0 of treatment), followed by five daily injections of IT-IC (25 mcg) on days 5-9. Tumor growth and survival were followed. In addition, tumors were analyzed by flow cytometry. Results Similar to RT, CY enhanced the antitumor effect of IC. The strongest antitumor effect was achieved when CY, RT and IC were combined, as compared to combinations of IC+RT or IC+CY. Flow cytometric analyses showed that the combined treatment with CY, RT and IC decreased Tregs and increased the ratio of CD8+ cells/Tregs within the tumors. Moreover, in mice bearing two separate tumors, the combination of RT and IT-IC delivered to one tumor, together with systemic CY, led to a systemic antitumor effect detected as shrinkage of the tumor not treated directly with RT and IT-IC. Cured mice developed immunological memory as they were able to reject B78 tumor rechallenge. Conclusion Taken together, these preclinical results show that CY can augment the antitumor efficacy of IT- IC, given alone or in combination with local RT, suggesting potential benefit in clinical testing of these combinations.
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Affiliation(s)
- Noah Tsarovsky
- Department of Human Oncology, Madison, WI, United States
| | - Mildred Felder
- Department of Human Oncology, Madison, WI, United States
| | - Mackenzie Heck
- Department of Human Oncology, Madison, WI, United States
| | | | | | | | - Jen Zaborek
- Department of Biostatistics and Medical Informatics, Madison, WI, United States
| | - Zachary S. Morris
- Department of Human Oncology, Madison, WI, United States
- Paul P. Carbone Comprehensive Cancer Center, Madison, WI, United States
| | - Amy K. Erbe
- Department of Human Oncology, Madison, WI, United States
- Paul P. Carbone Comprehensive Cancer Center, Madison, WI, United States
| | - Paul M. Sondel
- Department of Human Oncology, Madison, WI, United States
- Paul P. Carbone Comprehensive Cancer Center, Madison, WI, United States
- Department of Pediatrics, University of Wisconsin, Madison, WI, United States
| | - Alexander L. Rakhmilevich
- Department of Human Oncology, Madison, WI, United States
- Paul P. Carbone Comprehensive Cancer Center, Madison, WI, United States
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Ishii H, Chikamatsu K, Igarashi S, Takahashi H, Sakamoto K, Higuchi H, Tanaka S, Matsuoka T, Masuyama K. Establishment of Synergistic Chemoimmunotherapy for Head and Neck Cancer Using Peritumoral Immature Dendritic Cell Injections and Low-Dose Chemotherapies. Transl Oncol 2017; 11:132-139. [PMID: 29268186 PMCID: PMC5738236 DOI: 10.1016/j.tranon.2017.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 11/28/2017] [Indexed: 01/30/2023] Open
Abstract
The lack of available tumor antigens with strong immunogenicity, human leukocyte antigen restriction, and immunosuppression via regulatory T-cells (Tregs) and myeloid-derived suppressor cells are limitations for dendritic cell (DC)–based immunotherapy in patients with advanced head and neck cancer (HNC). We sought to overcome these limitations and induce effective antitumor immunity in the host. The effect of low-dose docetaxel (DTX) treatment on DC maturation was examined in an ex vivo study, and a phase I clinical trial of combination therapy with direct peritumoral immature DC (iDC) injection with OK-432 and low-dose cyclophosphamide (CTX) plus DTX was designed. Low-dose DTX did not negatively affect iDC viability and instead promoted maturation and IL-12 production. Five patients with metastatic or recurrent HNC were enrolled for the trial. All patients experienced grade 1 to 3 fevers. Intriguingly, elevated CD8+ effector T-cells and reduced Tregs were observed in four patients who completed two treatment cycles. All patients were judged to have progressive disease, but tumor regressions were observed in a subset of targeted metastatic lesions in two of five patients. Our results show that the combination of direct peritumoral iDC injection with OK-432 and low-dose CTX plus DTX is well tolerated and should give rise to changing the immune profile of T-cell subsets and improvement of immunosuppression in advanced HNC patients. Additionally, our ex vivo data on the effect of low-dose DTX treatment on DC maturation may contribute to developing new combination therapies with low-dose chemotherapy and immunotherapy.
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Affiliation(s)
- Hiroki Ishii
- Department of Otolaryngology, Head and Neck Surgery, University of Yamanashi.
| | - Kazuaki Chikamatsu
- Department of Otolaryngology, Head and Neck Surgery, University of Yamanashi; Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine
| | - Satoshi Igarashi
- Department of Otolaryngology, Head and Neck Surgery, University of Yamanashi
| | - Hideyuki Takahashi
- Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine
| | - Kaname Sakamoto
- Department of Otolaryngology, Head and Neck Surgery, University of Yamanashi
| | - Hiroji Higuchi
- Division of Transfusion Medicine and Cell Therapy, University of Yamanashi Hospital
| | - Shota Tanaka
- Department of Otolaryngology, Head and Neck Surgery, University of Yamanashi
| | - Tomokazu Matsuoka
- Department of Otolaryngology, Head and Neck Surgery, University of Yamanashi
| | - Keisuke Masuyama
- Department of Otolaryngology, Head and Neck Surgery, University of Yamanashi.
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Rödel F, Frey B, Multhoff G, Gaipl U. Contribution of the immune system to bystander and non-targeted effects of ionizing radiation. Cancer Lett 2015; 356:105-13. [DOI: 10.1016/j.canlet.2013.09.015] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 08/13/2013] [Accepted: 09/11/2013] [Indexed: 12/21/2022]
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Kim SJ, Ha GH, Kim SH, Kang CD. Combination of cancer immunotherapy with clinically available drugs that can block immunosuppressive cells. Immunol Invest 2013; 43:517-34. [PMID: 24295450 DOI: 10.3109/08820139.2013.857352] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Although cancer immunotherapy, which is able to target specifically cancer cells without detrimental effects to normal cell functions, would serve as an ideal therapeutic modality, most of the randomized clinical trials of cancer immunotherapy have not demonstrated a meaningful survival benefit to cancer patients over preexisting therapeutic modalities. Due to the discrepancy between the impressive preclinical results and the limited clinical results, the cancer immunotherapy is not accepted generally as a standard therapy for cancers. A variety of immune escape mechanisms are thought to be involved in this ineffectiveness of cancer immunotherapy. Therefore, elimination of immunosuppressive activities in tumor microenvironment will enhance the effectiveness of cancer immunotherapy, which is currently focused on activation of tumor-specific immune responses. Since there are now increasing evidences showing that many cytotoxic anticancer drugs including targeted agents given in lower-than-therapeutic doses have not only the ability to eliminate tumor cells but can also block the immunosuppressive activities in tumor microenvironments and consequently favor the development of anticancer immune responses, clinically available drugs can be considered for their rapid application to cancer immunotherapies to enhance the efficacy of cancer immunotherapies with marginal effects on cancer treatment.
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Affiliation(s)
- So-Jung Kim
- MD-PhD Program, Pusan National University School of Medicine , Yangsan , South Korea 626-870
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5
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Qu P, Boelte KC, Lin PC. Negative regulation of myeloid-derived suppressor cells in cancer. Immunol Invest 2013; 41:562-80. [PMID: 23017135 DOI: 10.3109/08820139.2012.685538] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Myeloid-derived suppressor cells (MDSC) are a heterogeneous population of immature myeloid cells with suppressive function on immune response. In this review, we discuss recent studies about mechanisms of expansion and suppressive function of MDSCs during inflammation, infection and autoimmune diseases, as well as pro-angiogenic and pro-metastatic functions of these cells in tumor development. Further, we focus on novel studies of MDSCs and therapeutic approaches to eliminate these cells in cancer.
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Affiliation(s)
- Peng Qu
- National Cancer Institute, National Institutes of Health, Frederick, Maryland 21702, USA
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6
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Rittenhouse-Olson K. Letter from the editor. Immunol Invest 2012; 41:551-4. [PMID: 22938016 DOI: 10.3109/08820139.2012.707937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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7
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Eleftheriadis T, Pissas G, Karioti A, Antoniadi G, Liakopoulos V, Dafopoulou K, Pournaras S, Koukoulis G, Stefanidis I. The Indoleamine 2,3-dioxygenase Inhibitor 1-methyl-tryptophan Suppresses Mitochondrial Function, Induces Aerobic Glycolysis and Decreases Interleukin-10 Production in Human Lymphocytes. Immunol Invest 2012; 41:507-20. [DOI: 10.3109/08820139.2012.682244] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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CHOI YOOJIN, YANG KWANGMO, KIM SUNGDAE, YOO YOUNGHYUN, LEE SANGWHA, SEO SUYEONG, SUH HONGSUK, YEE SUNGTAE, JEONG MINHO, JO WOLSOON. Resveratrol analogue HS-1793 induces the modulation of tumor-derived T cells. Exp Ther Med 2012; 3:592-598. [PMID: 22969934 PMCID: PMC3438654 DOI: 10.3892/etm.2012.472] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 01/20/2012] [Indexed: 12/18/2022] Open
Abstract
Recent advances in the understanding of the mechanisms responsible for tumor progression suggest the possibility to control cancer growth, not only through chemotherapy-induced cancer cell destruction, but also by stimulating anticancer immunity. However, immune tolerance against tumor antigens disturbs diverse forms of immunotherapy. One of the most potent and well-studied tumor-induced immunosuppressive phenotypes found in the tumor microenvironment is the regulatory subpopulation cells (CD4(+)CD25(+)FoxP3(+) Treg cells). Among the great number of natural agents derived from plants and potentially useful for application in the complementary therapy of cancer, resveratrol is gaining attention for its immunomodulating properties in breast cancer, since the ineffectiveness of numerous immunotherapy strategies may be related, in part, to their negative effects on Treg cells. The present study was undertaken to examine whether HS-1793, a synthetic resveratrol analogue free from the restriction of the metabolic instability and high dose requirement of resveratrol, shows a direct effect on immune responses by enhancing lymphocyte proliferation or an immunomodulatory effect by inducing changes in the Treg cell population in FM3A breast tumor-bearing mice. Although HS-1793 had no direct immunostimulatory effect, it dose-dependently decreased IL-2 secretion and increased IL-4 secretion of concanavalin A-stimulated lymphocytes from tumor-bearing mice, which suggest that HS-1793 may induce changes in the subpopulations of tumor-derived T lymphocytes. The CD4(+)CD25(+) cell population from tumor-bearing mice decreased after HS-1793 treatment in a dose-dependent manner, while the CD4(+) T cell population remained unchanged. FoxP3(+)-expressing cells among the CD4(+)CD25(+) population showed a similar pattern. In contrast, the CD8(+) T cell population as well as the interferon (IFN)-γ-expressing CD8(+) T cell population and IFN-γ secretion of splenocytes from tumor-bearing mice were significantly upregulated by HS-1793 treatment. These results suggest that HS-1793 induces the modulation of tumor-derived T lymphocytes, particulary having a suppressive effect on the Treg cell population, likely contributing to enhanced tumor-specific cytotoxic T lymphocyte responses and CD4(+) T cells involving antitumor immunity. Therefore, HS-1793 may serve as a promising adjuvant therapeutic reagent in breast cancer immunotherapy.
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Affiliation(s)
- YOO JIN CHOI
- Research Center, Dong Nam Institute of Radiological and Medical Sciences, Busan 619-953
| | - KWANG MO YANG
- Research Center, Dong Nam Institute of Radiological and Medical Sciences, Busan 619-953
| | - SUNG DAE KIM
- Research Center, Dong Nam Institute of Radiological and Medical Sciences, Busan 619-953
| | - YOUNG HYUN YOO
- Anatomy and Cell Biology, Dong-A University College of Medicine and MitochondriaHub Regulation Center, Busan 602-714
| | | | | | - HONGSUK SUH
- Department of Chemistry and Chemistry Institute for Functional Materials,Pusan National University, Busan 609-735
| | - SUNG TAE YEE
- Department of Biology, Sunchon National University, Sunchon,
Republic of Korea
| | | | - WOL SOON JO
- Research Center, Dong Nam Institute of Radiological and Medical Sciences, Busan 619-953
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Heimburg-Molinaro J, Lum M, Vijay G, Jain M, Almogren A, Rittenhouse-Olson K. Cancer vaccines and carbohydrate epitopes. Vaccine 2011; 29:8802-26. [PMID: 21964054 PMCID: PMC3208265 DOI: 10.1016/j.vaccine.2011.09.009] [Citation(s) in RCA: 175] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 08/18/2011] [Accepted: 09/06/2011] [Indexed: 12/17/2022]
Abstract
Tumor-associated carbohydrate antigens (TACA) result from the aberrant glycosylation that is seen with transformation to a tumor cell. The carbohydrate antigens that have been found to be tumor-associated include the mucin related Tn, Sialyl Tn, and Thomsen-Friedenreich antigens, the blood group Lewis related Lewis(Y), Sialyl Lewis(X) and Sialyl Lewis(A), and Lewis(X) (also known as stage-specific embryonic antigen-1, SSEA-1), the glycosphingolipids Globo H and stage-specific embryonic antigen-3 (SSEA-3), the sialic acid containing glycosphingolipids, the gangliosides GD2, GD3, GM2, fucosyl GM1, and Neu5GcGM3, and polysialic acid. Recent developments have furthered our understanding of the T-independent type II response that is seen in response to carbohydrate antigens. The selection of a vaccine target antigen is based on not only the presence of the antigen in a variety of tumor tissues but also on the role this antigen plays in tumor growth and metastasis. These roles for TACAs are being elucidated. Newly acquired knowledge in understanding the T-independent immune response and in understanding the key roles that carbohydrates play in metastasis are being applied in attempts to develop an effective vaccine response to TACAs. The role of each of the above mentioned carbohydrate antigens in cancer growth and metastasis and vaccine attempts using these antigens will be described.
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Affiliation(s)
| | - Michelle Lum
- Department of Cellular and Molecular Biology, Roswell Park Cancer Institute, Buffalo, NY 14263
| | - Geraldine Vijay
- University of Texas, MD Anderson Cancer Center, Houston, Texas 77030
| | - Miten Jain
- Department of Biomolecular Engineering, University of California Santa Cruz, CA 95064
| | - Adel Almogren
- Department Of Pathology, College of Medicine, King Saud University, Riyadh, 11461 Saudi Arabia
| | - Kate Rittenhouse-Olson
- Department Of Pathology, College of Medicine, King Saud University, Riyadh, 11461 Saudi Arabia
- Department of Biotechnical and Clinical Laboratory Sciences, University at Buffalo, Buffalo, NY 14214
- Department of Microbiology and Immunology, University at Buffalo, Buffalo, NY 14214
- Department of Immunology, Roswell Park Cancer Institute, Buffalo, NY 14263
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