Antitumor activity of dual blockade of PD-L1 and MEK in NSCLC patients derived three-dimensional spheroid cultures

Carminia Maria Della Corte1, Giusi Barra1, Vincenza Ciaramella1, Raimondo Di Liello1, Giovanni Vicidomini2, Silvia Zappavigna3, Amalia Luce3, Marianna Abate3, Alfonso Fiorelli2, Michele Caraglia3, Mario Santini2, Erika Martinelli1, Teresa Troiani1, Fortunato Ciardiello1, Floriana Morgillo1
1Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli studi della Campania “Luigi Vanvitelli”, Naples, Italy
2Chirurgia Toracica, Dipartimento di Scienze Mediche Traslazionali, Università degli studi della Campania “Luigi Vanvitelli”, Napoli, Italy
3Biochimica Generale, Dipartimento di Medicina di Precisione, Università degli studi della Campania “Luigi Vanvitelli”, Napoli, Italy

Tóm tắt

Anti-PD-1/PD-L1 drugs are effective as monotherapy in a proportion of NSCLC patients and there is a strong rationale for combining them with targeted therapy. Inhibition of MAPK pathway may have pleiotropic effects on the microenvironment. This work investigates the efficacy of combining MEK and PD-L1 inhibition in pre-clinical and ex-vivo NSCLC models. We studied the effects of MEK inhibitors (MEK-I) on PD-L1 and MCH-I protein expression and cytokine production in vitro in NSCLC cell lines and in PBMCs from healthy donors and NSCLC patients, the efficacy of combining MEK-I with anti-PD-L1 antibody in ex-vivo human spheroid cultures obtained from fresh biopsies from NSCLC patients in terms of cell growth arrest, cytokine production and T-cell activation by flow cytometry. MEK-I modulates in–vitro the immune micro-environment through a transcriptionally decrease of PD-L1 expression, enhance of MHC-I expression on tumor cells, increase of the production of several cytokines, like IFNγ, IL-6, IL-1β and TNFα. These effects trigger a more permissive anti-tumor immune reaction, recruiting immune cells to the tumor sites. We confirmed these data on ex-vivo human spheroids, showing a synergism of MEK and PD-L1 inhibition as result of both direct cancer cell toxicity of MEK-I and its immune-stimulatory effect on cytokine secretion profile of cancer cells and PBMCs with the induction of the ones that sustain an immune-reactive and inflammatory micro-environment. Our work shows the biological rationale for combining immunotherapy with MEK-I in a reproducible ex-vivo 3D-culture model, useful to predict sensitivity of patients to such therapies.

Tài liệu tham khảo

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