期刊
GUT
卷 67, 期 6, 页码 1112-+出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/gutjnl-2017-313738
关键词
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资金
- NIH [T32 CA 009621, 5R01CA168863]
- Pancreatic Cancer Action Network (PANCAN) Translational ResearchGrant [15-65-25 LINE]
- Pancreatic Action Network Translational Research Grant [16-65-Hawk]
- Siteman Cancer Center Frontier Fund
- NCI/NIH Specialized Programs of Research Excellence (SPORE) grant [1P50CA196510]
- Pfizer/Washington University School of Medicine Biomedical Collaborative
Objective Chemokine pathways are co-opted by pancreatic adenocarcinoma (PDAC) to facilitate myeloid cell recruitment from the bone marrow to establish an immunosuppressive tumour microenvironment (TME). Targeting tumour-associated CXCR2+ neutrophils (TAN) or tumour-associated CCR2(+) macrophages (TAM) alone improves antitumour immunity in preclinical models. However, a compensatory influx of an alternative myeloid subset may result in a persistent immunosuppressive TME and promote therapeutic resistance. Here, we show CCR2 and CXCR2 combined blockade reduces total tumour-infiltrating myeloids, promoting a more robust antitumour immune response in PDAC compared with either strategy alone. Methods Blood, bone marrow and tumours were analysed from PDAC patients and controls. Treatment response and correlative studies were performed in mice with established orthotopic PDAC tumours treated with a small molecule CCR2 inhibitor (CCR2i) and CXCR2 inhibitor (CXCR2i), alone and in combination with chemotherapy. Results A systemic increase in CXCR2(+) TAN correlates with poor prognosis in PDAC, and patients receiving CCR2i showed increased tumour-infiltrating CXCR2(+) TAN following treatment. In an orthotopic PDAC model, CXCR2 blockade prevented neutrophil mobilisation from the circulation and augmented chemotherapeutic efficacy. However, depletion of either CXCR2(+) TAN or CCR2(+) TA M resulted in a compensatory response of the alternative myeloid subset, recapitulating human disease. This was overcome by combined CCR2i and CXCR2i, which augmented antitumour immunity and improved response to FOLFIRINOX chemotherapy. Conclusion Dual targeting of CCR2(+) TA M and CXCR2(+) TAN improves antitumour immunity and chemotherapeutic response in PDAC compared with either strategy alone.
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