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@ARTICLE{Wang:282366,
author = {L. Wang and R. Luo$^*$ and K. Onyshchenko$^*$ and X.
Rao$^*$ and M. Wang and B. Menz and S. Gaedicke and A.-L.
Grosu$^*$ and E. Firat and G. Niedermann$^*$},
title = {{A}dding liposomal doxorubicin enhances the abscopal effect
induced by radiation/α{PD}1 therapy depending on tumor cell
mitochondrial {DNA} and c{GAS}/{STING}.},
journal = {Journal for ImmunoTherapy of Cancer},
volume = {11},
number = {8},
issn = {2051-1426},
address = {London},
publisher = {BioMed Central},
reportid = {DKFZ-2023-01748},
pages = {e006235},
year = {2023},
abstract = {Localized radiotherapy (RT) can cause a T cell-mediated
abscopal effect on non-irradiated tumor lesions, especially
in combination with immune checkpoint blockade. However,
this effect is still clinically rare and improvements are
highly desirable. We investigated whether triple combination
with a low dose of clinically approved liposomal doxorubicin
(Doxil) could augment abscopal responses compared with
RT/αPD-1 and Doxil/αPD-1. We also investigated whether the
enhanced abscopal responses depended on the mitochondrial
DNA (mtDNA)/cyclic GMP-AMP synthase (cGAS)/stimulator of
interferon genes (STING)/IFN-I pathway.We used Doxil in
combination with RT and αPD-1 in two tumor models
(B16-CD133 melanoma and MC38 colon carcinoma) with mice
bearing two tumors, only one of which was irradiated.
Mechanistic studies on the role of the
mtDNA/cGAS/STING/IFN-I axis were performed using inhibitors
and knockout cells in vitro as well as in mice.Addition of a
single low dose of Doxil to RT and αPD-1 strongly enhanced
the RT/αPD-1-induced abscopal effect in both models.
Complete cures of non-irradiated tumors were mainly observed
in triple-treated mice. Triple therapy induced more
cross-presenting dendritic cells (DCs) and more
tumor-specific CD8+ T cells than RT/αPD-1 and Doxil/αPD-1,
particularly in non-irradiated tumors. Coincubation of
Doxil-treated and/or RT-treated tumor cells with DCs
enhanced DC antigen cross-presentation which is crucial for
inducing CD8+ T cells. CD8+ T cell depletion or implantation
of cGAS-deficient or STING-deficient tumor cells abolished
the abscopal effect. Doxorubicin-induced/Doxil-induced
IFNβ1 markedly depended on the cGAS/STING pathway.
Doxorubicin-treated/Doxil-treated tumor cells depleted of
mtDNA secreted less IFNβ1, of the related T cell-recruiting
chemokine CXCL10, and ATP; coincubation with mtDNA-depleted
tumor cells strongly reduced IFNβ1 secretion by DCs.
Implantation of mtDNA-depleted tumor cells, particularly at
the non-irradiated/abscopal site, substantially diminished
the Doxil-enhanced abscopal effect and tumor infiltration by
tumor-specific CD8+ T cells.These data show that single
low-dose Doxil can substantially enhance the
RT/αPD-1-induced abscopal effect, with a strong increase in
cross-presenting DCs and CD8+ tumor-specific T cells
particularly in abscopal tumors compared with RT/αPD-1 and
Doxil/αPD-1. Moreover, they indicate that the
mtDNA/cGAS/STING/IFN-I axis is important for the
immunogenic/immunomodulatory doxorubicin effects. Our
findings may be helpful for the planning of clinical
radiochemoimmunotherapy trials in (oligo)metastatic
patients.},
keywords = {Combined Modality Therapy (Other) / Immunotherapy (Other) /
Programmed Cell Death 1 Receptor (Other) /
Radioimmunotherapy (Other) / Radiotherapy (Other)},
cin = {FR01},
ddc = {610},
cid = {I:(DE-He78)FR01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:37640480},
doi = {10.1136/jitc-2022-006235},
url = {https://inrepo02.dkfz.de/record/282366},
}