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Chemotherapy enhances tumor cell susceptibility to CTL-mediated killing during cancer immunotherapy in mice
Rupal Ramakrishnan, … , Esteban Celis, Dmitry I. Gabrilovich
Rupal Ramakrishnan, … , Esteban Celis, Dmitry I. Gabrilovich
Published March 15, 2010
Citation Information: J Clin Invest. 2010;120(4):1111-1124. https://doi.org/10.1172/JCI40269.
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Research Article Oncology

Chemotherapy enhances tumor cell susceptibility to CTL-mediated killing during cancer immunotherapy in mice

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Abstract

Cancer immunotherapy faces a serious challenge because of low clinical efficacy. Recently, a number of clinical studies have reported the serendipitous finding of high rates of objective clinical response when cancer vaccines are combined with chemotherapy in patients with different types of cancers. However, the mechanism of this phenomenon remains unclear. Here, we tested in mice several cancer vaccines and an adoptive T cell transfer approach to cancer immunotherapy in combination with several widely used chemotherapeutic drugs. We found that chemotherapy made tumor cells more susceptible to the cytotoxic effect of CTLs through a dramatic perforin-independent increase in permeability to GrzB released by the CTLs. This effect was mediated via upregulation of mannose-6-phosphate receptors on the surface of tumor cells and was observed in mouse and human cells. When combined with chemotherapy, CTLs raised against specific antigens were able to induce apoptosis in neighboring tumor cells that did not express those antigens. These data suggest that small numbers of CTLs could mediate a potent antitumor effect when combined with chemotherapy. In addition, these results provide a strong rationale for combining these modalities for the treatment of patients with advanced cancers.

Authors

Rupal Ramakrishnan, Deepak Assudani, Srinivas Nagaraj, Terri Hunter, Hyun-Il Cho, Scott Antonia, Soner Altiok, Esteban Celis, Dmitry I. Gabrilovich

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Figure 2

Chemotherapy sensitizes tumor cells to the cytotoxic effect of CTLs.

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Chemotherapy sensitizes tumor cells to the cytotoxic effect of CTLs.
(A)...
(A) Tumor-free C57BL/6 mice were immunized with Kb-bound p53-derived peptide. Splenocytes were isolated, restimulated with the specific peptide for 6 days, and used as effectors in a CTL assay against EL-4 target cells loaded with specific (p53) or control peptides. EL-4 cells were pretreated overnight with 1.5 μg/ml DOX or 12.5 nM TAX. Standard 4-hour 51Cr-release assay was performed. For A–E, data are shown as mean ± SEM. Each experiment was performed 3 times with the same results. (B) Splenocytes from immunized mice were pretreated overnight with DOX or TAX at doses described above and used as effectors against EL-4 target cells loaded with specific or control peptides in a Cr51 release assay. (C) Results of a CTL assay wherein both effectors and targets were pretreated with TAX as described above. Spl, splenocytes. (D) T cells from mice immunized with Neu-derived p66 peptide were used as effectors against either nonmodified 4T1 cells or 4T1-Neu cells transfected with Neu-expressing plasmid. The targets were pretreated with TAX for 18 hours. (E) T cells from 2C-transgenic mice were used as effectors against EL-4 cells loaded with the specific (S.P.) or control (C.P.) peptides. The target cells were pretreated with TAX overnight. (F) Cytotoxicity against H332 SCLC cells was measured in duplicate in a standard 6-hour chromium release assay as detailed in Methods. PBMCs stimulated with SCLC tumor cells lysates were used as effectors. The viability of target cells and PBMCs in all tests was similar and greater than 85% at onset of assay. UNT, SCLC and PBMCs were not treated with TAX; SCLC+TAX, tumor cells were pretreated for 18 hours with 100 nM TAX; PBMC+TAX, PBMCs were pretreated for 18 hours with 100 nM TAX; SCLC/PBMC+TAX, tumor cells and PBMCs were treated with TAX. (G) Survivin-specific T cells were generated by 2 rounds of stimulation of mononuclear cells from HLA-A2+ healthy volunteers as described elsewhere (18). The T cells were column purified and added to the tumor cells at indicated ratios. Primary tumor from HLA-A2+ patient with non-SCLC cancer was used as target. The tumor cells were treated with 50 nM TAX 18 hours prior to 51Cr release assay.

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