Sunitinib mediates reversal of myeloid-derived suppressor cell accumulation in renal cell carcinoma patients

JS Ko, AH Zea, BI Rini, JL Ireland, P Elson… - Clinical cancer …, 2009 - AACR
JS Ko, AH Zea, BI Rini, JL Ireland, P Elson, P Cohen, A Golshayan, PA Rayman, L Wood…
Clinical cancer research, 2009AACR
Purpose: Immune dysfunction reported in renal cell carcinoma (RCC) patients may
contribute to tumor progression. Myeloid-derived suppressor cells (MDSC) represent one
mechanism by which tumors induce T-cell suppression. Several factors pivotal to the
accumulation of MDSC are targeted by the tyrosine kinase inhibitor, sunitinib. The effect of
sunitinib on MDSC-mediated immunosuppression in RCC patients has been investigated.
Experimental Design: Patient peripheral blood levels of MDSC and regulatory T-cell (Treg) …
Abstract
Purpose: Immune dysfunction reported in renal cell carcinoma (RCC) patients may contribute to tumor progression. Myeloid-derived suppressor cells (MDSC) represent one mechanism by which tumors induce T-cell suppression. Several factors pivotal to the accumulation of MDSC are targeted by the tyrosine kinase inhibitor, sunitinib. The effect of sunitinib on MDSC-mediated immunosuppression in RCC patients has been investigated.
Experimental Design: Patient peripheral blood levels of MDSC and regulatory T-cell (Treg) and T-cell production of IFN-γ were evaluated before and after sunitinib treatment. Correlations between MDSC and Treg normalization as well as T-cell production of IFN-γ were examined. The in vitro effect of sunitinib on patient MDSC was evaluated.
Results: Metastatic RCC patients had elevated levels of CD33+HLA-DR and CD15+CD14 MDSC, and these were partially overlapping populations. Treatment with sunitinib resulted in significant reduction in MDSC measured by several criteria. Sunitinib-mediated reduction in MDSC was correlated with reversal of type 1 T-cell suppression, an effect that could be reproduced by the depletion of MDSC in vitro. MDSC reduction in response to sunitinib correlated with a reversal of CD3+CD4+CD25hiFoxp3+ Treg cell elevation. No correlation existed between a change in tumor burden and a change in MDSC, Treg, or T-cell production of IFN-γ. In vitro addition of sunitinib reduced MDSC viability and suppressive effect when used at ≥1.0 μg/mL. Sunitinib did not induce MDSC maturation in vitro.
Conclusions: Sunitinib-based therapy has the potential to modulate antitumor immunity by reversing MDSC-mediated tumor-induced immunosuppression.
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