| Autor: |
Gross NE; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center., Zhang Z; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center.; Convergence Institute., Mitchell JT; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center.; Convergence Institute.; Department of Genetic Medicine., Charmsaz S; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center., Hernandez AG; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center., Coyne EM; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center., Shin SM; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center., Vargas Carvajal DC; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center., Sidiropoulos DN; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center.; Convergence Institute., Cho Y; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center., Mo G; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center., Yuan X; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center.; Convergence Institute., Cannon C; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center.; Convergence Institute., Suresh Babu J; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center., Lyman MR; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center., Armstrong T; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center., Kagohara LT; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center.; Convergence Institute., Bever KM; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center.; Bloomberg-Kimmel Institute for Cancer Immunotherapy; and., Le DT; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center.; Bloomberg-Kimmel Institute for Cancer Immunotherapy; and., Jaffee EM; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center.; Convergence Institute.; Bloomberg-Kimmel Institute for Cancer Immunotherapy; and., Fertig EJ; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center.; Convergence Institute.; Department of Genetic Medicine.; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Department of Applied Mathematics and Statistics, Johns Hopkins University Whiting School of Engineering, Baltimore, Maryland, USA., Ho WJ; Department of Oncology, Sidney Kimmel Comprehensive Cancer Center.; Convergence Institute. |
| Abstrakt: |
Pancreatic ductal adenocarcinoma (PDAC) is highly lethal and resistant to immunotherapy. Although immune recognition can be enhanced with immunomodulatory agents including checkpoint inhibitors and vaccines, few patients experience clinical efficacy because the tumor immune microenvironment (TiME) is dominated by immunosuppressive myeloid cells that impose T cell inhibition. Inhibition of phosphodiesterase-5 (PDE5) was reported to downregulate metabolic regulators arginase and inducible NOS in immunosuppressive myeloid cells and enhance immunity against immune-sensitive tumors, including head and neck cancers. We show for the first time to our knowledge that combining a PDE5 inhibitor, tadalafil, with a mesothelin-specific vaccine, anti-programmed cell death protein 1, and anti-cytotoxic T lymphocyte-associated protein 4 yields antitumor efficacy even against immune-resistant PDAC. To determine immunologic advantages conferred by tadalafil, we profiled the TiME using mass cytometry and single-cell RNA-sequencing analysis with Domino to infer intercellular signaling. Our analyses demonstrated that tadalafil reprograms myeloid cells to be less immunosuppressive. Moreover, tadalafil synergized with the vaccine, enhancing T cell activation including mesothelin-specific T cells. Tadalafil treatment was also associated with myeloid/T cell signaling axes important for antitumor responses (e.g., Cxcr3, Il12). Our study shows that PDE5 inhibition combined with vaccine-based immunotherapy promotes pro-inflammatory states of myeloid cells, activation of T cells, and enhanced myeloid/T cell crosstalk to yield antitumor efficacy against immune-resistant PDAC. |
