Decoupling FcRn and tumor contributions to elevated immune checkpoint inhibitor clearance in cancer cachexia

Autor: Trang T. Vu, Kyeongmin Kim, Millennium Manna, Justin Thomas, Bryan C. Remaily, Emma J. Montgomery, Travis Costa, Lauren Granchie, Zhiliang Xie, Yizhen Guo, Min Chen, Alyssa Marie M. Castillo, Samuel K. Kulp, Xiaokui Mo, Sridhar Nimmagadda, Paul Gregorevic, Dwight H. Owen, Latha P. Ganesan, Thomas A. Mace, Christopher C. Coss, Mitch A. Phelps
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Pharmacological Research, Vol 199, Iss , Pp 107048- (2024)
Druh dokumentu: article
ISSN: 1096-1186
DOI: 10.1016/j.phrs.2023.107048
Popis: High baseline clearance of immune checkpoint inhibitors (ICIs), independent of dose or systemic exposure, is associated with cachexia and poor outcomes in cancer patients. Mechanisms linking ICI clearance, cachexia and ICI therapy failure are unknown. Here, we evaluate in four murine models and across multiple antibodies whether altered baseline catabolic clearance of administered antibody requires a tumor and/or cachexia and whether medical reversal of cachexia phenotype can alleviate altered clearance. Key findings include mild cachexia phenotype and lack of elevated pembrolizumab clearance in the MC38 tumor-bearing model. We also observed severe cachexia and decreased, instead of increased, baseline pembrolizumab clearance in the tumor-free cisplatin-induced cachexia model. Liver Fcgrt expression correlated with altered baseline catabolic clearance, though elevated clearance was still observed with antibodies having no (human IgA) or reduced (human H310Q IgG1) FcRn binding. We conclude cachexia phenotype coincides with altered antibody clearance, though tumor presence is neither sufficient nor necessary for altered clearance in immunocompetent mice. Magnitude and direction of clearance alteration correlated with hepatic Fcgrt, suggesting changes in FcRn expression and/or recycling function may be partially responsible, though factors beyond FcRn also contribute to altered clearance in cachexia.
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