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Background: A phase II trial (EC-CRT-001) demonstrated the promising efficacy of combining toripalimab (an anti-PD-1 antibody) with definitive chemoradiotherapy (CRT) for locally advanced oesophageal squamous cell carcinoma (ESCC). Biomarkers are key to identifying patients who may benefit from this therapeutic approach., Methods: Of the 42 patients with ESCC who received toripalimab combined with definitive CRT, 37 were included in this analysis. Baseline assessments included PET/CT metabolic parameters (SUV max , SUV mean , SUV peak , MTV, and TLG), RNA sequencing of tumour biopsies to quantify the tissue mutational burden (TMB), and multiplex immunofluorescence staining to estimate immune cell infiltration in the tumour microenvironment (TME). Frozen neoplastic samples were procured for RNA sequencing to further explore the immune-related TME., Results: Among the 37 patients, high baseline SUV max (≥12.0; OR = 6.5, 95% CI 1.4-48.2, p = 0.032) and TLG (≥121.8; OR = 6.8, 95% CI 1.6-33.5, p = 0.012) were significantly correlated with lower complete response rates. All five PET/CT parameters were notably associated with overall survival; only SUV max and TLG were associated with a significantly worse progression-free survival. A trend towards an inverse correlation was observed between SUV max and TMB (R = -0.33, p = 0.062). PD-1 + CD8 + T cell infiltration was negatively correlated with MTV (R = -0.355, p = 0.034) and TLG (R = -0.385, p = 0.021). Moreover, RNA sequencing revealed that the high TLG subgroup exhibited low immune cell infiltration, indicating an immunosuppressive landscape., Conclusions: High baseline SUV max and TLG might predict poorer treatment response and worse survival in patients with ESCC undergoing immunotherapy combined with CRT. In addition, high PET/CT metabolic parameters, particularly TLG, were correlated with an immunosuppressive TME, which warrants further exploration., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Immunotherapy has become a powerful cancer treatment, but only a small fraction of patients have achieved durable benefits due to the immune escape mechanism. In this study, epigenetic regulation is combined with gene therapy-mediated immune checkpoint blockade to relieve this immune escape mechanism. PPD (i.e., mPEG-b-PLG/PEI-RT3/DNA) is developed to mediate plasmid-encoding shPD-L1 delivery by introducing multiple interactions (i.e., electrostatic, hydrogen bonding, and hydrophobic interactions) and polyproline II (PPII)-helix conformation, which downregulates PD-L1 expression on tumour cells to relieve the immunosuppression of T cells. Zebularine (abbreviated as Zeb), a DNA methyltransferase inhibitor (DNMTi), is used for the epigenetic regulation of the tumour immune microenvironment, thus inducing DC maturation and MHC I molecule expression to enhance antigen presentation. PPD plus Zeb combination therapy initiates a systemic anti-tumour immune response and effectively prevents tumour relapse and metastasis by generating durable immune memory. This strategy provides a scheme for tumour treatment and the inhibition of relapse and metastasis., (© 2021. The Author(s).)

Weak T cell responses and immune checkpoints within tumors could be two key factors for limiting antitumor efficacy in the field of cancer immunotherapy. Thus, the combined strategy of tumor vaccines and immune checkpoint blockade has been widely studied and expected to boost antitumor immune responses. Herein, we first developed a two-barreled strategy to combine the nanovaccine with a gene-mediated PD-L1 blockade. On the one hand, polyethyleneimine (PEI) worked as a vaccine carrier to codeliver the antigen ovalbumin (OVA) and the adjuvant unmethylated cytosine-phosphate-guanine (CpG) to formulate the PEI/OVA/CpG nanovaccine through electrostatic binding, which realized both dendritic cell activation and antigen cross-presentation enhancement. On the other hand, the PD-L1 silence gene was loaded by PEI to form PEI/ p shPD-L1 complexes, which were further in situ shielded by aldehyde-modified polyethylene glycol (OHC-PEG-CHO) via pH-responsive Schiff base bonds. The formed p shPD-L1@NPs could decrease PD-L1 expression on the tumor cells. However, such a combined two-barreled strategy improved feebly for tumor inhibition in comparison with monotherapy, exhibiting the antagonistic effect, which might be due to the limited T cell response enhancement in the tumor microenvironment. To solve this problem, we have further developed a three-barreled strategy to combine oral administration of l-arginine, which worked as an amplifier to induce robust T cell response enhancement, without causing the upregulation of other negative immune regulators. Superior antitumor behavior and tumor rechallenge protection were realized by the three-barreled strategy in B16F10-OVA (B16-OVA)-bearing mice. The unique three-barreled strategy we developed might offer a novel clinical therapeutic treatment.

The immune checkpoint blockade of programmed death ligand-1 (PD-L1) or programmed death-1 (PD-1) has been a promising strategy to restore T cell mediated tumor suppression. In this study, a plasmid DNA which expressed small hairpin RNA of PD-L1 (shPD-L1) was loaded in the ultrasensitive pH triggered charge/size dual-rebound P[(GP)D] nanoparticles (NPs) to silence the PD-L1 gene for reducing the PD-L1/PD-1 interactions between tumors and T cells. To increase the penetration of the shPD-L1 loaded P[(GP)D] NPs (shPD-L1@NPs) in tumors, hyaluronidase (HAase) was utilized to degrade the overexpressed hyaluronicacid (HA) in the extracellular matrix (ECM) of the tumor tissues. The HAase-enhanced tumor accumulation and penetration of the P[(GP)D] NPs were carefully explored. Further in vivo antitumor therapy was carried out in the malignant melanoma mouse tumor model, and a significant tumor inhibition effect was achieved by the combination treatment of HAase and shPD-L1@NPs. Our results verified that the HAase could effectively degrade the HA in tumors and increase the penetration of the shPD-L1@NPs for achieving more efficient PD-L1 gene silence and finally realizing potent tumor suppression. This combination treatment strategy has great potentials to be adopted for other nanomedicines, and it will have broad applications for cancer therapy in the future., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Tumor vaccine has been one of the research hotspots for cancer immunotherapy in recent years. By introducing tumor antigens into the body, the patient's own immune system will be specifically activated to induce effective immune responses for controlling or eliminating the malignant tumor cells. In this study, a simple nanovaccine was developed to induce antigen-specific anti-tumor immune responses. Polycationic polyethylenimine (PEI) was utilized to co-deliver the antigen ovalbumin (OVA) and the adjuvant unmethylated cytosine-phosphate-guanine (CpG) by electrostatic binding. The positively charged PEI could be beneficial to augment the PEI/CpG/OVA nanovaccine uptake in dendritic cells (DCs) and facilitate the endosomal escape of the nanovaccine for antigen delivering into the cytoplasm. The nanovaccine showed significant stimulation on DCs' maturation in vitro, and it was further applied for in vivo anti-tumor immunotherapy. To enhance the tumor infiltration of the nanovaccine-generated tumor-specific T cells, hyaluronidase (HAase) was employed to increase the permeability of the tumor tissues by breaking down the hyaluronan (HA) in the extracellular matrix (ECM) of tumors. Highly enhanced in vivo anti-tumor therapeutic efficiency was achieved by combining the PEI/CpG/OVA nanovaccine with HAase, which was attributed to the increased quantity of OVA-specific T cells in tumor tissues. The combination of nanovaccine with HAase has offered a simple and efficient strategy for inducing powerful anti-tumor effect in cancer immunotherapy., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Purpose: This study aimed to investigate the predictive value of metabolic features in response to induction immuno-chemotherapy in patients with locally advanced non-small cell cancer (LA-NSCLC), using ultra-high sensitivity dynamic total body [18F]FDG PET/CT. Methods: The study analyzed LA-NSCLC patients who received two cycles of induction immuno-chemotherapy and underwent a 60-min dynamic total body [18F]FDG PET/CT scan before treatment. The primary tumors (PTs) were manually delineated, and their metabolic features, including the Patlak-Ki, Patlak-Intercept, maximum SUV (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were evaluated. The overall response rate (ORR) to induction immuno-chemotherapy was evaluated according to RECIST 1.1 criteria. The Patlak-Ki of PTs was calculated from the 20–60 min frames using the Patlak graphical analysis. The best feature was selected using Laplacian feature importance scores, and an unsupervised K-Means method was applied to cluster patients. ROC curve was used to examine the effect of selected metabolic feature in predicting tumor response to treatment. The targeted next generation sequencing on 1021 genes was conducted. The expressions of CD68, CD86, CD163, CD206, CD33, CD34, Ki67 and VEGFA were assayed through immunohistochemistry. The independent samples t test and the Mann–Whitney U test were applied in the intergroup comparison. Statistical significance was considered at P < 0.05. Results: Thirty-seven LA-NSCLC patients were analyzed between September 2020 and November 2021. All patients received two cycles of induction chemotherapy combined with Nivolumab/ Camrelizumab. The Laplacian scores showed that the Patlak-Ki of PTs had the highest importance for patient clustering, and the unsupervised K-Means derived decision boundary of Patlak-Ki was 2.779 ml/min/100 g. Patients were categorized into two groups based on their Patlak-Ki values: high FDG Patlak-Ki (H-FDG-Ki, Patlak-Ki > 2.779 ml/min/100 g) group (n = 23) and low FDG Patlak-Ki (L-FDG-Ki, Patlak-Ki ≤ 2.779 ml/min/100 g) group (n = 14). The ORR to induction immuno-chemotherapy was 67.6% (25/37) in the whole cohort, with 87% (20/23) in H-FDG-Ki group and 35.7% (5/14) in L-FDG-Ki group (P = 0.001). The sensitivity and specificity of Patlak-Ki in predicting the treatment response were 80% and 75%, respectively [AUC = 0.775 (95%CI 0.605–0.945)]. The expression of CD3+/CD8+ T cells and CD86+/CD163+/CD206+ macrophages were higher in the H-FDG-Ki group, while Ki67, CD33+ myeloid cells, CD34+ micro-vessel density (MVD) and tumor mutation burden (TMB) were comparable between the two groups. Conclusions: The total body [18F]FDG PET/CT scanner performed a dynamic acquisition of the entire body and clustered LA-NSCLC patients into H-FDG-Ki and L-FDG-Ki groups based on the Patlak-Ki. Patients with H-FDG-Ki demonstrated better response to induction immuno-chemotherapy and higher levels of immune cell infiltration in the PTs compared to those with L-FDG-Ki. Further studies with a larger patient cohort are required to validate these findings. [ABSTRACT FROM AUTHOR]

Serous ovarian carcinoma (SOC) is a gynecological malignancy with high mortality rates. Currently, there is a lack of reliable biomarkers for accurate SOC patient prognosis. Here, we analyzed SOC RNA-Seq data from The Cancer Genome Atlas (TCGA) to identify prognostic biomarkers. Through the pearson correlation analysis, univariate Cox regression analysis, and LASSO-penalized Cox regression analysis, we identified nine lncRNAs significantly associated with four types of RNA modification writers (m6A, m1A, APA, and A-I) and with the prognosis of SOC patients (P < 0.05). Six writer-related lncRNAs were ultimately selected following multivariate Cox analysis. We established a risk prediction model based on these six lncRNAs and evaluated its prognostic value in multiple groups (training set, testing set, and entire set). Our risk prediction model could effectively predict the prognosis of SOC patients with different clinical characteristics and their responses to immunotherapy. Lastly, we validated the predictive reliability and sensitivity of the lncRNA-based model via a nomogram. This study explored the association between RNA modification writer-related lncRNAs and SOC prognosis, providing a potential complement for the clinical management of SOC patients. [ABSTRACT FROM AUTHOR]

• A multifunctional nanoagent is developed for multi-mode imaging guided photothermal therapy. • The multifunctional nanoagent can be disassembled to release luteolin after photothermal therapy. • The released luteolin can regulate inflammation caused by photothermal therapy and relieve immunosuppressive microenvironment. • The released luteolin can combine with photothermal therapy and immunotherapy to inhibit tumour recurrence and metastasis. The multifunctional nanoparticles (FeLPNPs) with great clinical translational potential could be applied for multi-mode imaging guided photothermal therapy (PTT), subsequently were disassembled by an iron chelator to release luteolin. The released luteolin could precisely regulate inflammation caused by PTT and relieve immunosuppressive microenvironment, and combined with PTT and immunotherapy to effectively inhibit tumour recurrence and metastasis. [Display omitted] Inflammation is a beneficial response of the body in response to external stimuli, while the overwhelming inflammation caused by disease therapy often leads to treatment failure. Therefore, precise regulation of inflammation is essential in remodelling body microenvironment and enhancing the therapy efficiency. Herein, we show an efficient strategy for precisely regulating inflammation and immunosuppressive microenvironment after photothermal therapy (PTT) by controlling release of dietary luteolin through dynamical disassembly of photothermal agent, which dramatically increase the therapy efficiency of PTT and accompanied immunotherapy. As a result, not only the local tumour could be effectively destructed by PTT, but also the combination of PTT-induced immunogenic death (ICD), and regulation of inflammation after PTT and immunosuppressive tumour microenvironment by released luteolin could achieve the effective inhibition of tumour recurrence and metastasis. As a proof of concept, this research demonstrates how to solve tumour recurrence and metastasis by precise regulation of inflammation inherited in cancer therapy. [ABSTRACT FROM AUTHOR]

The antitumor efficacy of tumor vaccines is often limited by weak T cell responses and poor activated T cells infiltration. Herein, we reported a novel synergistic strategy to simultaneously overcome these two obstacles to realize enhanced tumor elimination. To induce the robust T cell responses, we designed a minimalist tumor nanovaccine based on stepwise electrostatic interactions. The dual-functional delivery system PEI/CaCO 3 (polyethylenimine coated CaCO 3), could not only act as a vaccine carrier that absorbed antigen ovalbumin (OVA) and adjuvant unmethylated cytosine-phosphate-guanine (CpG) with high efficiency, but also work as an underlying adjuvant to activate bone marrow-derived dendritic cells (BMDCs). Therefore, the formed PEI/CaCO 3 /OVA/CpG vaccines (NVs) realized the significant enhancement of both the BMDCs activation and the specific responses of T cells in vivo. In addition, to enhance the infiltration of activated T cells in the tumor sites, the Spam1 gene, which could express hyaluronidase (HAase), was explored using PEI as the gene carrier shielded with aldehyde modified polyethylene glycol (CHO-PEG-CHO) through pH responsive Schiff base bonds. PEG/PEI/ p Spam1 (p Spam1@NPs) could achieve a high HAase expression in the tumor sites to further degrade the tumor extracellular matrix, thus promoting the infiltration of immune cells. Besides, the degradation of extracellular matrix increased blood perfusion and relieved the tumor hypoxia to modulate the immune-suppressive microenvironment. Highly enhanced antitumor efficiency and tumor re-challenge prevention were achieved by combined NVs with p Spam1@NPs in B16-OVA bearing mice. The facile synergistic strategy we presented here is expected to be further used for personalized immunotherapy in the future. [ABSTRACT FROM AUTHOR]