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The unsatisfactory immunotherapeutic responses are primarily attributed to the insufficient immune recognition and the presence of an immunosuppressive tumor microenvironment (ITM). This study focuses on the development of a tricomponent immunoactivating nanomedicine called TIN that combines a photosensitizer, an inhibitor of epidermal growth factor receptor (EGFR) and a CSF-1R inhibitor to enable photodynamic immunotherapy by downregulating PD-L1 expression and repolarizing tumor-associated macrophages (TAMs). TIN is designed to facilitate the drug delivery and target specific pathways involved in tumor progression. By inhibiting the activity of EGFR and CSF-1R, TIN reduces PD-L1 expression on tumor cells and induces the TAMs polarization to M1 phenotype, restoring the immune recognition of T cells and the phagocytosis of macrophage to reshape the immunosuppressive microenvironment. Additionally, the photodynamic therapy (PDT) of TIN can greatly destroy the primary tumor and trigger immunogenic cell death (ICD). Importantly, the immune checkpoint blockade effect of TIN can enhance the immune response of PDT-induced ICD for metastatic tumor treatment. This study presents a self-assembling strategy for the development of an all-in-one nanomedicine, effectively integrating multiple therapeutic modalities to provide a comprehensive and systemic approach for tumor suppression., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Tumor cells overexpress programmed cell death ligand 1 (PD-L1) to impede immune responses and escape immune elimination. Development of effective combination regimens to sensitize immunotherapy is promising but always challenging. Herein, a self-reinforced photodynamic immunostimulator (designated as PCS) is constructed for metastatic breast cancer treatment through simultaneous downregulation and blockade of PD-L1. Specifically, PCS is prepared by encapsulating signal transducer and activator of transcription 3 (STAT3) inhibitor (Stattic) into photosensitizer (protoporphyrin IX) modified PD-L1 blockade peptide (CVRARTR) through drug self-assembly. PCS can facilitate the targeted drug accumulation in PD-L1 overexpressed breast cancer cells to block PD-L1 and inhibit the phosphorylation of STAT3 to downregulate PD-L1. Moreover, PCS increases intracellular oxidative stress to show a robust anti-proliferation effect through photodynamic therapy (PDT), which also triggers an immunogenic cell death (ICD) to expose the immunostimulatory signals. Consequently, the efficient PD-L1 inhibition and robust PDT of PCS synergistically suppress the malignant growth of breast cancer, and concurrently activate the systemic anti-tumor immunity for metastatic inhibition with no obvious side effects. Such a photodynamic immunostimulator may provide an effective combination regimen for therapies activated immunotherapy against metastatic breast cancer. [ABSTRACT FROM AUTHOR]

Tumor cells are characterized by unlimited proliferation and escape of immune clearance, which are closely associated with the down regulation of surface antigens. In this work, a carrier free photodynamic modulator (CeTaz) is developed to improve immunosuppressive tumor microenvironment and promote the recognition of tumors by T cells by epigenetic reprogramming. Specifically, CeTaz is assembled by chlorine e6 (Ce6) and tazemetostat (Taz) through intermolecular interactions. Upon light irradiation, CeTaz is able to promote the generation of reactive oxygen species (ROS) for a robust photodynamic therapy (PDT) to inhibit localized tumor growth. Meanwhile, the PDT also induces immunogenic cell death (ICD) to initiate immune response, leading to the activation of effector T cells. More importantly, CeTaz could inhibit the epigenetic regulator of EZH2 to suppress the methylation of H3K27, which would promote tumor cells to express MHC-I and release CXCL10. Consequently, the epigenetically reprogrammed tumor cells are readily recognized by effector T cells to enhance the antitumor immunity. Results indicate that the PDT activated immunotherapy of CeTaz could simultaneously inhibit the growth of primary and distant tumors with a low system toxicity. This study would advance the development of carrier free nanomedicine for precise treatment of metastatic tumor. [ABSTRACT FROM AUTHOR]

• Self-delivery nanomedicine of PyroR was prepared without drug-excipients. • PyroR could enhance the stability and facilitate the delivery of photosensitizers and TLR agonists. • Photodynamic therapy (PDT) of PyroR could efficiently inhibit primary tumor growth and initiate immunological cascade. • PryoR could repolarize M2 macrophages into M1 phenotype for immunotherapy against metastatic tumors. Immunotherapy is a promising clinical treatment strategy against malignant tumor metastasis, however, it often shows an inadequate efficacy owing to the immunosuppressive tumor microenvironment (ITM). Herein, we develop a self-delivery re-educator to induce immunogenic cell death (ICD) and macrophage polarization for photodynamic therapy (PDT) and immunotherapy against breast cancer. To be specific, the self-delivery re-educator (designated as PyroR) is prepared by the self-assembly of the photosensitizer pyropheophorbide-a (Pyro) and TLR agonist resiquimod (R848). Without any carriers, nanosized PyroR exhibits high drug contents and could avoid the side effects raised by excipients. After intravenous administration, PyroR could generate a lot of reactive oxygen species (ROS) for PDT against primary tumor in the presence of light irradiation. Meanwhile, PDT triggered ICD cascade would promote dendritic cells (DCs) maturation and activate cytotoxic T lymphocytes (CTLs) for immunotherapy against distant and metastatic tumors. More importantly, R848 is able to polarize macrophages from M2 to M1 phenotype, which would improve the ITM to enhance antitumor immunity. Consequently, the PDT-initiated immunotherapy of PyroR demonstrates significant inhibition effects on primary, distant and metastatic tumors while causes a minimal system toxicity. This self-delivery re-educating strategy would shed light on constructing carrier-free nanomedicine for treatment of malignant tumors. [ABSTRACT FROM AUTHOR]