Single dual-specific anti-PD-L1/TGF-β antibody synergizes with chemotherapy as neoadjuvant treatment for pancreatic ductal adenocarcinoma: a preclinical experimental study

Int J Surg. 2024 May 1;110(5):2679-2691. doi: 10.1097/JS9.0000000000001226.

Abstract

Aims: Chemotherapy resistance is an important cause of neoadjuvant therapy failure in pancreatic ductal adenocarcinoma (PDAC). BiTP (anti-PD-L1/TGF-β bispecific antibody) is a single antibody that can simultaneously and dually target transforming growth factor-beta (TGF-β) and programmed cell death ligand 1 (PD-L1). We attempted in this study to investigate the efficacy of BiTP in combination with first-line chemotherapy in PDAC.

Methods: Preclinical assessments of BiTP plus gemcitabine and nab-paclitaxel were completed through a resectable KPC mouse model (C57BL/6J). Spectral flow cytometry, tissue section staining, enzyme-linked immunosorbent assays, Counting Kit-8, transwell, and Western blot assays were used to investigate the synergistic effects.

Results: BiTP combinatorial chemotherapy in neoadjuvant settings significantly downstaged PDAC tumors, enhanced survival, and had a higher resectability for mice with PDAC. BiTP was high affinity binding to targets and reverse chemotherapy resistance of PDAC cells. The combination overcame immune evasion through reprogramming tumor microenvironment via increasing penetration and function of T cells, natural killer cells, and dendritic cells and decreasing the function of immunosuppression-related cells as regulatory T cells, M2 macrophages, myeloid-derived suppressor cells, and cancer-associated fibroblasts.

Conclusion: Our results suggest that the BiTP combinatorial chemotherapy is a promising neoadjuvant therapy for PDAC.

MeSH terms

  • Albumins / administration & dosage
  • Albumins / pharmacology
  • Animals
  • Antibodies, Bispecific / administration & dosage
  • Antibodies, Bispecific / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • B7-H1 Antigen / antagonists & inhibitors
  • B7-H1 Antigen / immunology
  • Carcinoma, Pancreatic Ductal* / drug therapy
  • Carcinoma, Pancreatic Ductal* / immunology
  • Carcinoma, Pancreatic Ductal* / therapy
  • Cell Line, Tumor
  • Deoxycytidine* / administration & dosage
  • Deoxycytidine* / analogs & derivatives
  • Deoxycytidine* / pharmacology
  • Disease Models, Animal
  • Drug Synergism
  • Gemcitabine*
  • Humans
  • Mice
  • Mice, Inbred C57BL*
  • Neoadjuvant Therapy* / methods
  • Paclitaxel* / administration & dosage
  • Paclitaxel* / pharmacology
  • Pancreatic Neoplasms* / drug therapy
  • Pancreatic Neoplasms* / immunology
  • Pancreatic Neoplasms* / therapy
  • Transforming Growth Factor beta* / antagonists & inhibitors
  • Transforming Growth Factor beta* / metabolism
  • Tumor Microenvironment / drug effects
  • Tumor Microenvironment / immunology