Reprogramming the microenvironment with tumor-selective angiotensin blockers enhances cancer immunotherapy
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Published version
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Author(s) • • • • • • • • •
Chauhan, Vikash P.
Chen, Ivy X.
Tong, Rong
Ng, Mei Rosa
Martin, John D.
Naxerova, Kamila
Wu, Michelle W.
Huang, Peigen
Boucher, Yves
Kohane, Daniel S.
Date Issued
April 2019
Journal
Proceedings of the National Academy of Sciences
Publisher
Proceedings of the National Academy of Sciences
Version
Final published version
Abstract
© 2019 National Academy of Sciences. All rights reserved. Cancer-associated fibroblasts (CAFs) can either suppress or support T lymphocyte activity, suggesting that CAFs may be reprogrammable to an immunosupportive state. Angiotensin receptor blockers (ARBs) convert myofibroblast CAFs to a quiescent state, but whether ARBs can reprogram CAFs to promote T lymphocyte activity and enhance immunotherapy is unknown. Moreover, ARB doses are limited by systemic adverse effects such as hypotension due to the importance of angiotensin signaling outside tumors. To enhance the efficacy and specificity of ARBs in cancer with the goal of revealing their effects on antitumor immunity, we developed ARB nanoconjugates that preferentially accumulate and act in tumors. We created a diverse library of hundreds of aciddegradable polymers and chemically linked ARBs to the polymer most sensitive to tumor pH. These tumor microenvironmentactivated ARBs (TMA-ARBs) remain intact and inactive in circulation while achieving high concentrations in tumors, wherein they break down to active ARBs. This tumor-preferential activity enhances the CAF-reprogramming effects of ARBs while eliminating blood pressure-lowering effects. Notably, TMA-ARBs alleviate immunosuppression and improve T lymphocyte activity, enabling dramatically improved responses to immune-checkpoint blockers in mice with primary as well as metastatic breast cancer.
MIT Department
Koch Institute for Integrative Cancer Research at MIT
Massachusetts Institute of Technology. Department of Chemical Engineering
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DOI of Published Version
https://doi.org/10.1073/pnas.1819889116