Cisplatin Alters Antitumor Immunity and Synergizes with PD-1/PD-L1 Inhibition in Head and Neck Squamous Cell Carcinoma

TLDR

Head and neck squamous cell carcinoma is traditionally treated with cisplatin, and anti‑PD‑1 immunotherapy has recently been approved, yet preclinical data on how cisplatin affects antitumor immunity alone or with immunotherapies are scarce. Sublethal cisplatin boosts antigen presentation and T‑cell killing while upregulating PD‑L1, and in a syngeneic HNSCC mouse model, combining cisplatin with anti‑PD‑L1/PD‑1 delayed tumor growth and improved survival without compromising tumor‑infiltrating immune cells or adding toxicity, indicating that moderate cisplatin doses can enhance antitumor immunity beyond direct cytotoxicity and synergize with PD‑1 blockade. Cancer Immunol Res 5(12):1141‑1151; ©2017 AACR.

Abstract

Head and neck squamous cell carcinoma (HNSCC) has been treated for decades with cisplatin chemotherapy, and anti-PD-1 immunotherapy has recently been approved for the treatment of this disease. However, preclinical studies of how antitumor immunity in HNSCC is affected by cisplatin alone or in combination with immunotherapies are lacking. Here, we show that sublethal doses of cisplatin may enhance antigen presentation and T-cell killing in vitro, though cisplatin also upregulates tumor cell expression of PD-L1 and may impair T-cell function at higher doses. In a syngeneic mouse model of HNSCC, concurrent use of cisplatin and anti-PD-L1/PD-1 delayed tumor growth and enhanced survival without significantly reducing the number or function of tumor-infiltrating immune cells or increasing cisplatin-induced toxicities. These results suggest that moderate doses of cisplatin may enhance antitumor immunity by mechanisms other than direct tumor cell killing, which may be further enhanced by anti-PD-L1/PD-1 therapy. Cancer Immunol Res; 5(12); 1141-51. ©2017 AACR.