Molecular Therapy · 2018 · 122 citations · 44 references
MedicineOncologyPharmacologyCancer ImmunologyImmunotherapyMolecular OncologyCancer ImmunotherapyCheckpoint Inhibitor TherapyCombination ImmunotherapyImmune Checkpoint InhibitorsTargeted Cancer TherapyTargeted TherapyCombination Checkpoint TherapyImmune Checkpoint Blockade CombinationsImmune Checkpoint EvasionImmune Checkpoint Inhibitor TherapyResistance To Checkpoint InhibitorsT Cell CytotoxicityT Cell-mediated CytotoxicityT-cell Recruitment
Wnt/β-catenin signaling mediates cancer immune evasion and resistance to immune checkpoint therapy, in part by blocking cytokines that trigger immune cell recruitment. Inhibition of β-catenin may be an effective strategy for increasing the low response rate to these effective medicines in numerous cancer populations. DCR-BCAT is a nanoparticle drug product containing a chemically optimized RNAi trigger targeting CTNNB1, the gene that encodes β-catenin. In syngeneic mouse tumor models, β-catenin inhibition with DCR-BCAT significantly increased T cell infiltration and potentiated the sensitivity of the tumors to checkpoint inhibition. The combination of DCR-BCAT and immunotherapy yielded significantly greater tumor growth inhibition (TGI) compared to monotherapy in B16F10 melanoma, 4T1 mammary carcinoma, Neuro2A neuroblastoma, and Renca renal adenocarcinoma. Response to the RNAi-containing combination therapy was not dependent on Wnt activation status of the tumor. Importantly, this drug combination was associated with elevated levels of biomarkers of T cell-mediated cytotoxicity. Finally, when CTLA-4 and PD-1 antibodies were combined with DCR-BCAT in MMTV-Wnt1 transgenic mice, a genetic model of spontaneous Wnt-driven tumors, complete regressions were achieved in the majority of treated subjects. These data support RNAi-mediated β-catenin inhibition as an effective strategy to increase response rates to cancer immunotherapy.
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