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Publication : Cancer immunotherapy via targeted TGF-β signalling blockade in T<sub>H</sub> cells.

First Author  Li S Year  2020
Journal  Nature Volume  587
Issue  7832 Pages  121-125
PubMed ID  33087933 Mgi Jnum  J:297413
Mgi Id  MGI:6472597 Doi  10.1038/s41586-020-2850-3
Citation  Li S, et al. (2020) Cancer immunotherapy via targeted TGF-beta signalling blockade in TH cells. Nature 587(7832):121-125
abstractText  Cancer arises from malignant cells that exist in dynamic multilevel interactions with the host tissue. Cancer therapies aiming to directly kill cancer cells, including oncogene-targeted therapy and immune-checkpoint therapy that revives tumour-reactive cytotoxic T lymphocytes, are effective in some patients(1,2), but acquired resistance frequently develops(3,4). An alternative therapeutic strategy aims to rectify the host tissue pathology, including abnormalities in the vasculature that foster cancer progression(5,6); however, neutralization of proangiogenic factors such as vascular endothelial growth factor A (VEGFA) has had limited clinical benefits(7,8). Here, following the finding that transforming growth factor-beta (TGF-beta) suppresses T helper 2 (TH2)-cell-mediated cancer immunity(9), we show that blocking TGF-beta signalling in CD4(+) T cells remodels the tumour microenvironment and restrains cancer progression. In a mouse model of breast cancer resistant to immune-checkpoint or anti-VEGF therapies(10,11), inducible genetic deletion of the TGF-beta receptor II (TGFBR2) in CD4(+) T cells suppressed tumour growth. For pharmacological blockade, we engineered a bispecific receptor decoy by attaching the TGF-beta-neutralizing TGFBR2 extracellular domain to ibalizumab, a non-immunosuppressive CD4 antibody(12,13), and named it CD4 TGF-beta Trap (4T-Trap). Compared with a non-targeted TGF-beta-Trap, 4T-Trap selectively inhibited TH cell TGF-beta signalling in tumour-draining lymph nodes, causing reorganization of tumour vasculature and cancer cell death, a process dependent on the TH2 cytokine interleukin-4 (IL-4). Notably, the 4T-Trap-induced tumour tissue hypoxia led to increased VEGFA expression. VEGF inhibition enhanced the starvation-triggered cancer cell death and amplified the antitumour effect of 4T-Trap. Thus, targeted TGF-beta signalling blockade in helper T cells elicits an effective tissue-level cancer defence response that can provide a basis for therapies directed towards the cancer environment.
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