Hyperthermic Intrathoracic Chemotherapy Modulates the Immune Microenvironment of Pleural Mesothelioma and Improves the Impact of Dual Immune Checkpoint Inhibition

Pleural mesothelioma is a fatal disease with limited treatment options. Recently, pleural mesothelioma management has improved with the development of immune checkpoint inhibitors (ICI). In first-line therapy, dual PD-1 and CTLA-4 blockade enhances tumor control and patient survival compared with chemotherapy. Unfortunately, only a fraction of patients is responsive to immunotherapy, and approaches to reshape the tumor immune microenvironment and make ICIs more effective are urgently required. In this study, we evaluated the effect of hyperthermic intrathoracic chemotherapy (HITOC), a treatment that combines fever-range hyperthermia with local intrapleural cisplatin chemotherapy, on the tumor immune microenvironment and response to ICIs. To do this, we developed a murine pleural mesothelioma model of HITOC. We found that HITOC significantly improved tumor control and animal survival through a mechanism involving the development of a cytotoxic immune response. Additionally, HITOC enhanced immune checkpoint expression by T lymphocytes and synergized with dual PD-1 and CTLA-4 inhibition, leading to further improvement in animal survival. Finally, the analysis of peritoneal mesothelioma patient samples treated by pressurized intraperitoneal aerosol chemotherapy revealed a similar immunomodulation. In conclusion, HITOC remodels the tumor immune microenvironment of pleural mesothelioma by promoting T-cell infiltration into the tumor and could be considered in combination with ICIs in the context of a clinical trial.

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Publication Details

Journal
Cancer Immunology Research
Published
2024-11-25
DOI
https://doi.org/10.1158/2326-6066.cir-24-0245
Citations
4
Primary Topic
Occupational and environmental lung diseases
Type
article
Field-Weighted Citation Impact
1.68

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article

Hyperthermic Intrathoracic Chemotherapy Modulates the Immune Microenvironment of Pleural Mesothelioma and Improves the Impact of Dual Immune Checkpoint Inhibition

Olga De Souza Silva, Etienne Meylan, Johanna A. Joyce, Aspasia Gkasti et al.
4 citations
Cancer Immunology Research
Occupational and environmental lung diseases
1.68
article

Hyperthermic Intrathoracic Chemotherapy Modulates the Immune Microenvironment of Pleural Mesothelioma and Improves the Impact of Dual Immune Checkpoint Inhibition

Olga De Souza Silva, Etienne Meylan, Johanna A. Joyce, Aspasia Gkasti, Daniel Clerc, Etienne Abdelnour‐Berchtold, Michel González, Paul J. Dyson, Christine Sempoux, Damien N. Marie, Solange Peters, Martin Hübner, Louis-Emmanuel Chriqui, Julien Dagher, Yameng Hao, Jean Yannis Perentes, Hugo Teixeira Farinha, Amy J. Managh, Sabrina Cavin, Michel Christodoulou, Thorsten Krueger, Alexandros Sifis, Luca Tiron
article en
4 citations

Abstract

Pleural mesothelioma is a fatal disease with limited treatment options. Recently, pleural mesothelioma management has improved with the development of immune checkpoint inhibitors (ICI). In first-line therapy, dual PD-1 and CTLA-4 blockade enhances tumor control and patient survival compared with chemotherapy. Unfortunately, only a fraction of patients is responsive to immunotherapy, and approaches to reshape the tumor immune microenvironment and make ICIs more effective are urgently required. In this study, we evaluated the effect of hyperthermic intrathoracic chemotherapy (HITOC), a treatment that combines fever-range hyperthermia with local intrapleural cisplatin chemotherapy, on the tumor immune microenvironment and response to ICIs. To do this, we developed a murine pleural mesothelioma model of HITOC. We found that HITOC significantly improved tumor control and animal survival through a mechanism involving the development of a cytotoxic immune response. Additionally, HITOC enhanced immune checkpoint expression by T lymphocytes and synergized with dual PD-1 and CTLA-4 inhibition, leading to further improvement in animal survival. Finally, the analysis of peritoneal mesothelioma patient samples treated by pressurized intraperitoneal aerosol chemotherapy revealed a similar immunomodulation. In conclusion, HITOC remodels the tumor immune microenvironment of pleural mesothelioma by promoting T-cell infiltration into the tumor and could be considered in combination with ICIs in the context of a clinical trial.

Cancer Immunology ResearchVol. 13(2)
Université Libre de Bruxelles (BE), Loughborough University (GB), Institut Jules Bordet (BE), Centre Hospitalier Universitaire Vaudois (CH), Ludwig Cancer Research (CH), Swiss Cancer Center Léman (CH), Hôpital du Valais (CH), École Polytechnique Fédérale de Lausanne (CH), University of Lausanne (CH)
Krebsliga Schweiz, China Scholarship Council, Fondation ISREC
Good health and well-being
Openalex Percentile: Top 14%
Occupational and environmental lung diseases
1.68
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