Short-term starvation reduces IGF-1 levels to sensitize lung tumors to PD-1 immune checkpoint blockade

D Ajona, S Ortiz-Espinosa, T Lozano, F Exposito… - Nature Cancer, 2020 - nature.com
D Ajona, S Ortiz-Espinosa, T Lozano, F Exposito, A Calvo, K Valencia, M Redrado…
Nature Cancer, 2020nature.com
Harnessing the immune system by blocking the programmed cell death protein 1 (PD-1)
pathway has been a major breakthrough in non-small-cell lung cancer treatment.
Nonetheless, many patients fail to respond to PD-1 inhibition. Using three syngeneic
models, we demonstrate that short-term starvation synergizes with PD-1 blockade to inhibit
lung cancer progression and metastasis. This antitumor activity was linked to a reduction in
circulating insulin-like growth factor 1 (IGF-1) and a downregulation of IGF-1 receptor (IGF …
Abstract
Harnessing the immune system by blocking the programmed cell death protein 1 (PD-1) pathway has been a major breakthrough in non-small-cell lung cancer treatment. Nonetheless, many patients fail to respond to PD-1 inhibition. Using three syngeneic models, we demonstrate that short-term starvation synergizes with PD-1 blockade to inhibit lung cancer progression and metastasis. This antitumor activity was linked to a reduction in circulating insulin-like growth factor 1 (IGF-1) and a downregulation of IGF-1 receptor (IGF-1R) signaling in tumor cells. A combined inhibition of IGF-1R and PD-1 synergistically reduced tumor growth in mice. This effect required CD8 cells, boosted the intratumoral CD8/Treg ratio and led to the development of tumor-specific immunity. In patients with non-small-cell lung cancer, high plasma levels of IGF-1 or high IGF-1R expression in tumors was associated with resistance to anti-PD-1–programmed death-ligand 1 immunotherapy. In conclusion, our data strongly support the clinical evaluation of IGF-1 modulators in combination with PD-1 blockade.
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