Recent
experiments in mouse models have shown that injecting an inactivated flu virus
into cancer tumors makes them shrink and boosts the effectiveness of
immunotherapy.
When
it comes to cancer tumors,
many factors influence whether or not they will respond to treatment. One of
these is whether the tumors are "hot" or "cold." What does
this mean?
In
recent years, a new type of anticancer therapy has been gaining in popularity:
immunotherapy. This form of therapy works by boosting the body's own immune
response to cancer tumors.
However,
for the therapy to have a higher chance of working, the tumors have to be
"hot" tumors — that is, they must contain immune cells. If a tumor does
not contain (enough) immune cells, or contains immunosuppressant cells, it is
called a "cold" tumor.
One
question that researchers have been trying hard to answer is: How do we turn
cold tumors into hot tumors that will respond to immunotherapy?
A
team of investigators from the Rush University Medical Center in Chicago, IL,
may now have found an effective way of doing just that by using
inactivated flu viruses
— essentially, flu vaccines — in mouse model experiments.
The
researchers explain their process, as well as their findings, in a study paper
that now features in the journal PNAS.
New approach shrinks tumors in mice
The
researchers got the idea for their new study by looking at data from the
National Cancer Institute. The data indicated that people with lung cancer who
had also been in the hospital with influenza-related lung infections tended to
live longer than those with lung cancer who had not had a flu virus.
When
they recreated this scenario in mouse models, the researchers confirmed that
those with cancer tumors and influenza-related infections tended to live
longer.
Going
forward, the team wants "to understand how our strong immune responses
against pathogens like influenza and
their components could improve our much weaker immune response against some
tumors," says senior study author Dr. Andrew Zloza.
"However,"
he adds, "there are many factors we do not understand about live
infections, and this effect does not repeat in tumors where influenza
infections do not naturally occur, like skin."
So,
the researchers injected an inactivated influenza virus into melanoma tumors
in mouse models.
They
found that this "vaccine" turned tumors from cold to hot by
increasing the concentration of dendritic cells in the tumors. These cells can
stimulate an immune response, and indeed, they led to an increase in CD8+ T
cells. These can recognize and destroy cancer cells.
As
a result, the mice's melanoma tumors either grew at a slower rate or started
shrinking.
Also,
the researchers saw that delivering the flu vaccine into a melanoma tumor on
one side of a mouse's body led to the reduction not just of the growth of the
injected tumor, but also to the slower growth of another tumor, on a different
side of the body, which they had not injected.
The
researchers saw similar results when delivering the flu vaccine to tumors of
metastatic triple-negative breast
cancer in mouse models.
"Based
on this result, we hope that in [humans], injecting one tumor with an influenza
vaccine [will] lead to immune responses in their other tumors as well,"
says Dr. Zloza.
Flu shots might boost immunotherapy
"Our
successes with a flu vaccine that we created made us wonder if seasonal flu
vaccines that are already [Food and Drug Administration]-approved could be
repurposed as treatments for cancer," Dr. Zloza adds.
"Since these have been used in millions of people and
have already been shown to be safe, we thought using flu shots to treat cancer
could be brought to patients quickly."
Dr. Andrew Zloza
The
researchers therefore worked with specially engineered mouse models, into which
they were able to transplant both tumors and immune cells from humans with lung
cancer and metastatic melanoma.
Dr.
Zloza and colleagues found that injecting these human-derived tumors with a
regular, FDA-approved flu shot led them to shrink.
"Such
[a] transplant allows us to utilize patient-grade drugs in a living system.
This is as close as we can get to testing something ahead of a clinical
trial," he explains.
The
researchers also wanted to see if they could use flu shots as an adjuvant
therapy — that is, as an aid to existing anticancer therapies.
So,
in additional experiments, they delivered the flu shots alongside a form of
immunotherapy that relies on immune checkpoint inhibitors. These are drugs that
stimulate immune cells to mount an attack against cancer tumors.
In
doing this, the researchers found two things. The first was that the flu
vaccines were able to reduce tumor growth on their own, regardless of whether
or not the targeted tumor responded to checkpoint inhibitor therapy.
The
second was that when the tumor did respond to immunotherapy, the flu shot
combination led to an even more pronounced reduction in tumor growth.
"These
results propose that eventually both [people] who respond and who do not
respond to other immunotherapies might benefit from the injection of influenza
vaccines into the tumor, and it may increase the small proportion of patients
that are now long-term responders to immunotherapies," says Dr. Zloza.
"Since
humans and mice are about 95% genetically identical, the hope is that this
approach will work in patients. The next step planned is to conduct clinical
trials to test various factors," he concludes.
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