Neoadjuvant Radiation Therapy and Surgery Improves Metastasis-Free Survival over Surgery Alone in a Primary Mouse Model of Soft Tissue Sarcoma.


Journal

Molecular cancer therapeutics
ISSN: 1538-8514
Titre abrégé: Mol Cancer Ther
Pays: United States
ID NLM: 101132535

Informations de publication

Date de publication:
03 01 2023
Historique:
received: 09 12 2021
revised: 28 06 2022
accepted: 20 09 2022
pubmed: 27 9 2022
medline: 5 1 2023
entrez: 26 9 2022
Statut: ppublish

Résumé

This study aims to investigate whether adding neoadjuvant radiotherapy (RT), anti-programmed cell death protein-1 (PD-1) antibody (anti-PD-1), or RT + anti-PD-1 to surgical resection improves disease-free survival for mice with soft tissue sarcomas (STS). We generated a high mutational load primary mouse model of STS by intramuscular injection of adenovirus expressing Cas9 and guide RNA targeting Trp53 and intramuscular injection of 3-methylcholanthrene (MCA) into the gastrocnemius muscle of wild-type mice (p53/MCA model). We randomized tumor-bearing mice to receive isotype control or anti-PD-1 antibody with or without radiotherapy (20 Gy), followed by hind limb amputation. We used micro-CT to detect lung metastases with high spatial resolution, which was confirmed by histology. We investigated whether sarcoma metastasis was regulated by immunosurveillance by lymphocytes or tumor cell-intrinsic mechanisms. Compared with surgery with isotype control antibody, the combination of anti-PD-1, radiotherapy, and surgery improved local recurrence-free survival (P = 0.035) and disease-free survival (P = 0.005), but not metastasis-free survival. Mice treated with radiotherapy, but not anti-PD-1, showed significantly improved local recurrence-free survival and metastasis-free survival over surgery alone (P = 0.043 and P = 0.007, respectively). The overall metastasis rate was low (∼12%) in the p53/MCA sarcoma model, which limited the power to detect further improvement in metastasis-free survival with addition of anti-PD-1 therapy. Tail vein injections of sarcoma cells into immunocompetent mice suggested that impaired metastasis was due to inability of sarcoma cells to grow in the lungs rather than a consequence of immunosurveillance. In conclusion, neoadjuvant radiotherapy improves metastasis-free survival after surgery in a primary model of STS.

Identifiants

pubmed: 36162051
pii: 711999
doi: 10.1158/1535-7163.MCT-21-0991
pmc: PMC9812921
mid: NIHMS1840527
doi:

Substances chimiques

Tumor Suppressor Protein p53 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

112-122

Subventions

Organisme : NCI NIH HHS
ID : U24 CA220245
Pays : United States
Organisme : NCI NIH HHS
ID : U54 CA168512
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA196667
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA014236
Pays : United States
Organisme : NCI NIH HHS
ID : R35 CA197616
Pays : United States
Organisme : NIA NIH HHS
ID : RF1 AG070149
Pays : United States

Informations de copyright

©2022 American Association for Cancer Research.

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Auteurs

Rutulkumar Patel (R)

Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina.

Yvonne M Mowery (YM)

Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina.
Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, North Carolina.

Yi Qi (Y)

Department of Radiology, Duke University Medical Center, Durham, North Carolina.

Alex M Bassil (AM)

Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina.

Matt Holbrook (M)

Department of Radiology, Duke University Medical Center, Durham, North Carolina.

Eric S Xu (ES)

Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina.

Cierra S Hong (CS)

Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina.

Jonathon E Himes (JE)

Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina.

Nerissa T Williams (NT)

Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina.

Jeffrey Everitt (J)

Department of Pathology, Duke University School of Medicine, Durham, North Carolina.

Yan Ma (Y)

Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina.

Lixia Luo (L)

Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina.

Sara R Selitsky (SR)

QuantBio LLC, Durham, North Carolina.

Jennifer L Modliszewski (JL)

QuantBio LLC, Durham, North Carolina.

Junheng Gao (J)

Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina.

Sin-Ho Jung (SH)

Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina.

David G Kirsch (DG)

Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina.
Department of Pharmacology & Cancer Biology, Duke University School of Medicine, Durham, North Carolina.

Cristian T Badea (CT)

Department of Radiology, Duke University Medical Center, Durham, North Carolina.

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