Tretinoin improves the anti-cancer response to cyclophosphamide, in a model-selective manner

Abstract Background Chemotherapy is included in treatment regimens for many solid cancers, but when administered as a single agent it is rarely curative. The addition of immune checkpoint therapy to standard chemotherapy regimens has improved response rates and increased survival in some cancers. Ho...

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Main Authors: Caitlin M. Tilsed, M. Lizeth Orozco Morales, Rachael M. Zemek, Brianna A. Gordon, Matthew J. Piggott, Anna K. Nowak, Scott A. Fisher, Richard A. Lake, W. Joost Lesterhuis
Format: Article
Language:English
Published: BMC 2024-02-01
Series:BMC Cancer
Subjects:
Online Access:https://doi.org/10.1186/s12885-024-11915-5
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author Caitlin M. Tilsed
M. Lizeth Orozco Morales
Rachael M. Zemek
Brianna A. Gordon
Matthew J. Piggott
Anna K. Nowak
Scott A. Fisher
Richard A. Lake
W. Joost Lesterhuis
author_facet Caitlin M. Tilsed
M. Lizeth Orozco Morales
Rachael M. Zemek
Brianna A. Gordon
Matthew J. Piggott
Anna K. Nowak
Scott A. Fisher
Richard A. Lake
W. Joost Lesterhuis
author_sort Caitlin M. Tilsed
collection DOAJ
description Abstract Background Chemotherapy is included in treatment regimens for many solid cancers, but when administered as a single agent it is rarely curative. The addition of immune checkpoint therapy to standard chemotherapy regimens has improved response rates and increased survival in some cancers. However, most patients do not respond to treatment and immune checkpoint therapy can cause severe side effects. Therefore, there is a need for alternative immunomodulatory drugs that enhance chemotherapy. Methods We used gene expression data from cyclophosphamide (CY) responders and non-responders to identify existing clinically approved drugs that could phenocopy a chemosensitive tumor microenvironment (TME), and tested combination treatments in multiple murine cancer models. Results The vitamin A derivative tretinoin was the top predicted upstream regulator of response to CY. Tretinoin pre-treatment induced an inflammatory, interferon-associated TME, with increased infiltration of CD8 + T cells, sensitizing the tumor to subsequent chemotherapy. However, while combination treatment significantly improved survival and cure rate in a CD4+ and CD8+ T cell dependent manner in AB1-HA murine mesothelioma, this effect was model-selective, and could not be replicated using other cell lines. Conclusions Despite the promising data in one model, the inability to validate the efficacy of combination treatment in multiple cancer models deprioritizes tretinoin/cyclophosphamide combination therapy for clinical translation.
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spelling doaj.art-604f2ab58dbd40a8bc1286fd39a00ca82024-03-05T19:22:44ZengBMCBMC Cancer1471-24072024-02-0124111110.1186/s12885-024-11915-5Tretinoin improves the anti-cancer response to cyclophosphamide, in a model-selective mannerCaitlin M. Tilsed0M. Lizeth Orozco Morales1Rachael M. Zemek2Brianna A. Gordon3Matthew J. Piggott4Anna K. Nowak5Scott A. Fisher6Richard A. Lake7W. Joost Lesterhuis8National Centre for Asbestos Related DiseasesTelethon Kids Institute, University of Western AustraliaTelethon Kids Institute, University of Western AustraliaSchool of Molecular Sciences, University of Western AustraliaSchool of Molecular Sciences, University of Western AustraliaNational Centre for Asbestos Related DiseasesNational Centre for Asbestos Related DiseasesNational Centre for Asbestos Related DiseasesNational Centre for Asbestos Related DiseasesAbstract Background Chemotherapy is included in treatment regimens for many solid cancers, but when administered as a single agent it is rarely curative. The addition of immune checkpoint therapy to standard chemotherapy regimens has improved response rates and increased survival in some cancers. However, most patients do not respond to treatment and immune checkpoint therapy can cause severe side effects. Therefore, there is a need for alternative immunomodulatory drugs that enhance chemotherapy. Methods We used gene expression data from cyclophosphamide (CY) responders and non-responders to identify existing clinically approved drugs that could phenocopy a chemosensitive tumor microenvironment (TME), and tested combination treatments in multiple murine cancer models. Results The vitamin A derivative tretinoin was the top predicted upstream regulator of response to CY. Tretinoin pre-treatment induced an inflammatory, interferon-associated TME, with increased infiltration of CD8 + T cells, sensitizing the tumor to subsequent chemotherapy. However, while combination treatment significantly improved survival and cure rate in a CD4+ and CD8+ T cell dependent manner in AB1-HA murine mesothelioma, this effect was model-selective, and could not be replicated using other cell lines. Conclusions Despite the promising data in one model, the inability to validate the efficacy of combination treatment in multiple cancer models deprioritizes tretinoin/cyclophosphamide combination therapy for clinical translation.https://doi.org/10.1186/s12885-024-11915-5CyclophosphamideTretinoinInterferonSensitisationCombination treatment
spellingShingle Caitlin M. Tilsed
M. Lizeth Orozco Morales
Rachael M. Zemek
Brianna A. Gordon
Matthew J. Piggott
Anna K. Nowak
Scott A. Fisher
Richard A. Lake
W. Joost Lesterhuis
Tretinoin improves the anti-cancer response to cyclophosphamide, in a model-selective manner
BMC Cancer
Cyclophosphamide
Tretinoin
Interferon
Sensitisation
Combination treatment
title Tretinoin improves the anti-cancer response to cyclophosphamide, in a model-selective manner
title_full Tretinoin improves the anti-cancer response to cyclophosphamide, in a model-selective manner
title_fullStr Tretinoin improves the anti-cancer response to cyclophosphamide, in a model-selective manner
title_full_unstemmed Tretinoin improves the anti-cancer response to cyclophosphamide, in a model-selective manner
title_short Tretinoin improves the anti-cancer response to cyclophosphamide, in a model-selective manner
title_sort tretinoin improves the anti cancer response to cyclophosphamide in a model selective manner
topic Cyclophosphamide
Tretinoin
Interferon
Sensitisation
Combination treatment
url https://doi.org/10.1186/s12885-024-11915-5
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