Immune checkpoint blockade (ICB) therapies have achieved significant breakthroughs in cancer treatment over the past decade. However, ICB is largely ineffective in desert-type gastric cancer due to intrinsic tumor heterogeneity and a highly immunosuppressive tumor microenvironment (TME). Transforming tumors from an immunosuppressive state to an immunostimulatory state is a potential approach to enhance ICB response. In this study, we developed a chromosomal instability-subtype gastric cancer mouse model with an immunoactive TME and a stem cell-originated mouse-derived allograft model with an immunosuppressed TME to investigate mechanisms regulating the tumor immunophenotype and uncover therapeutic strategies to remodel the TME. Blocking β-catenin signaling attenuated the immunochemotherapeutic resistance of mouse-derived allograft tumors. The tyrosine kinase inhibitor apatinib reprogrammed the TME by increasing CD8+ T-cell and IGHA+ plasma cell infiltration and decreasing M2 macrophages, but apatinib also induced PD-L1 and CD80 expression in both human and mouse desert-type tumors. Oxaliplatin decreased the apatinib-induced expression of immune checkpoints and enhanced the antitumor efficacy of immunotherapy. A prospective clinical trial (NCT04195828) demonstrated that a neoadjuvant regimen of apatinib plus ICB and chemotherapy was effective in patients with desert-type gastric cancer. Collectively, these findings identify potential drug targets for immune desert-type gastric cancer driven by β-catenin signaling. Significance: Apatinib combined with oxaliplatin reprograms the tumor immune microenvironment in desert-type gastric cancer, enhancing the efficacy of immune checkpoint blockade and paving the way for optimized combination immunotherapeutic strategies.
Combining Apatinib and Oxaliplatin Remodels the Immunosuppressive Tumor Microenvironment and Sensitizes Desert-Type Gastric Cancer to Immunotherapy.
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作者:Lin Guang-Tan, Yan Cheng, Li Lu-Jie, Qiu Xiao-Wen, Zhao Yu-Xuan, Lin Ju-Li, Chen Yu-Jing, Feng Chuan, Chen Shao-Qiong, Xie Jian-Wei, Zheng Chao-Hui, Nomura Sachiyo, Huang Chang-Ming, Li Ping, Cao Long-Long
期刊: | Cancer Research | 影响因子: | 16.600 |
时间: | 2025 | 起止号: | 2025 Jun 2; 85(11):2117-2133 |
doi: | 10.1158/0008-5472.CAN-24-2697 |
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