COX-2/PGE2 axis blockade with celecoxib enhances anti-PD-1 efficacy by activating natural killer cells for residual hepatocellular carcinoma after radiofrequency ablation

塞来昔布阻断COX-2/PGE2轴可通过激活自然杀伤细胞增强抗PD-1疗法对射频消融术后残留肝细胞癌的疗效

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作者:Yu Lei # ,Yaowei Bai # ,Xiatong Bai # ,Bo Sun ,Licheng Zhu ,Wenlong Wu ,Yang Su ,Hongsen Zhang ,Yingliang Wang ,Chuansheng Zheng

Abstract

Background and aims: Radiofrequency ablation (RFA) is an effective treatment for hepatocellular carcinoma (HCC), but incomplete ablation and recurrence of residual tumors remain significant challenges, partly due to local inflammation and elevated COX-2 levels in the tumor microenvironment. This study aims to investigate the potential of combining celecoxib, a COX-2 inhibitor, with anti-PD-1 monoclonal antibody (αPD-1) to enhance anti-tumor efficacy and activate immune responses. Methods: In vitro, ELISA was used to assess the effects of radiofrequency heat treatment and celecoxib on PGE2 secretion by Hepa1-6 cells. Scanning electron microscopy, flow cytometry, and CCK-8 assays were employed to evaluate the function and cytotoxic activity of NK92 cells against Hepa1-6 cells. In vivo, orthotopic HCC mice were divided into five groups to evaluate tumor volume, pathology, and survival. The role of celecoxib in the COX-2/PGE2/NK cell axis and its impact on NK cell immune function were investigated. Results: In vitro experiments showed that celecoxib reversed PGE2-mediated suppression of NK cell function and cytotoxic activity against HCC cells by inhibiting PGE2 secretion. In vivo, orthotopic HCC mice treated with celecoxib and αPD-1 exhibited significantly reduced tumor volumes, attenuated the infiltration and activation of NK cells, and prolonged survival compared to control groups. The combination therapy also demonstrated a notable abscopal-like effect, inhibiting metastatic tumor growth and activating systemic immunity. Conclusions: Taken together, these findings suggest that celecoxib combined with αPD-1 represents a promising strategy for treating residual HCC after RFA, with enhanced anti-tumor effects and good safety. Graphical : Supplementary Information: The online version contains supplementary material available at 10.1186/s13046-025-03582-6.

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