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CD47 blockade improves the therapeutic effect of osimertinib in non-small cell lung cancer |
Wei-Bang Yu1, Yu-Chi Chen1, Can-Yu Huang1, Zi-Han Ye1, Wei Shi1, Hong Zhu2, Jia-Jie Shi1, Jun Chen3, Jin-Jian Lu1,4,5() |
1. State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao 999078, China 2. Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, and Cancer Center of Zhejiang University, Zhejiang University, Hangzhou 310000, China 3. Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510000, China 4. Department of Pharmaceutical Sciences, Faculty of Health Sciences, University of Macau, Macao 999078, China 5. MoE Frontiers Science Center for Precision Oncology, University of Macau, Macao 999078, China |
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Abstract The third-generation epidermal growth factor receptor (EGFR) inhibitor osimertinib (OSI) has been approved as the first-line treatment for EGFR-mutant non-small cell lung cancer (NSCLC). This study aims to explore a rational combination strategy for enhancing the OSI efficacy. In this study, OSI induced higher CD47 expression, an important anti-phagocytic immune checkpoint, via the NF-κB pathway in EGFR-mutant NSCLC HCC827 and NCI-H1975 cells. The combination treatment of OSI and the anti-CD47 antibody exhibited dramatically increasing phagocytosis in HCC827 and NCI-H1975 cells, which highly relied on the antibody-dependent cellular phagocytosis effect. Consistently, the enhanced phagocytosis index from combination treatment was reversed in CD47 knockout HCC827 cells. Meanwhile, combining the anti-CD47 antibody significantly augmented the anticancer effect of OSI in HCC827 xenograft mice model. Notably, OSI induced the surface exposure of “eat me” signal calreticulin and reduced the expression of immune-inhibitory receptor PD-L1 in cancer cells, which might contribute to the increased phagocytosis on cancer cells pretreated with OSI. In summary, these findings suggest the multidimensional regulation by OSI and encourage the further exploration of combining anti-CD47 antibody with OSI as a new strategy to enhance the anticancer efficacy in EGFR-mutant NSCLC with CD47 activation induced by OSI.
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Keywords
osimertinib
anti-CD47 antibody
combination strategy
ADCP
EGFR
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Corresponding Author(s):
Jin-Jian Lu
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Just Accepted Date: 01 September 2022
Online First Date: 23 November 2022
Issue Date: 15 March 2023
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