RRC ID 89676
Author Hosoya K, Ozasa H, Tsuji T, Oi M, Shima Y, Suminaga K, Hashimoto K, Yoshida H, Funazo T, Ajimizu H, Nomizo T, Yoshida H, Katsuragawa H, Tsuji K, Sano N, Takada S, Mineharu Y, Nishikawa S, Menju T, Yoshizawa A, Arakawa Y, Wake H, Hirai T.
Title Anti-PD-1 plus anti-CTLA-4 blockade overcomes immune exclusion in NSCLC brain metastases by enhancing CD8+ T cell responses and promoting tertiary lymphoid structure formation.
Journal Nat Commun
Abstract Brain metastases (BrMs) in non-small cell lung cancer (NSCLC) respond poorly to anti-PD-1 monotherapy, but the underlying immune resistance remains incompletely defined. Here we integrate clinical outcome analyses, paired human tissue profiling and syngeneic mouse models to characterize the BrM immune microenvironment. Clinical analyses suggest improved intracranial disease control with nivolumab plus ipilimumab compared with nivolumab alone. Paired human specimens show that BrMs contain fewer cytotoxic T lymphocytes (CTLs) and tertiary lymphoid structures (TLSs) than primary tumors, defining an immune-excluded phenotype. A syngeneic BrM model recapitulates this phenotype and resists anti-PD-1 monotherapy, whereas combined anti-PD-1 and anti-CTLA-4 blockade suppresses tumor growth and prolongs survival. Single-cell RNA sequencing, flow cytometry and immunofluorescence show increased CTL infiltration and effector function after combination therapy. CD8+ T cell depletion abrogates therapeutic benefit, and combination therapy expands T follicular helper-like cells and induces TLS-like structures. These findings manifest increased adaptive immune response of dual checkpoint blockade in NSCLC BrMs.
Volume 17(1)
Published 2026-7-7
DOI 10.1038/s41467-026-74782-7
PII 10.1038/s41467-026-74782-7
PMID 42414284
PMC PMC13342341
MeSH Animals Brain Neoplasms* / drug therapy Brain Neoplasms* / immunology Brain Neoplasms* / secondary CD8-Positive T-Lymphocytes* / drug effects CD8-Positive T-Lymphocytes* / immunology CTLA-4 Antigen* / antagonists & inhibitors CTLA-4 Antigen* / immunology Carcinoma, Non-Small-Cell Lung* / drug therapy Carcinoma, Non-Small-Cell Lung* / immunology Carcinoma, Non-Small-Cell Lung* / pathology Cell Line, Tumor Female Humans Immune Checkpoint Inhibitors* / pharmacology Immune Checkpoint Inhibitors* / therapeutic use Ipilimumab / pharmacology Ipilimumab / therapeutic use Lung Neoplasms* / drug therapy Lung Neoplasms* / immunology Lung Neoplasms* / pathology Mice Mice, Inbred C57BL Programmed Cell Death 1 Receptor* / antagonists & inhibitors Programmed Cell Death 1 Receptor* / immunology T-Lymphocytes, Cytotoxic / drug effects T-Lymphocytes, Cytotoxic / immunology Tertiary Lymphoid Structures* / immunology Tertiary Lymphoid Structures* / pathology Tumor Microenvironment / drug effects Tumor Microenvironment / immunology
Resource
DNA material pcDNA3 Venus-Akaluc (RDB15781)