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Comparison of metabolic and immunologic responses to transarterial chemoembolization with different chemoembolic regimens in a rabbit VX2 liver tumor model
Ist Teil von
European radiology, 2022-04, Vol.32 (4), p.2437-2447
Ort / Verlag
Berlin/Heidelberg: Springer Berlin Heidelberg
Erscheinungsjahr
2022
Quelle
MEDLINE
Beschreibungen/Notizen
Objectives
The goal of this study was to investigate the effects of TACE using Lipiodol, Oncozene™ drug-eluting embolics (DEEs), or LUMI™-DEEs alone, or combined with bicarbonate on the metabolic and immunological tumor microenvironment in a rabbit VX2 tumor model.
Methods
VX2 liver tumor-bearing rabbits were assigned to five groups. MRI and extracellular pH (pH
e
) mapping using Biosensor Imaging of Redundant Deviation in Shifts (BIRDS) were performed before and after intra-arterial therapy with conventional TACE (cTACE), DEE-TACE with Idarubicin-eluting Oncozene™-DEEs, or Doxorubicin-eluting LUMI™-DEEs, each with or without prior bicarbonate infusion, and in untreated rabbits or treated with intra-arterial bicarbonate only. Imaging results were validated with immunohistochemistry (IHC) staining of cell viability (PCNA, TUNEL) and immune response (HLA-DR, CD3). Statistical analysis was performed using Mann–Whitney
U
test.
Results
pH
e
mapping revealed that combining cTACE with prior bicarbonate infusion significantly increased tumor pH
e
compared to control (
p
= 0.0175) and cTACE alone (
p
= 0.0025). IHC staining revealed peritumoral accumulation of HLA-DR
+
antigen-presenting cells and CD3 + T-lymphocytes in controls. cTACE-treated tumors showed reduced immune infiltration, which was restored through combination with bicarbonate. DEE-TACE with Oncozene™-DEEs induced moderate intratumoral and marked peritumoral infiltration, which was slightly reduced with bicarbonate. Addition of bicarbonate prior to LUMI™-beads enhanced peritumoral immune cell infiltration compared to LUMI™-beads alone and resulted in the strongest intratumoral immune cell infiltration across all treated groups.
Conclusions
The choice of chemoembolic regimen for TACE strongly affects post-treatment TME pH
e
and the ability of immune cells to accumulate and infiltrate the tumor tissue.
Key Points
•
Combining conventional transarterial chemotherapy with prior bicarbonate infusion increases the pH
e
towards a more physiological value (p
=
0.0025).
•
Peritumoral infiltration and intratumoral accumulation patterns of antigen-presenting cells and T-lymphocytes after transarterial chemotherapy were dependent on the choice of the chemoembolic regimen.
•
Combination of intra-arterial treatment with Doxorubicin-eluting LUMI™-beads and bicarbonate infusion resulted in the strongest intratumoral presence of immune cells (positivity index of 0.47 for HLADR
+
-cells and 0.62 for CD3
+
-cells).