5-Aza-2'-deoxycytidine potentiates antitumour immune response induced by photodynamic therapy

Eur J Cancer. 2014 May;50(7):1370-81. doi: 10.1016/j.ejca.2014.01.017. Epub 2014 Feb 18.


Photodynamic therapy (PDT) of tumours is based on administration of a photosensitiser followed by irradiation of the tumour with visible light leading to production of reactive oxygen species that cause direct tumour cell death and vascular damage. PDT also initiates acute local inflammation, which facilitates the development of adaptive antitumour immunity. It has recently been reported that PDT can induce strong antitumour immunity towards tumours cells expressing P1A, tumour-associated antigen. Using four different tumour models, we show that antitumour immune response can be further improved when PDT is combined with a clinically approved epigenetic agent that induces expression of a silenced P1A antigen. Induction of P1A with 5-aza-2'-deoxycytidine, a methyltransferase inhibitor, resulted in potentiated antitumour effects in mice with Lewis lung carcinoma and 4T1 mammary carcinoma when combined with PDT treatment. In CT26 colon carcinoma and EMT6 mammary carcinoma models the combination therapy resulted in complete responses and long-term survival. All long-term surviving mice were resistant to re-inoculation with the same tumour cells. Antitumour efficacy of the combination treatment was severely impaired by depletion of CD8(+) cytotoxic T cells, whereas adoptive transfer of CD8(+) T cells from long-term surviving mice allowed for significant tumour growth delay in tumour-bearing mice. Taken together, these findings show that PDT leads to strong specific antitumour immune responses, and that epigenetic modification of tumour antigens levels may be a novel approach to further enhance the effectiveness of PDT. The present results provide a strong rationale for clinical development of this therapeutic approach.

Keywords: 5-Aza-2′-deoxycitidine; Cancer; Photodynamic therapy; Specific antitumour immunity; Tumour associated antigens.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antigens, Neoplasm / metabolism*
  • Antimetabolites, Antineoplastic / pharmacology*
  • Azacitidine / analogs & derivatives*
  • Azacitidine / pharmacology
  • CD8-Positive T-Lymphocytes / immunology
  • Carcinoma, Lewis Lung / drug therapy*
  • Carcinoma, Lewis Lung / immunology
  • Cell Line, Tumor
  • Decitabine
  • Disease Models, Animal
  • Female
  • Flow Cytometry
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / immunology
  • Mice
  • Mice, Inbred BALB C
  • Mice, Inbred C57BL
  • Photochemotherapy*
  • Reverse Transcriptase Polymerase Chain Reaction


  • Antigens, Neoplasm
  • Antimetabolites, Antineoplastic
  • cancer-testis antigen P1A, mouse
  • Decitabine
  • Azacitidine