Cisplatin unleashes Toll-like receptor 3-mediated apoptosis through the downregulation of c-FLIP in malignant mesothelioma

Cancer Lett. 2020 Mar 1;472:29-39. doi: 10.1016/j.canlet.2019.12.016. Epub 2019 Dec 12.


Toll-like receptor 3 (TLR3) is an immune receptor that behaves like a death receptor in tumor cells, thereby providing an original target for cancer therapy. The therapeutic potential of TLR3 targeting in malignant mesothelioma, an aggressive and incurable neoplasia of the pleura and peritoneum, has so far not been addressed. We investigated TLR3 expression and sensitivity of human mesothelioma cell lines to the synthetic dsRNA Poly(I:C), alone or in combination with cisplatin, the gold standard chemotherapy in mesothelioma. Activation of TLR3 by Poly(I:C) induced apoptosis of 4/8 TLR3-positive cell lines but not of TLR3-negative cell lines. The combined cisplatin/Poly(I:C) treatment enhanced apoptosis of 3/4 Poly(I:C)-sensitive cell lines and overcame resistance to Poly(I:C) or cisplatin alone in 2/4 cell lines. Efficacy of the combined treatment relied on cisplatin-induced downregulation of c-FLIP, the main regulator of the extrinsic apoptotic pathway, leading to an enhanced caspase-8-mediated pathway. Of note, 6/6 primary cell samples isolated from patients with peritoneal mesothelioma expressed TLR3. Patient-derived cells were sensitive to Poly(I:C) alone while the combined cisplatin/Poly(I:C) treatment induced dramatic cell death. Our findings demonstrate that TLR3 targeting in combination with cisplatin presents an innovative therapeutic strategy in mesothelioma.

Keywords: Apoptosis; Immune receptor; Inflammation; Mesothelioma; Therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Apoptosis / drug effects*
  • CASP8 and FADD-Like Apoptosis Regulating Protein / genetics*
  • Caspase 8 / genetics
  • Cell Line, Tumor
  • Cell Proliferation / drug effects
  • Cisplatin / pharmacology
  • Gene Expression Regulation, Neoplastic / drug effects
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / physiopathology
  • Mesothelioma / drug therapy*
  • Mesothelioma / genetics
  • Mesothelioma / physiopathology
  • Mesothelioma, Malignant
  • Poly I-C / pharmacology
  • Signal Transduction / drug effects
  • Toll-Like Receptor 3 / genetics*


  • CASP8 and FADD-Like Apoptosis Regulating Protein
  • CFLAR protein, human
  • TLR3 protein, human
  • Toll-Like Receptor 3
  • CASP8 protein, human
  • Caspase 8
  • Poly I-C
  • Cisplatin