The effect of CD40 agonist antibody therapy on the pancreatic cancer microenvironment

Abstract

The fourth leading cause of cancer-related fatalities in the USA is pancreatic ductal adenocarcinoma (PDAC), a particularly deadly illness that is resistant to immunotherapy. One of the Main Obstacles in cancer research is developing better treatments for PDAC, which has the lowest 5-year survival rate of any malignancy. Anti-CTLA-4, anti-PD-L1, and anti-PD-1 immune checkpoint blockade medications also have poor results in these patients, which may indicate the presence of other immunosuppressive mechanisms in the pancreatic tumor microenvironment (TME). A new therapeutic avenue for cancer immunotherapy is CD40 activation. When CD40 is activated, it can retrain macrophages to eliminate tumor stroma and license dendritic cells to encourage anticancer T-cell activation. Several different formulations of agonist CD40 antibodies have been tested in clinical settings and determined to be both viable and tolerated. A number of agonistic CD40 monoclonal antibody (mAb) clinical trials are now underway, but little is known about the biological consequences and treatment-related regulation of the TME. Because CD40 agonist antibodies (αCD40) improve macrophage tumoricidal activity and promote antigen-presenting cell (APC) development, they may change the pancreatic TME to make it more susceptible to immune checkpoint blockage. It is believed that CD40 agonists work through T-cells and macrophages to provide antitumor effects on PDAC. Rapid tumor infiltration, tumoricidal effects, and tumor stroma depletion were all boosted by CD40-activated macrophages. Therefore, this study provides a CD40-dependent strategy for targeting tumor stroma in cancer treatment, indicating that cancer immune surveillance does not necessarily rely on therapy-induced T-cells. The purpose of this study was to examine how CD40 agonist antibody therapy might change the microenvironment and treat PDAC in humans.

Keywords: CD40 agonist antibody; Immunotherapy; Macrophage; Pancreatic cancer; T cells; Tumor microenvironment.