Synergistic therapeutic combination with a CAF inhibitor enhances CAR-NK-mediated cytotoxicity via reduction of CAF-released IL-6
Open accessAbstract
Background: Cancer-associated fibroblasts (CAFs) in the tumor microenvironment (TME) contribute to an impaired functionality of natural killer (NK) cells that have emerged as a promising therapeutic modality. The interaction between CAFs and NK cells within the TME exerts major inhibitory effects on immune responses, indicating CAF-targeted therapies as potential targets for effective NK-mediated cancer killing. Methods: To overcome CAF-induced NK dysfunction, we selected an antifibrotic drug, nintedanib, for synergistic therapeutic combination. To evaluate synergistic therapeutic efficacy, we established an in vitro 3D Capan2/patient-derived CAF spheroid model or in vivo mixed Capan2/CAF tumor xenograft model. The molecular mechanism of NK-mediated synergistic therapeutic combination with nintedanib was revealed through in vitro experiments. In vivo therapeutic combination efficacy was subsequently evaluated. Additionally, the expression score of target proteins was measured in patient-derived tumor sections by the immunohistochemical method. Results: Nintedanib blocked the platelet-derived growth factor receptor β (PDGFRβ) signaling pathway and diminished the activation and growth of CAFs, markedly reducing CAF-secreted IL-6. Moreover, coadministration of nintedanib improved the mesothelin (MSLN) targeting chimeric antigen receptor-NK-mediated tumor killing abilities in CAF/tumor spheroids or a xenograft model. The synergistic combination resulted in intense NK infiltration in vivo. Nintedanib alone exerted no effects, whereas blockade of IL-6 trans-signaling ameliorated the function of NK cells. The combination of the expression of MSLN and the PDGFRβ+-CAF population area, a potential prognostic/therapeutic marker, was associated with inferior clinical outcomes. Conclusion: Our strategy against PDGFRβ+-CAF-containing pancreatic cancer allows improvements in the therapy of pancreatic ductal adenocarcinoma.
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Nintedanib can inhibit CAF infiltration.
“It has been reported that nintedanib can inhibit CAF infiltration 50”
From TBX3 shapes an immunosuppressive microenvironment and induces immunotherapy resistance (2025) · cites this paper as [50]
The Results section on MSLN-targeted CAR-NK treatment (page unavailable) reports significantly reduced CAF populations in tumor sections from nintedanib-treated mice. The Results also report fewer CAFs in treated spheroid co-cultures, but attribute that reduction to effects including CAF cell death; the paper does not establish that nintedanib inhibits CAF infiltration into tumors. (LLM, conf=0.85)
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- Authors
- Lee, Y. E., Go, G.-Y., Koh, E.-Y., Yoon, H.-N., Seo, M., Hong, S.-M., Jeong, J. H., Kim, J.-C., Cho, D., Kim, T. S., Kim, S. C., Jun, E., & Jang, M.
- Affiliations
- Korea University (KR)
- Korea Institute of Science and Technology (KR)
- Asan Medical Center (KR)
- Corporate Research & Development Center, UCI therapeutics, Seoul, Korea (the Republic of)
- Samsung Medical Center (KR)
- Kyung Hee University (KR)
- Corresponding author
- Kim, Song Cheol
- Jun, Eunsung
- Jang, Mihue
- ORCID
- Venue
- Journal for ImmunoTherapy of Cancer
- Publisher
- BMJ
- Published
- 2023-02
- Volume
- 11
- Issue
- 2
- Pages
- e006130
- ISSN
- 2051-1426 (ISSN-L)
- PMC
- PMC9972461
- OpenAlex
- W4322505517
- Cited by
- 61
- References
- 51
- Citations by year
- 2026: 12 · 2025: 30 · 2024: 15 · 2023: 4
- FWCI
- 6.69
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal for ImmunoTherapy of Cancer (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Ministry of Science and ICT, Ministry of Trade, Industry, and Energy, and Ministry of Health and Welfare (RS-2022-00166088)
- Asan Institute for Life Sciences, Asan Medical Center (2021IP0020-1)
- National Research Foundation of Korea (2020M3A9I4038662, 2020M3A9I4038667, 2020R1C1C1006421)
- Samsung Research Funding & Incubation Center of Samsung Electronics (SRFC-TC2003-02)
- Korea Institute of Science and Technology (2E31621, 2V09550)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Immune Cell Function and Interaction
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Oncology › CAR-T cell therapy research
- Keywords
- cancer-associated fibroblasts, nintedanib, CAR-NK cells, mesothelin, interleukin-6, PDGFRβ signaling, pancreatic ductal adenocarcinoma, tumor microenvironment, NK cell dysfunction, antifibrotic therapy, IL-6 trans-signaling, NK cell infiltration, CAF-targeted therapy
- MeSH terms
- Cancer-Associated Fibroblasts, Receptors, Chimeric Antigen, Humans, Pancreatic Neoplasms, Interleukin-6, Tumor Microenvironment
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