Cited by 181Cancer Immunotherapy and BiomarkersCancer, Stress, Anesthesia, and Immune ResponseExercise and Physiological Responses

The DOI matches its Crossref record; 70 of the 70 references it cites were found in a registry or an index; 9 of the 102 sources its claims cite were checked for support.

Exercise Training Improves Tumor Control by Increasing CD8+ T-cell Infiltration via CXCR3 Signaling and Sensitizes Breast Cancer to Immune Checkpoint Blockade

Open access

Published version of a preprint

Abstract

The mechanisms behind the antitumor effects of exercise training (ExTr) are not fully understood. Using mouse models of established breast cancer, we examined here the causal role of CD8+ T cells in the benefit acquired from ExTr in tumor control, as well as the ability of ExTr to improve immunotherapy responses. We implanted E0771, EMT6, MMTV-PyMT, and MCa-M3C breast cancer cells orthotopically in wild-type or Cxcr3−/− female mice and initiated intensity-controlled ExTr sessions when tumors reached approximately 100 mm3. We characterized the tumor microenvironment (TME) using flow cytometry, transcriptome analysis, proteome array, ELISA, and immunohistochemistry. We used antibodies against CD8+ T cells for cell depletion. Treatment with immune checkpoint blockade (ICB) consisted of anti–PD-1 alone or in combination with anti–CTLA-4. ExTr delayed tumor growth and induced vessel normalization, demonstrated by increased pericyte coverage and perfusion and by decreased hypoxia. ExTr boosted CD8+ T-cell infiltration, with enhanced effector function. CD8+ T-cell depletion prevented the antitumor effect of ExTr. The recruitment of CD8+ T cells and the antitumor effects of ExTr were abrogated in Cxcr3−/− mice, supporting the causal role of the CXCL9/CXCL11–CXCR3 pathway. ExTr also sensitized ICB-refractory breast cancers to treatment. Our results indicate that ExTr can normalize the tumor vasculature, reprogram the immune TME, and enhance the antitumor activity mediated by CD8+ T cells via CXCR3, boosting ICB responses. Our findings and mechanistic insights provide a rationale for the clinical translation of ExTr to improve immunotherapy of breast cancer.

Overview

Integrity signals

Registry

Crossref · 10.1158/2326-6066.cir-20-0499

Cites

0 citation errors · 0 not checkable

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Claims the paper makes

62 Own result · 47 Not checked yet · 22 Own interpretation · 10 Own method · 5 No basis given · 3 Partly supported · 1 Supported so far · accuracy not yet measured

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Show all 97 claims

  • It may state two separate claims as one. 36
  • Probably not a substantial claim. 21
  • The quote only partly states this claim. 2
53 of 53
  • The paper relies on this without support.

    The way exercise changes host immune responses against cancer, alone or with immune modulators, remains incompletely understood.

    “However, how exercise modulates host immune responses against cancer or in combination with immune modulators is not fully understood.”
  • The paper relies on this without support.

    An abnormal tumor microenvironment caused partly by poor perfusion excludes CD8+ T cells and reduces the effect of immunotherapies such as immune checkpoint blockade.

    “An abnormal TME, caused in part by hypoperfusion, results in the exclusion of CD8+ T cells and reduces the impact of immunotherapies such as ICB.”
  • The paper relies on this without support.

    C57BL/6 mice do not express functional CXCL11.

    “C57BL/6 mice do not express functional CXCL11.”
  • The paper relies on this without support.

    No prior report has described exercise training's ability to improve immunotherapy in established tumors.

    “ExTr is an emerging antitumor strategy (2,10), yet its potential to enhance immunotherapy in established tumors has not been reported.”
  • The authors state this as an assumption.

    A single exercise training velocity is suitable for every mouse strain and experimental condition.

    “We found a significant variability of ExTr dose within preclinical models, even though it is usually assumed that the same ExTr velocity would fit all mouse strains and experimental conditions.”
5 of 5

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1 of 1

Citations

Cites

Show all 70 references

Research works printed but not linked: 3

  1. Liu, 2017, Role of cytotoxic tumor-infiltrating lymphocytes in predicting outcomes in metastatic HER2-positive breast cancer: a secondary analysis of a randomized clinical trial, JAMA Oncol, 3, e172085, 10.1001/jamaoncol.2017.2085 · DOI · Paper page
  2. American College of Sports Medicine, 2018, ACSM's guidelines for exercise testing and prescription
  3. Chen, 2013, Role of macrophage polarization in tumor angiogenesis and vessel normalization: implications for new anticancer therapies, Int Rev Cell Mol Biol, 301, 1

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Metadata

Authors
Gomes-Santos, I. L., Amoozgar, Z., Kumar, A. S., Ho, W. W., Roh, K., Talele, N. P., Curtis, H., Kawaguchi, K., Jain, R. K., & Fukumura, D.
Affiliations
Harvard University (US)
Corresponding author
  • Jain, Rakesh K.
  • Fukumura, Dai
Venue
Cancer Immunology Research
Published
2021-04-10
Volume
9
Issue
7
Pages
765-778
ISSN
  • 2326-6066 (ISSN-L)
  • 2326-6074
OpenAlex
W3153058261
Cited by
181
References
74
Citations by year
2026: 46 · 2025: 34 · 2024: 42 · 2023: 27 · 2022: 29 · 2021: 2
FWCI
9.65
Type
journal article
Language
en
Open access
Locations
  • Cancer Immunology Research (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP #2014/13690–8, #2016/21320–1)
  • NCI (#R25CA174650)
Topics
  • Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Stress, Anesthesia, and Immune Response
  • Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
Keywords
exercise training, breast cancer, CD8+ T cells, CXCR3, tumor microenvironment, immune checkpoint blockade, anti-PD-1, anti-CTLA-4, tumor vasculature normalization, pericytes, tumor hypoxia, immunotherapy sensitization, antitumor immunity
MeSH terms
Immune Checkpoint Inhibitors, Animals, Breast Neoplasms, Combined Modality Therapy, Disease Models, Animal, Exercise Therapy, Female, Humans, Physical Conditioning, Animal, Signal Transduction, Mice, Knockout, CD8-Positive T-Lymphocytes, Drug Resistance, Neoplasm, Cell Line, Tumor, Mice, Receptors, CXCR3, Chemokine CXCL9, Chemokine CXCL11, Tumor Microenvironment

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