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Natural Killer Cells and Their Therapeutic Role in Pancreatic Cancer : a Systematic Review

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Natural Killer Cells and Their Therapeutic Role in Pancreatic Cancer : a Systematic Review This item is the archived peer-reviewed author-version of: Natural killer cells and their therapeutic role in pancreatic cancer : a systematic review Reference: van Audenaerde Jonas, Roeyen Geert, Darcy Phillip K., Kershaw Michael H., Peeters Marc, Smits Evelien.- Natural killer cells and their therapeutic role in pancreatic cancer : a systematic review Pharmacology and therapeutics - ISSN 0163-7258 - Oxford, Pergamon-elsevier science ltd, 189(2018), p. 31-44 Full text (Publisher's DOI): https://doi.org/10.1016/J.PHARMTHERA.2018.04.003 To cite this reference: https://hdl.handle.net/10067/1536840151162165141 Institutional repository IRUA Accepted Manuscript Natural Killer cells and their therapeutic role in pancreatic cancer: A systematic review Jonas R.M. Van Audenaerde, Geert Roeyen, Phillip K. Darcy, Michael H. Kershaw, M. Peeters, Evelien L.J. Smits PII: S0163-7258(18)30066-4 DOI: doi:10.1016/j.pharmthera.2018.04.003 Reference: JPT 7208 To appear in: Please cite this article as: Jonas R.M. Van Audenaerde, Geert Roeyen, Phillip K. Darcy, Michael H. Kershaw, M. Peeters, Evelien L.J. Smits , Natural Killer cells and their therapeutic role in pancreatic cancer: A systematic review. The address for the corresponding author was captured as affiliation for all authors. Please check if appropriate. Jpt(2018), doi:10.1016/j.pharmthera.2018.04.003 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. ACCEPTED MANUSCRIPT P&T 23335 Manuscript title Natural Killer cells and their therapeutic role in pancreatic cancer: a systematic review Authors Van Audenaerde Jonas RM1,3, Roeyen Geert2, Darcy Phillip K3, Kershaw Michael H3, Peeters M1,4, Smits Evelien LJ1,5 Affiliations 1Center for Oncological Research, University of Antwerp, Antwerp, Belgium; 2Dept of Hepatobiliary, Endocrine and Transplantation Surgery, Antwerp University Hospital, Antwerp, Belgium; 3Cancer Immunotherapy and Immune Innovation Laboratory, Peter MacCallum Cancer Centre, Melbourne, Australia; 4Dept of Oncology and Multidisciplinary Oncological Centre Antwerp, Antwerp University Hospital, Antwerp, Belgium. 5Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Antwerp, Belgium; Corresponding author / contact information Jonas RM Van Audenaerde Center for Oncological Research Campus 3 Eiken – Room D.T.433 Universiteitsplein 1 B-2610 Wilrijk Belgium T: +32 3 265 25 33 Email: [email protected] ACCEPTED MANUSCRIPT Page 1 of 25 ACCEPTED MANUSCRIPT Abstract Pancreatic cancer is among the three deadliest cancers worldwide with the lowest 5-year survival of all cancers. Despite all efforts, therapeutic improvements have barely been made over the last decade. Even recent highly promising targeted and immunotherapeutic approaches did not live up to their expectations. Therefore, other horizons have to be explored. Natural Killer (NK) cells are gaining more and more interest as a highly attractive target for cancer immunotherapies, both as pharmaceutical target and for cell therapies. In this systematic review we summarise the pathophysiological adaptions of NK cells in pancreatic cancer and highlight possible (future) therapeutic NK cell-related targets. Furthermore, an extensive overview of recent therapeutic approaches with an effect on NK cells is given, including cytokine-based, viro- and bacteriotherapy and cell therapy. We also discuss ongoing clinical trials that might influence NK cells. In conclusion, although several issues regarding NK cells in pancreatic cancer remain unsolved and need further investigation, extensive evidence is already provided that support NK cell oriented approaches in pancreatic cancer. Key Words (6) Natural Killer (NK) cells; Pancreatic cancer (PDAC); Systematic review; Immunotherapy; Treatment overview; NK Cell biology; ACCEPTED MANUSCRIPT Page 2 of 25 ACCEPTED MANUSCRIPT Table of Contents 1. Introduction ............................................................................................................................................... 5 2. Methodology ............................................................................................................................................. 5 3. The Biology and physiological changes of NK cells in PDAC ...................................................................... 6 3.1. It’s all about the numbers, or not? .................................................................................................... 6 3.2. Downregulation of activating receptors ............................................................................................ 7 3.3. Factors in PDAC that influence NK cell activation ............................................................................. 8 4. The effect of the current standard of care in PDAC on NK cells ................................................................ 9 4.1. Surgery ............................................................................................................................................... 9 4.2. Chemotherapy ................................................................................................................................. 10 5. Immunomodulating therapies in PDAC with an effect on NK cells ......................................................... 11 5.1. Chemokines and Cytokines .............................................................................................................. 11 5.2. IFNα: lessons from the CapRI trials and beyond ............................................................................. 13 5.3. Viro- and bacteriotherapy ............................................................................................................... 14 5.4. Other compounds ............................................................................................................................ 15 6. Cell Therapies in PDAC ............................................................................................................................. 17 7. Conclusion ............................................................................................................................................... 18 8. Conflict of interest ................................................................................................................................... 18 9. References ............................................................................................................................................... 19 ACCEPTED MANUSCRIPT Page 3 of 25 ACCEPTED MANUSCRIPT Table of abbreviations 5-FU: 5-fluoro-uracil AAV: adeno-associated virus ADAM: ADAM metallopeptidase domain ADCC: antibody-dependent cell-mediated cytotoxicity CCL: chemokine (C-C motif) ligand CD: cluster of differentiation CTLA-4: cytotoxic T-lymphocyte–associated antigen-4 CXCL: C-X-C motif chemokine ligand DNAM-1: DNAX accessory molecule-1 FcγR: Fcγ receptor GM-CSF: granulocyte-macrophage colony-stimulating factor Gzm B: granzyme B Hsp: heat shock protein IDO-2,3: indoleamine-2,3-dioxygenase IFN: interferon IL: interleukin ILC: innate lymphoid cell imILT: immunostimulating interstitial laser thermotherapy IRE: Irreversible Electroporation KIR: killer cell immunoglobulin-like receptor MHC: major histocompatibility complex MICA/B: major histocompatibility complex class I-related chain A and B NCR: natural cytotoxicity receptors NK cell: natural killer cell NKT cell: Natural killer T cell OS: overall survival PCC: pancreatic cancer cell PD-1: programmed death-1 PDAC: pancreatic ductal adenocarcinoma PD-L1: programmed death-ligand-1 Perf: perforin PSC: pancreatic stellate cell TGFβ: transforming growth factor β TINK: tumour infiltrating natural killer cell TLR: Toll-like receptor TME: tumour microenvironment TNF: tumour necrosis factor Treg: regulatory T cell ULBP1-6: UL16 binding protein 1-6 VLP: virus-like particle ACCEPTED MANUSCRIPT Page 4 of 25 ACCEPTED MANUSCRIPT 1. Introduction Pancreatic ductal adenocarcinoma (PDAC) is among the three most deadliest cancers in Western countries, recently overtaking breast cancer (1). The 5-year survival of 7% has barely changed in 50 years and is stated as the worst of any cancer type (1, 2). PDAC has proven to be an extremely difficult-to-treat cancer because of its rapidly progressive nature and high grade of resistance to all conventional, targeted and immunotherapies (3, 4). This is painfully evidenced by an unforgiving reality test when preclinical insights are tested in the clinic (5, 6). Indeed, 47 clinical trials failed to show improvement over gemcitabine treatment, which is in sharp contrast with recent, encouraging discoveries in cancer immunotherapy in other tumour types (6). Even the highly promising immune checkpoint inhibitors programmed cell death-1 (PD-1)/programmed cell death-ligand 1 (PD-L1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) have had no significant effect in PDAC (7, 8). The tumour microenvironment (TME) is believed to be a major confounding factor involved in the failure of all these new approaches (9-13). A hallmark of this TME in PDAC is the strong desmoplastic reaction which
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