Dual efficacy of tocilizumab in managing PD-1 inhibitors-induced myocardial inflammatory injury and suppressing tumor growth with PD-1 inhibitors: a preclinical study

Abstract The combined use of tocilizumab (TCZ) and immune checkpoint inhibitors (ICIs) in cancer treatment is gaining attention, but preclinical studies are lacking. Our study aims to investigate the synergistic anti-tumor effect of TCZ combined with ICIs and its role in treating immune-related adve...

Full description

Saved in:
Bibliographic Details
Main Authors: Yanxin Chen, Yuxi Luo, Yunwei Liu, Daya Luo, Anwen Liu
Format: Article
Language:English
Published: Springer 2025-01-01
Series:Cancer Immunology, Immunotherapy
Subjects:
Online Access:https://doi.org/10.1007/s00262-024-03899-9
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850087246981496832
author Yanxin Chen
Yuxi Luo
Yunwei Liu
Daya Luo
Anwen Liu
author_facet Yanxin Chen
Yuxi Luo
Yunwei Liu
Daya Luo
Anwen Liu
author_sort Yanxin Chen
collection DOAJ
description Abstract The combined use of tocilizumab (TCZ) and immune checkpoint inhibitors (ICIs) in cancer treatment is gaining attention, but preclinical studies are lacking. Our study aims to investigate the synergistic anti-tumor effect of TCZ combined with ICIs and its role in treating immune-related adverse events (irAEs). The clinical significance of high interleukin-6 (IL-6) expression in tumor patients was analyzed from the Cancer Genome Atlas (TCGA) database. The expression levels of IL-6 were compared before and during the onset of ICIs-associated myocarditis patients. ICIs-related myocardial inflammatory injury and therapeutic lung cancer models were constructed in C57BL/6 J mice using murine-derived programmed death-1 (PD-1) inhibitors alone or in combination with TCZ. Possible inflammatory mechanisms were proposed and validated. The anti-tumor effects and mechanisms of both drugs in combination were assessed. Patients with high IL-6 expression had a poor prognosis, and those with ICIs-associated myocarditis exhibited elevated IL-6 from baseline. In the PD-1 inhibitors-associated myocardial inflammatory injury mouse model, the levels of IL-6 in the blood and cardiac tissues were significantly elevated. TCZ ameliorated immune myocardial inflammatory injury by inhibiting the IL-6/janus kinase 2 (JAK2)/signal transducer and activator of the transcription 3 (STAT3) pathway. The group treated with PD-1 inhibitors combined with TCZ showed significantly slower tumor growth than that treated with PD-1 inhibitors alone. TCZ resisted tumor growth by inhibiting the IL-6-JAK2-STAT3 pathway. By targeting the IL-6-JAK2-STAT3 pathway, TCZ can alleviate PD-1 inhibitors-associated myocardial inflammatory injury mediated by M1-polarized macrophages and plays a synergistic anti-tumor role by inhibiting lung cancer cell proliferation.
format Article
id doaj-art-a937b863febd419a8f1b9e80317eda4e
institution DOAJ
issn 1432-0851
language English
publishDate 2025-01-01
publisher Springer
record_format Article
series Cancer Immunology, Immunotherapy
spelling doaj-art-a937b863febd419a8f1b9e80317eda4e2025-08-20T02:43:15ZengSpringerCancer Immunology, Immunotherapy1432-08512025-01-0174211810.1007/s00262-024-03899-9Dual efficacy of tocilizumab in managing PD-1 inhibitors-induced myocardial inflammatory injury and suppressing tumor growth with PD-1 inhibitors: a preclinical studyYanxin Chen0Yuxi Luo1Yunwei Liu2Daya Luo3Anwen Liu4Department of Oncology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Oncology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Oncology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Nanchang UniversityDepartment of Oncology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityAbstract The combined use of tocilizumab (TCZ) and immune checkpoint inhibitors (ICIs) in cancer treatment is gaining attention, but preclinical studies are lacking. Our study aims to investigate the synergistic anti-tumor effect of TCZ combined with ICIs and its role in treating immune-related adverse events (irAEs). The clinical significance of high interleukin-6 (IL-6) expression in tumor patients was analyzed from the Cancer Genome Atlas (TCGA) database. The expression levels of IL-6 were compared before and during the onset of ICIs-associated myocarditis patients. ICIs-related myocardial inflammatory injury and therapeutic lung cancer models were constructed in C57BL/6 J mice using murine-derived programmed death-1 (PD-1) inhibitors alone or in combination with TCZ. Possible inflammatory mechanisms were proposed and validated. The anti-tumor effects and mechanisms of both drugs in combination were assessed. Patients with high IL-6 expression had a poor prognosis, and those with ICIs-associated myocarditis exhibited elevated IL-6 from baseline. In the PD-1 inhibitors-associated myocardial inflammatory injury mouse model, the levels of IL-6 in the blood and cardiac tissues were significantly elevated. TCZ ameliorated immune myocardial inflammatory injury by inhibiting the IL-6/janus kinase 2 (JAK2)/signal transducer and activator of the transcription 3 (STAT3) pathway. The group treated with PD-1 inhibitors combined with TCZ showed significantly slower tumor growth than that treated with PD-1 inhibitors alone. TCZ resisted tumor growth by inhibiting the IL-6-JAK2-STAT3 pathway. By targeting the IL-6-JAK2-STAT3 pathway, TCZ can alleviate PD-1 inhibitors-associated myocardial inflammatory injury mediated by M1-polarized macrophages and plays a synergistic anti-tumor role by inhibiting lung cancer cell proliferation.https://doi.org/10.1007/s00262-024-03899-9IL-6TocilizumabImmune checkpoint inhibitorsMyocardial inflammatory injury
spellingShingle Yanxin Chen
Yuxi Luo
Yunwei Liu
Daya Luo
Anwen Liu
Dual efficacy of tocilizumab in managing PD-1 inhibitors-induced myocardial inflammatory injury and suppressing tumor growth with PD-1 inhibitors: a preclinical study
Cancer Immunology, Immunotherapy
IL-6
Tocilizumab
Immune checkpoint inhibitors
Myocardial inflammatory injury
title Dual efficacy of tocilizumab in managing PD-1 inhibitors-induced myocardial inflammatory injury and suppressing tumor growth with PD-1 inhibitors: a preclinical study
title_full Dual efficacy of tocilizumab in managing PD-1 inhibitors-induced myocardial inflammatory injury and suppressing tumor growth with PD-1 inhibitors: a preclinical study
title_fullStr Dual efficacy of tocilizumab in managing PD-1 inhibitors-induced myocardial inflammatory injury and suppressing tumor growth with PD-1 inhibitors: a preclinical study
title_full_unstemmed Dual efficacy of tocilizumab in managing PD-1 inhibitors-induced myocardial inflammatory injury and suppressing tumor growth with PD-1 inhibitors: a preclinical study
title_short Dual efficacy of tocilizumab in managing PD-1 inhibitors-induced myocardial inflammatory injury and suppressing tumor growth with PD-1 inhibitors: a preclinical study
title_sort dual efficacy of tocilizumab in managing pd 1 inhibitors induced myocardial inflammatory injury and suppressing tumor growth with pd 1 inhibitors a preclinical study
topic IL-6
Tocilizumab
Immune checkpoint inhibitors
Myocardial inflammatory injury
url https://doi.org/10.1007/s00262-024-03899-9
work_keys_str_mv AT yanxinchen dualefficacyoftocilizumabinmanagingpd1inhibitorsinducedmyocardialinflammatoryinjuryandsuppressingtumorgrowthwithpd1inhibitorsapreclinicalstudy
AT yuxiluo dualefficacyoftocilizumabinmanagingpd1inhibitorsinducedmyocardialinflammatoryinjuryandsuppressingtumorgrowthwithpd1inhibitorsapreclinicalstudy
AT yunweiliu dualefficacyoftocilizumabinmanagingpd1inhibitorsinducedmyocardialinflammatoryinjuryandsuppressingtumorgrowthwithpd1inhibitorsapreclinicalstudy
AT dayaluo dualefficacyoftocilizumabinmanagingpd1inhibitorsinducedmyocardialinflammatoryinjuryandsuppressingtumorgrowthwithpd1inhibitorsapreclinicalstudy
AT anwenliu dualefficacyoftocilizumabinmanagingpd1inhibitorsinducedmyocardialinflammatoryinjuryandsuppressingtumorgrowthwithpd1inhibitorsapreclinicalstudy