Cancer Cell International (Dec 2022)

Gaseous nitric oxide tumor ablation induces an anti-tumor abscopal effect

  • Hila Confino,
  • Frederick M. Dirbas,
  • Matan Goldshtein,
  • Shay Yarkoni,
  • Rinat Kalaora,
  • Meital Hatan,
  • Shani Puyesky,
  • Yakir Levi,
  • Lidor Malka,
  • Matt Johnson,
  • Selena Chaisson,
  • Jedidiah M. Monson,
  • Amir Avniel,
  • Steve Lisi,
  • David Greenberg,
  • Ido Wolf

DOI
https://doi.org/10.1186/s12935-022-02828-z
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 13

Abstract

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Abstract Background In-situ tumor ablation provides the immune system with the appropriate antigens to induce anti-tumor immunity. Here, we present an innovative technique for generating anti-tumor immunity by delivering exogenous ultra-high concentration (> 10,000 ppm) gaseous nitric oxide (UHCgNO) intratumorally. Methods The capability of UHCgNO to induce apoptosis was tested in vitro in mouse colon (CT26), breast (4T1) and Lewis lung carcinoma (LLC-1) cancer cell lines. In vivo, UHCgNO was studied by treating CT26 tumor-bearing mice in-situ and assessing the immune response using a Challenge assay. Results Exposing CT26, 4T1 and LLC-1 cell lines to UHCgNO for 10 s–2.5 min induced cellular apoptosis 24 h after exposure. Treating CT26 tumors in-situ with UHCgNO followed by surgical resection 14 days later resulted in a significant secondary anti-tumor effect in vivo. 100% of tumor-bearing mice treated with 50,000 ppm UHCgNO and 64% of mice treated with 20,000 ppm UHCgNO rejected a second tumor inoculation, compared to 0% in the naive control for 70 days. Additionally, more dendrocytes infiltrated the tumor 14 days post UHCgNO treatment versus the nitrogen control. Moreover, T-cell penetration into the primary tumor was observed in a dose-dependent manner. Systemic increases in T- and B-cells were seen in UHCgNO-treated mice compared to nitrogen control. Furthermore, polymorphonuclear-myeloid-derived suppressor cells were downregulated in the spleen in the UHCgNO-treated groups. Conclusions Taken together, our data demonstrate that UHCgNO followed by the surgical removal of the primary tumor 14 days later induces a strong and potent anti-tumor response.

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