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How does cisplatin boost checkpoint therapy?

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Cisplatin-triggered tumor ferroptosis polarized N1 neutrophils and remodeled cold NSCLC tumors toward hotter T-cell/Th1 states, synergizing with ferroptosis activators in EGFR-mutant settings.

Source

Cisplatin Promotes the Efficacy of Immune Checkpoint Inhibitor Therapy by Inducing Ferroptosis and Activating Neutrophils

Zhou Z, Zhao Y, Chen S, et al. · Frontiers in pharmacology · 2022

doi.org/10.3389/fphar.2022.870178Read the full paper ↗43 citationscc by

What they did

Studied cisplatin effects on ferroptosis and neutrophil polarization in NSCLC models (including A549/LLC systems), assessed T-cell infiltration/Th1 differentiation, and tested ferroptosis-activator combinations aimed at EGFR-mutant immunotherapy resistance.

What they found

Cisplatin induced tumor-cell ferroptosis then N1 neutrophil polarization that helped convert “cold” to “hot” tumors via T-cell infiltration and Th1 differentiation; ferroptosis activation synergized with chemoimmunotherapy in EGFR-mutant NSCLC models.

The limits

What it doesn't show

Mouse/cell mechanisms may not fully predict human EGFR-mutant responses; clinical dosing/schedule optimization was not a randomized patient trial here.

Key terms

Ferroptosis
Iron-dependent regulated cell death exploited here by cisplatin.
N1 neutrophils
Anti-tumor polarized neutrophils in the tumor microenvironment.
Cold vs hot tumor
Poor vs rich T-cell inflamed immune microenvironment.
ICI
Immune checkpoint inhibitor therapy.
EGFR-mutant NSCLC
Lung cancers with EGFR drivers often less ICI-responsive.

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Cisplatin was proposed to induce:

Common questions

Key cisplatin immune sequence?

Ferroptosis → N1 neutrophils → hotter T-cell/Th1 milieu.

Cold→hot remodeling via?

Enhanced T-cell infiltration and Th1 differentiation.

Combo idea for EGFR-mutant disease?

Add a ferroptosis activator to chemoimmunotherapy.

Example cell models?

A549 and LLC among others.