Cyclooxygenase-2 Inhibitor: A Potential Combination Strategy With Immunotherapy in Cancer.

Dan Pu,Lin Huang,Yan Li,Changlong Qin,Qiang Wu,Qinghua Zhou,Lu Li,Liyuan Yin,Yuwen Zhou

doi:10.3389/fonc.2021.637504

Abstract

The clinical application of immunotherapy is the milestone of cancer treatment. However, some patients have bad reaction. Cyclooxygenase-2 (COX-2) is frequently expressed in multiple cancer cells and is associated with poor prognosis. It is the key enzyme of prostaglandin E2 (PGE2) that has been proved to promote the development, proliferation and metastasis of tumor cells. Recent studies further find the PGE2 in tumor microenvironment (TME) actively triggers tumor immune evasion via many ways, leading to poor response of immunotherapy. COX-2 inhibitor is suggested to restrain the immunosuppression of PGE2 and may enhance or reverse the response of immune checkpoint inhibitors (ICIs). This review provides insight into the mechanism of COX-2/PGE2 signal in immunosuppressive TME and summarizes the clinical application and trials in cancer treatment.

Highlights

Previous evidences suggested that the impact of COX-2/prostaglandin E2 (PGE2) signal pathway in tumor microenvironment (TME) plays an important role in immunosuppression and further induces immune checkpoint inhibitors (ICIs) resistance
COX-2 derived PGE2 helps TME transformed from an anti-tumor response to an immunosuppressive response in a variety of ways, becoming an accomplice of cancer cell immune escape (Figure 1)
The COX-2/PGE2 signal is a promising target in combination with immunotherapy

Summary

INTRODUCTION

Previous evidences suggested that the impact of COX-2/PGE2 signal pathway in TME plays an important role in immunosuppression and further induces ICIs resistance. COX-2 deficiency resulted in low expression of immunosuppression factors like IL-6, IL-10, and CXCL1, while the mRNA of anti-tumor immune mediators are significantly increased, such as IFN-g, T-bet, CXCL10, and IL-12 [36]. COX-2 derived PGE2 helps TME transformed from an anti-tumor response to an immunosuppressive response in a variety of ways, becoming an accomplice of cancer cell immune escape (Figure 1). The benefit of COX-2 inhibitor might be based on the immune activation combined with ICI and chemotherapy plays a supporting role in it, which need to be further study in clinical practice.

Recruiting

Findings

CONCLUSION