Synergistic Effects of Cabozantinib and EGFR-Specific CAR-NK-92 Cells in Renal Cell Carcinoma

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Abstract
The chimeric antigen receptor-modified immune effector cell (CAR-T and CAR-NK) therapies are newly developed adoptive treatments of cancers. However, their therapeutic efficacy against solid tumors is limited. Combining CAR-T or CAR-NK cells with chemotherapeutic drugs to treat solid tumor may be a promising strategy. We developed an epidermal growth factor- (EGFR-) specific third-generation CAR. NK-92 cells were modified with the CAR by lentivirus infection. The specific killing ability of the CAR-modified NK-92 cells (CAR-NK-92) against renal cell carcinoma (RCC) cell lines was confirmed in vitro. The synergistic effects of cabozantinib and EGFR-specific CAR-NK-92 cells were investigated in vitro and in vivo. Our results showed that the CAR-NK-92 cells lyse RCC cells in an EGFR-specific manner. Treatment with cabozantinib could increase EGFR and decrease PD-L1 membrane surface expression in RCC cells and enhance the killing ability of CAR-NK-92 cells against the RCC cells in vitro. Furthermore, the CAR-NK-92 cells show synergistic therapeutic efficacy with cabozantinib against human RCC xenograft models. Our results provided the basis for combination with chemotherapy as a novel strategy for enhancing the therapeutic efficacy of CAR-modified immune effector cells for solid tumors.
Funding Information
  • Natural Science Foundation of Shandong Province (ZR2015JL027, BK20161157, BK2012146, BE2016643, 81301946)
  • Natural Science Foundation of Jiangsu Province (ZR2015JL027, BK20161157, BK2012146, BE2016643, 81301946)
  • Natural Science Foundation of Jiangsu Province (ZR2015JL027, BK20161157, BK2012146, BE2016643, 81301946)
  • Jiangsu Province Social Development Key Projects (ZR2015JL027, BK20161157, BK2012146, BE2016643, 81301946)
  • National Natural Science Foundation of China (ZR2015JL027, BK20161157, BK2012146, BE2016643, 81301946)

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