A HER2-Target Antibody Drug Conjugate Combined with anti-PD-(L)1 Treatment Eliminates hHER2 + Tumors in hPD-1 Transgenic Mouse Model and Contributes Immune Memory Formation

Abstract Purpose: Disitamab vedotin (RC48) is an HER2-directed antibody-drug conjugate, emerging as an effective strategy for cancer therapy, not only enhance antitumor immunity in previous animal models but also improve clinical outcomes for patients such as with gastric cancer, urothelium carcinoma and HER2 low-expressing breast cancer. Here, we explore the combination therapeutic efficacy of this novel HER2-targeting ADC with immune checkpoint inhibitors in a human HER2-expressing syngeneic breast cancer model. Methods: The human HER2+ cancer cell line is constructed by stably transfection and individual clones were isolated by single-cell sorting. Flow cytometry was performed to determine its binding activity. Cytotoxic effect was determined using an MTT assay with the supplement of RC48. Human PD-1 transgenic mice were used to analyze the in vivo anti-tumor effects of the ADC and its combination therapy with PD-1/PD-L1 antibody. Results: The combination of RC48 and PD-1/PD-L1 immune checkpoint inhibition significantly enhanced tumor suppression and antitumor immunity. Tumor rejection in the synergistic groups was accompanied by massive T-cell infiltration and immune marker activation. Furthermore, the combination therapy promoted immunological memory formation in the tumor-eradication animals, protecting them from tumor rechallenge. Conclusion: A novel HER2-targeting ADC combined with immune checkpoint inhibitors can achieve remarkable effects in mice and elicit long-lasting immune protection in a hHER2+ murine breast cancer model. This study provides insights into the efficacy of RC48 therapeutic activity and a rationale for potential therapeutic combination strategies with immunotherapy.