Press Release 20/12/2011 Cell autophagy: a key to the success of chemotherapy via a specific immune response Contrary to what is believed, chemotherapy alone does not destroy a tumor. In addition to its direct effects of cytotoxicity to cancerous cells, it stimulates the patient’s immune response to the tumor. Guido Kroemer, professor and hospital consultant at the Université Paris Descartes - HEGP (AP-HP) and his team working on “Apoptosis, cancer and immunity” (Gustave Roussy Cancer Institute, Inserm, Université Paris-Sud, les Cordeliers Reasearch Unit) have demonstrated that immunogenic cancer cell death causes this process. The destruction of cancer cells by chemotherapy stimulates a specific immune response that acts against residual tumor cells, and this immune response is responsible for the long-term effects of cancer treatment. We can say that certain chemotherapeutic agents convert the tumor cells into the form of a therapeutic vaccine by inducing immunogenic cancer cell death. Before it becomes immunogenic, cancer cell death must pass through an autophagy stage where the cells are partly destroyed by external stresses, notably those caused by cancer treatments. The dying tumor cells release warning messages, including ATP (molecules that store energy), that recruit the immune cells and allow a targeted response against the residual cancer cells. Extracellular ARP attracts dentritic cells, that play a critical role in the immune system within the tumor. These cells alert and activate the T lymphocytes, that can specifically attack the residual tumor cells. This discovery opens up a whole new field of research into the link between chemotherapy and the specific anti-tumor immune response. “Our results show that tumor cell autophagy is vital in boosting the patient’s immune system”, explains Mr. Guido Kroemer. cellule tumorale stress induit par la chimiothérapie Autophagie dégradation du cytoplasme et d’organites dans des vésicules fusionnées avec des lysosomes Apoptose Evolution extrême de l’autophagie vers la mort de la cellule avec libération d’ATP libération d’ATP recrutement des cellules immunitaire cellule activé dendritique Activation des lymphocytes T Puis destruction des cellules tumorales encore présentes lymphocyte T cellule tumorale résiduelle Tumor cell Chemotherapy-illicited stress Autophagy Destruction of cytoplasm and organites in vesicles that have fused with lysosomes Apoptosis The programmed terminal evolution of autophagy towards death of a cell and release of ATP Release of ATP Recruiting immune cells Activated dendtritic cell Activation of T lymphocytes Followed by destruction of residual tumor cells T lymphocyte Residual tumor cell The process of immunogenic autophagy We have to understand that the autophagy process is often inhibited in tumor cells, which causes the dying cells to release ATP and so reduces the therapeutic efficiency in the immune system. Scientists have discovered a way of increasing the therapeutic response in these cases. They inhibited the enzyme that breaks down extracellular ATP, thus increasing the concentration of these energy-storing molecules within the tumor. They also noted that by re-establishing higher concentrations of extracellular ARP, this increased recruiting of immune cells and enhanced the effects of chemotherapy. So this could prove to be an additional possibility of treatment for patients with types of cancer where there is little or no autophagy. These efficient treatments are still at the highly experimental stage. Assessment has still to be carried out in mice, followed by clinic tests on human subjects. Publication G. Autophagy-dependent anticancer immune responses induced by chemotherapeutic agents in mice. Michaud M, Martin I, Sukkuwala A, Adjemian S, Ma Y, Pellegati P, Shen S, Kepp 0, Scoazec M, Mignot G, RelloVarona S, Tailler M, Menger L, Vacchelli E, Galluzzi L, Ghirïnghelli F, Galluzzi L, di Virgilio F, Zitvogel L, Kroemer G. Science. 2011 Dec16;334:1573-1577 Guido Kroemer, M.D., Ph.D. PU-PH Related themes 1 INSERM, U848, Villejuif, France 2 Université Paris Descartes, Sorbonne Paris Cité, Paris, France 3 Metabolomics Platform, Institut Gustave Roussy, Villejuif, France 4 Pôle de Biologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France 5 Centre de Recherche des Cordeliers, Paris, France Contact presse Université Paris Descartes Alice Tschudy & Pierre-Yves Clausse 01 76 53 18 63/17 98 pressefclparisdescartes.fr