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Immunomodulation of intracranial melanoma in response to blood-tumor barrier opening with focused ultrasound.

Authors: Curley CT, Stevens AD, Mathew AS, Stasiak K, Garrison WJ, Miller GW, Sheybani ND, Engelhard VH, Bullock TNJ, Price RJ

<b>Background:</b> Focused ultrasound (FUS) activation of microbubbles (MBs) for blood-brain (BBB) and blood-tumor barrier (BTB) opening permits targeted therapeutic delivery. While the effects of FUS+MBs mediated BBB opening have been investigated for normal brain tissue, no such studies exist for intracranial tumors. As this technology advances into clinical immunotherapy trials, it will be crucial to understand how FUS+MBs modulates the tumor immune microenvironment. <b>Methods and Results:</b> Bulk RNA sequencing revealed that FUS+MBs BTB/BBB opening (1 MHz, 0.5 MPa peak-negative pressure) of intracranial B16F1cOVA tumors increases the expression of genes related to proinflammatory cytokine and chemokine signaling, pattern recognition receptor signaling, and antigen processing and presentation. Flow cytometry revealed increased maturation (i.e. CD86) of dendritic cells (DCs) in the meninges and altered antigen loading of DCs in both the tumor and meninges. For DCs in tumor draining lymph nodes, FUS+MBs had no effect on maturation and elicited only a trend towards increased presentation of tumor-derived peptide by MHC. Neither tumor endothelial cell adhesion molecule expression nor homing of activated T cells was affected by FUS+MBs. <b>Conclusion:</b> FUS+MBs-mediated BTB/BBB opening elicits signatures of inflammation; however, the response is mild, transient, and unlikely to elicit a systemic response independent of administration of immune adjuvants.

Introduction

Purpose Immunotherapy
Study Objective To determine how focused ultrasound with microbubbles (FUS+MBs) BTB/BBB opening modulates the immune microenvironment of intracranial melanoma brain tumors, meninges, and draining lymph nodes.
Animal model / Human subject Mice (C57BL6, sexL male, age: 8-10 weeks; CD45.1, sex: male, age: 8-10 weeks)
Disease model intracranial B16F1cOVA tumors
MRI or image guidance method 1.5T MRI (Siemens Avanto)
Targeted brain region(s) Intracranial B16F1Cova Tumor

Outcomes and Safety

Summary of Outcomes FUS-mediated BBB opening resulted in a mild inflammation response in intracranial B16 melanoma. There were no changes in T cell homing or expression of cell adhesion molecules on tumor endothelial cells. Ultimately, the effect of the BBB opening was mild and insufficient for a systemic response.
Duration of biological effect 24 hours
Safety-related matter Parameters are within a safe range, and no adverse effects are reported.

Brain Region

Ultrasound Parameters

Ultrasound instrument FUS system (RK-100, FUS Instruments) with a spherically focused ultrasound transducer
FUS Frequency 1.1 MHz
FUS Pressure 0.5 MPa
FUS Mode pulsed
Pulse duration 10 s
Duration of a single FUS session 2 min
Treatment frequency single

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