High-Dose Ascorbate in Combination with Anti-PD1 Checkpoint Inhibition as Treatment Option for Malignant Melanoma

Cells. 2023 Jan 7;12(2):254. doi: 10.3390/cells12020254.

Abstract

Ascorbate acts as a prooxidant when administered parenterally at high supraphysiological doses, which results in the generation of hydrogen peroxide in dependence on oxygen. Most cancer cells are susceptible to the emerging reactive oxygen species (ROS). Accordingly, we evaluated high-dose ascorbate for the treatment of the B16F10 melanoma model. To investigate the effects of ascorbate on the B16F10 cell line in vitro, viability, cellular impedance, and ROS production were analyzed. In vivo, C57BL/6NCrl mice were subcutaneously injected into the right flank with B16F10 cells and tumor-bearing mice were treated intraperitoneally with ascorbate (3 g/kg bodyweight), immunotherapy (anti-programmed cell death protein 1 (PD1) antibody J43; 2 mg/kg bodyweight), or both treatments combined. The efficacy and toxicity were analyzed by measuring the respective tumor sizes and mouse weights accompanied by histological analysis of the protein levels of proliferating cell nuclear antigen (Pcna), glucose transporter 1 (Glut-1), and CD3. Treatment of B16F10 melanoma-carrying mice with high-dose ascorbate yielded plasma levels in the pharmacologically effective range, and ascorbate showed efficacy as a monotherapy and when combined with PD1 inhibition. Our data suggest the applicability of ascorbate as an additional therapeutic agent that can be safely combined with immunotherapy and has the potential to potentiate anti-PD1-based immune checkpoint blockades.

Keywords: B16F10 melanoma cells; ascorbate; cancer; checkpoint blockade; immunotherapy; malignant melanoma; vitamin C.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antineoplastic Agents* / pharmacology
  • Melanoma* / drug therapy
  • Melanoma, Cutaneous Malignant
  • Mice
  • Mice, Inbred C57BL
  • Reactive Oxygen Species

Substances

  • Reactive Oxygen Species
  • Antineoplastic Agents

Grants and funding

M.B., H.N., C.B., T.S., and S.V. were supported by grants from Pascoe pharmazeutische Praeparate GmbH (grant no. D.31.15100 and D.32.22506). M.B. and S.V. were supported by the Else-Uebelmesser-Stiftung (grant no. D.30.21947; reference: GzV 1.14). The authors acknowledge support by the Open Access Publishing Fund of the University of Tuebingen.