Bladder cancer (BC) is the 4th most common cancer in men and the 11th most common in women. BC
has the highest lifetime per-patient treatment cost of all cancers, mainly because of its high recurrence rate.
Also, regular invasive cystoscopy and the subsequent surgical treatment of recurrences impair patient quality
of life and cause significant morbidity. Therefore, there is a clear clinical need for novel technologies to
effectively treat BC, ultimately reducing tumor recurrences, treatment costs, number of radical cystectomies,
and mortality. A promising therapeutic platform for cancer is offered by gold nanoparticles (GNP). Taking
advantage of gold’s high biocompatibility, GNP can be injected intravenously and accumulate preferentially in
cancer cells due to the enhanced permeability and retention effect. Among GNP platforms, gold nanostars
(GNS) have great therapeutic potential due to the unique star-shaped geometry that dramatically enhances
light absorption and effective conversion into heat due to the plasmonic effect. This photothermal process can
be exploited to specifically ablate tumors and, importantly, to amplify the anti-tumor immune response following
the highly immunogenic thermal death of cancer cells. Relatedly, many cancers exploit immune checkpoints –
such as the interaction between programmed cell death 1 (PD-1) and its ligand (PD-L1) – to evade the anti-
cancer immune response. Recent immunotherapies disabling this immune resistance mechanism have shown
encouraging clinical results, are FDA approved in BC, but do not offer a permanent cure for most patients.
We thus propose to develop the GNS technology for use in SYnergistic iMmuno PHOtothermal
NanotherapY (SYMPHONY), a novel therapy that integrates nanotechnology, biophotonics, and
immunotherapy. The central hypothesis of this proposal is that combining GNS-mediated photothermal
nanotherapy with PD-1/PD-L1 immune checkpoint blockade will result in dramatic therapeutic synergism to
treat cancer metastasis. The rationale for this hypothesis is that photothermal therapy not only reduces tumor
burden by direct heat-based ablation, but also causes intense immune responses that can be amplified with
PD-1/PD-L1 immune checkpoint blockade. The specific aims are: (1) Fabricate and modulate optical properties
of next-generation plasmonics GNS to maximize photothermal therapy of deep tumors;; (2) Coat and
functionalize GNS to safely improve in vivo BC targeting;; and (3) Evaluate effectiveness of SYMPHONY
therapy for treating BC in murine models. The results of our research proposal intends to prove that
nanoparticle therapy and immunotherapy can be synergistically combined to produce an antitumor systemic
response far superior to either single therapy alone. We will also prove that SYMPHONY triggers an extremely
potent systemic response that cures both primary and distant lesions, producing a ‘vaccine’ effect to prevent
future BC recurrences. The proposed work will set the stage for SYMPHONY’s rapid future clinical translation
to improve life quality and reduce mortality of BC patients.