Intratumoral Lactate Depletion Based on Injectable Nanoparticles-Hydrogel Composite System Synergizes with Immunotherapy Against Post-Ablative Hepatocellular Carcinoma Recurrence.

Thermal ablation is a crucial therapeutic modality for hepatocellular carcinoma (HCC), but its efficacy is often hindered by the high recurrence rate attributed to insufficient ablation. Furthermore, the residual tumors following insufficient ablation exhibit a more pronounced immunosuppressive state, which accelerates the disease progression and leads to immune checkpoint blockade (ICB) resistance. Herein, we present evidence that heightened intratumoral lactate accumulation, stemming from the augmented glycolytic activity of post-ablative residual HCC cells, may serve as a crucial driving force in exacerbating the immunosuppressive state of the tumor microenvironment (TME). To address this, we design an injectable nanoparticles-hydrogel composite system (LOX-MnO 2 @Gel) that gradually releases lactate oxidase (LOX)-loaded hollow mesoporous MnO 2 nanoparticles at the tumor site to continuously deplete intratumoral lactate via a cascade catalytic reaction. Using subcutaneous and orthotopic HCC tumor-bearing mouse models, we confirm that LOX-MnO 2 @Gel-mediated local lactate depletion could transform the immunosuppressive post-ablative TME into an immunocompetent one and synergizes with ICB therapy to significantly inhibit residual HCC growth and lung metastasis, thereby prolonging the survival of mice post-ablation. Our work proposes an appealing strategy for synergistically combining anti-tumor metabolic therapy with immunotherapy to combat post-ablative HCC recurrence. This article is protected by copyright. All rights reserved.