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Immunotherapy, an emerging field in cancer therapeutics, in colon cancer aims to reduce pre-surgical tumor burden by regulating host immune checkpoints, and when used in combination with neoadjuvant chemotherapy, may improve tumor therapeutic response. One such immune checkpoint is CCL2 (monocyte chemoattractant protein-1)-mediated recruitment of monocytes, which differentiate into tumor-associated macrophages (TAMs) in the tumor microenvironment that promote angiogenesis and tumorigenesis. Thus, CCL2 blockade may play an anti-tumor role via effects on tumor perfusion. However, there have been no studies investigating CCL2 blockade immunotherapy combined with chemotherapy in an animal model of colon cancer. Furthermore, there is a need to longitudinally assess tumor therapeutic response throughout treatment. In this study, CT26 murine colon carcinoma was injected into the flanks of Balb/c mice (n=80) to form tumor allografts. Mice in the key experimental group received combined chemotherapy (5-flurouracil) and immunotherapy (anti-CCL2), with appropriate controls. Tumor therapeutic response was monitored using diffuse reflectance spectroscopy (DRS) by measuring the tumor perfusion metrics, hemoglobin concentration and oxygenation. End-point immunohistochemical analysis was used to quantify TAM fraction (CD68 and DAPI), TAM polarization (iNOS and CD206), and hypoxia (pimonidazole) to spatially and temporally correlate to DRS results. The central hypothesis was that decreasing TAMs via CCL2 blockade alters tumor perfusion, thereby increasing tumor response to 5-fluorouracil. This study may potentially demonstrate an effective immunotherapy approach (CCL2 blockade) and a viable method to longitudinally and non-invasively assess tumor therapeutic response to such immunotherapy (DRS) in mouse allograft models of colon cancer.
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