作者与单位 Authors & Affiliations
Charles H. Earnshaw1, Poppy Dunn1, Shih-Chieh Chiang1, Agrin Moeini1, Maria A. Koufaki1, Eduardo Bonavita1, Massimo Russo1, Laetita Nebot-Bral1, Kimberley Hockenhull1, Erin Richardson1, Anna Pidoux1, Charlotte R. Bell1, Alexander R. Baker2, Richard Reeves3, Robert Sellers3, Sudhakar Sahoo3, Victoria Fife4, Matthew G. Roberts4, Theophile Bigirumurame5, Caroline Dive4, Julia A. Newton-Bishop6, Jeremie Nsengimana5, Christopher E. M. Griffiths4, Santiago Zelenay1
1Cancer Inflammation and Immunity Group, Cancer Research UK Manchester Institute, Manchester, United Kingdom,2Visualisation, Irradiation and Analysis, Cancer Research UK Manchester Institute, Manchester, United Kingdom,3Computational Biology Support, Cancer Research UK Manchester Institute, Manchester, United Kingdom,4Cancer Research UK National Biomarkers Centre, Manchester, United Kingdom,5Biostatistics Research Group, Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom,6Institute of Medical Research at St James’s, University of Leeds, Leeds, United Kingdom
摘要 Abstract
Melanoma is the form of skin cancer responsible for most patient deaths. Treatment with immune checkpoint blockade (ICB) has led to a significant improvement in outcomes. However, half of melanoma patients do not derive long-term benefit, and improved understanding of this is required to identify novel mechanisms of resistance and treatment. We screened a range of topical treatments, used in non-melanoma skin diseases, for anti-cancer activity in an ICB-refractory murine melanoma model. In particular, and building on previous work by us and others, we focused on topical treatments that had the potential to influence the inflammatory response within tumors, which in turn may improve anti-tumor immune responses.
In a story recently published in Cancer Discovery , we found topical glucocorticoids to uniquely trigger acute tumor shrinkage. After just two doses, GC-treated tumors shrank, whereas control-treated tumors doubled in volume. Intriguingly, this effect was lost in Rag1 -/- mice (deficient in B and T cells) or in mice depleted of CD8 + T cells, uncovering a key role for T cells in GC-induced tumor growth control. Of eight cancer models tested for GC-responsiveness, half experienced immune-depended control, and half were unresponsive.
GCs downregulated the expression of Glycoprotein A repetitions predominant (GARP) on the surface of melanoma cells. GARP is a cell-surface protein that plays a critical role in the activation of TGFbeta from its inactive latent form. Targeted mutagenesis and genetic knockout confirmed GC-induced GARP downregulation reduced TGFbeta signalling, allowing CD8 + T cell tumor killing. Of the eight tumor models tested, only the four GC-responsive tumors also responded to TGFbeta inhibition, suggesting that GCs triggered immune-dependent tumor control when tumors make use of TGFbeta signalling for immune evasion.
Unpublished data expands on this story. We examined the efficacy of using an anti-GARP antibody in mice, with and without immunotherapy, in order to identify further translational opportunities of this finding. Moreover, we have examined in-house melanoma patient biopsies to identify the immune environment of GARPhigh tumors vs GARPlow tumors, and correlated this with response to immunotherapy.
We discovered a paradoxical immune-dependent shrinkage induced by GCs in certain tumor models. Given the widespread use of GCs in patients receiving immunotherapy, these unexpected findings have the potential to result in significant clinical impact. The GARP/TGFbeta axis therefore represents a cancer-cell intrinsic immune evasive pathway targetable by steroids, and further studies investigating the approach of inhibiting GARP on tumor cells directly investigate its use as a therapeutic strategy.
利益披露 Disclosure
C. H. Earnshaw,
Almirall ).
P. Dunn, None..
S. Chiang, None.
A. Moeini,
Astra Zeneca Employment.
M. A. Koufaki, None..
E. Bonavita, None..
M. Russo, None..
L. Nebot-Bral, None..
K. Hockenhull, None..
E. Richardson, None..
A. Pidoux, None..
C. R. Bell, None..
A. R. Baker, None..
R. Reeves, None..
R. Sellers, None..
S. Sahoo, None..
V. Fife, None..
M. G. Roberts, None..
T. Bigirumurame, None..
C. Dive, None..
J. A. Newton-Bishop, None..
J. Nsengimana, None.
C. E. M. Griffiths,
Almirall ), Other, Honoraria.
Boehringer Ingelheim ), Other, Honoraria.
AbbVie Other, Honoraria.
Boots Ltd Other, Honoraria.
Bristol Meyers Squibb Other, Honoraria.
Evelo Bioscience Other, Honoraria.
GSK Other, Honoraria.
Inmagene Other, Honoraria.
Janssen Other, Honoraria.
Lilly Other, Honoraria.
Novartis Other, Honoraria.
Ono Pharmaceuticals Other, Honoraria.
S. Zelenay,
Ono Pharmaceutical ).
Nxera Pharma ).