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Sadagopan A, Michelakos T, Boyiadzis G, Ferrone C, Ferrone S. Human Leukocyte Antigen Class I Antigen-Processing Machinery Upregulation by Anticancer Therapies in the Era of Checkpoint Inhibitors: A Review. JAMA Oncol 2022; 8:462-473. [PMID: 34940799 PMCID: PMC8930447 DOI: 10.1001/jamaoncol.2021.5970] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Although typically impressive, objective responses to immune checkpoint inhibitors (ICIs) occur in only 12.5% of patients with advanced cancer. The majority of patients do not respond due to cell-intrinsic resistance mechanisms, including human leukocyte antigen (HLA) class I antigen-processing machinery (APM) defects. The APM defects, which have a negative effect on neoantigen presentation to cytotoxic T lymphocytes (CTLs), are present in the majority of malignant tumors. These defects are caused by gene variations in less than 25% of cases and by dysregulated signaling and/or epigenetic changes in most of the remaining cases, making them frequently correctable. This narrative review summarizes the growing clinical evidence that chemotherapy, targeted therapies, and, to a lesser extent, radiotherapy can correct HLA class I APM defects in cancer cells and improve responses to ICIs. OBSERVATIONS Most chemotherapeutics enhance HLA class I APM component expression and function in cancer cells, tumor CTL infiltration, and responses to ICIs in preclinical and clinical models. Despite preclinical evidence, radiotherapy does not appear to upregulate HLA class I expression in patients and does not enhance the efficacy of ICIs in clinical settings. The latter findings underscore the need to optimize the dose and schedule of radiation and timing of ICI administration to maximize their immunogenic synergy. By increasing DNA and chromatin accessibility, epigenetic agents (histone deacetylase inhibitors, DNA methyltransferase inhibitors, and EZH2 inhibitors) enhance HLA class I APM component expression and function in many cancer types, a crucial contributor to their synergy with ICIs in patients. Furthermore, epidermal growth factor receptor (EGFR) inhibitors and BRAF/mitogen-activated protein kinase kinase inhibitors are effective at upregulating HLA class I expression in EGFR- and BRAF-variant tumors, respectively; these changes may contribute to the clinical responses induced by these inhibitors in combination with ICIs. CONCLUSIONS AND RELEVANCE This narrative review summarizes evidence indicating that chemotherapy and targeted therapies are effective at enhancing HLA class I APM component expression and function in cancer cells. The resulting increased immunogenicity and recognition and elimination of cancer cells by cognate CTLs contributes to the antitumor activity of these therapies as well as to their synergy with ICIs.
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Affiliation(s)
- Ananthan Sadagopan
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Theodoros Michelakos
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gabriella Boyiadzis
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cristina Ferrone
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Soldano Ferrone
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Clinicopathologic significance of human leukocyte antigen class I expression in patients with stage II and III gastric cancer. Cancer Immunol Immunother 2019; 68:1779-1790. [PMID: 31620857 DOI: 10.1007/s00262-019-02410-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 10/05/2019] [Indexed: 12/12/2022]
Abstract
Human leukocyte antigen class I (HLA I) molecules composed of alpha (heavy) chain, including HLA-A, -B, or -C encoded by HLA genes, and beta-2-microglobulin (β2M) are membrane proteins on all nucleated cells that display peptide antigens for recognition by CD8-positive cytotoxic T cells. Here, we examined the clinicopathologic signification of HLA I expression in patients with gastric cancer (GC). Immunohistochemistry was performed to detect HLA A/B/C, β2M, CD8, p53, and programmed death-ligand 1 (PD-L1) in the center and invasive margin of the tumor in 395 stage II and III GCs using tissue array method. Additionally, Epstein-Barr virus (EBV) infection and microsatellite instability (MSI) status were investigated. Negative expression of HLA A/B/C and β2M was observed in 258 (65.3%) and 235 (59.5%) of 395 stage II and III GCs, respectively. Negative HLA I expression was significantly associated with aggressive clinicopathologic features. Furthermore, negative expression of HLA A/B/C and β2M was inversely correlated with CD8-positive cytotoxic T cell infiltration, EBV-positivity, and PD-L1 expression (all p < 0.001). Patients with HLA A/B/C-negative GC had worse overall survival (OS) (p = 0.019) and combined analysis with both HLA A/B/C and β2M expression status significantly predicted OS in univariate (p = 0.004) and multivariate survival analysis (p = 0.016). Negative expression of HLA A/B/C and β2M was frequently observed in stage II and III GCs, particularly with the aggressive clinicopathologic features, and correlated with an unfavorable prognosis and host immune response status. These findings contribute to further development of immunotherapy.
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Nishimoto Y, Murakami A, Sato S, Kajimura T, Nakashima K, Yakabe K, Sueoka K, Sugino N. Decreased carbonyl reductase 1 expression promotes tumor growth via epithelial mesenchymal transition in uterine cervical squamous cell carcinomas. Reprod Med Biol 2018; 17:173-181. [PMID: 29692675 PMCID: PMC5902461 DOI: 10.1002/rmb2.12086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 12/25/2017] [Indexed: 11/09/2022] Open
Abstract
Purpose Carbonyl reductase 1 (CBR1) is involved in cancer progression. Recently, the authors reported that the loss of CBR1 expression is associated with a poor prognosis in uterine cervical cancer. Here, we investigated whether the decreased CBR1 expression promotes cancer progression by inducing the epithelial mesenchymal transition (EMT). Methods Antisense constructs of CBR1 complementary DNA (antisense clones) and the empty vectors (control clones) were transfected into human uterine cervical squamous cell carcinoma cell lines (SKG II and SiHa) and the proliferation and EMT marker expression of these clones were analyzed in vitro. In an in vivo study, 107 cells of the antisense and control clones were subcutaneously injected into nude mice and the tumorigenesis was observed for 8 weeks. Results With the decreased CBR1 expression, the proliferation of the antisense clones increased, accompanied by a decrease in epithelial markers (E-cadherin and cytokeratin) and an increase in mesenchymal markers (fibronectin, alpha-smooth muscle actin, and N-cadherin), which suggests EMT induction. In the in vivo study, the tumor volume in the antisense group was significantly larger than that in the control group. Conclusion Decreased CBR1 expression promotes tumor growth by inducing EMT in uterine cervical squamous cell carcinomas.
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Affiliation(s)
- Yuki Nishimoto
- Department of Obstetrics and Gynecology Yamaguchi University Graduate School of Medicine Ube Japan
| | - Akihiro Murakami
- Department of Obstetrics and Gynecology Yamaguchi University Graduate School of Medicine Ube Japan
| | - Shun Sato
- Department of Obstetrics and Gynecology Yamaguchi University Graduate School of Medicine Ube Japan
| | - Takuya Kajimura
- Department of Obstetrics and Gynecology Yamaguchi University Graduate School of Medicine Ube Japan
| | - Kengo Nakashima
- Department of Obstetrics and Gynecology Yamaguchi University Graduate School of Medicine Ube Japan
| | - Kazuyuki Yakabe
- Department of Obstetrics and Gynecology Yamaguchi University Graduate School of Medicine Ube Japan
| | - Kotaro Sueoka
- Department of Obstetrics and Gynecology Yamaguchi University Graduate School of Medicine Ube Japan
| | - Norihiro Sugino
- Department of Obstetrics and Gynecology Yamaguchi University Graduate School of Medicine Ube Japan
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Stelloo E, Versluis MA, Nijman HW, de Bruyn M, Plat A, Osse EM, van Dijk RH, Nout RA, Creutzberg CL, de Bock GH, Smit VT, Bosse T, Hollema H. Microsatellite instability derived JAK1 frameshift mutations are associated with tumor immune evasion in endometrioid endometrial cancer. Oncotarget 2018; 7:39885-39893. [PMID: 27213585 PMCID: PMC5129978 DOI: 10.18632/oncotarget.9414] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 04/26/2016] [Indexed: 12/26/2022] Open
Abstract
JAK1 frameshift mutations may promote cancer cell immune evasion by impeding upregulation of the antigen presentation pathway in microsatellite unstable endometrial cancers (ECs). This study investigated the JAK1 mutation frequency, its functional implication in immune evasion and its prognostic significance in microsatellite unstable EC. Microsatellite instability and three microsatellite repeats within JAK1 were analyzed in 181 ECs. Sixty-two (34%) ECs showed microsatellite instability, of which 22 (35%) had a JAK1 mutation. LMP7, TAP1 and HLA class I protein expression and the presence of CD8-positive T-cells were analyzed in the microsatellite unstable ECs. JAK1 mutant microsatellite unstable ECs showed impaired upregulation of LMP7 (P=0.074) and HLA class I (P<0.001), validated using RNAseq data of the TCGA. TAP1 expression and presence of CD8-positive T-cells were not related to JAK1 mutations. In 198 additional microsatellite unstable ECs, the JAK1 mutation frequency was confirmed but no prognostic significance was found. For, JAK1 wildtype (n=135, 72%) and mutant (n=52, 28%) ECs, 10-year recurrence free rates were 84% and 77% (P=0.301). These observations show that JAK1 mutations are highly frequent in microsatellite unstable EC, not associated with survival, but are associated with impaired upregulation of LMP7 and HLA class I and may therefore facilitate immune escape.
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Affiliation(s)
- Ellen Stelloo
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marco A Versluis
- Department of Gynecologic Oncology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Hans W Nijman
- Department of Gynecologic Oncology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Marco de Bruyn
- Department of Gynecologic Oncology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Annechien Plat
- Department of Gynecologic Oncology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Elisabeth M Osse
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Reinhardt H van Dijk
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Remi A Nout
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Carien L Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Geertruida H de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Vincent T Smit
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tjalling Bosse
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Harry Hollema
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Tarazona R, Sanchez-Correa B, Casas-Avilés I, Campos C, Pera A, Morgado S, López-Sejas N, Hassouneh F, Bergua JM, Arcos MJ, Bañas H, Casado JG, Durán E, Labella F, Solana R. Immunosenescence: limitations of natural killer cell-based cancer immunotherapy. Cancer Immunol Immunother 2017; 66:233-245. [PMID: 27530271 PMCID: PMC11029053 DOI: 10.1007/s00262-016-1882-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/04/2016] [Indexed: 12/20/2022]
Abstract
Cancer is primarily considered a disease of old age. Immunosenescence refers to the age-associated changes in the immune system, and its contribution to the increased risk of cancer in old individuals has been discussed for many years. Natural killer (NK) cells are cytotoxic innate immune cells specialized in defence against tumour and virus-infected cells. NK cell cytotoxicity is the result of a fine balance between activating and inhibitory receptors. Several activating receptors have been identified that recognize different ligands frequently found over-expressed on tumour cells or virus-infected cells. The most important NK cell inhibitory receptors interact with major histocompatibility complex class I molecules expressed on almost all nucleated cells preventing NK cell-mediated lysis of healthy cells. NK cell immunosenescence is characterized by a redistribution of NK cell subsets, a diminished expression of several activating receptors and lower per-cell cytotoxicity. Altered expression of activating receptors has also been described in young and elderly cancer patients probably due to chronic exposure to ligands on tumour cells. Thus, the effect of both age and cancer may act synergistically to diminish NK cell-mediated tumour immunosurveillance. Different strategies harnessing the power of NK cells to target tumour cells have been designed including adoptive therapy with autologous or allogeneic expanded NK cells. In addition, checkpoint blockade of inhibitory receptors and the use of agonist antibodies to stimulate activating receptors are emerging areas of research. In this context, the effect of immunosenescence should be considered to improve the efficiency of cancer immunotherapy.
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Affiliation(s)
| | | | | | - Carmen Campos
- IMIBIC - Reina Sofia University Hospital - University of Cordoba, REIPI, Córdoba, Spain
| | - Alejandra Pera
- IMIBIC - Reina Sofia University Hospital - University of Cordoba, REIPI, Córdoba, Spain
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Sara Morgado
- Immunology Unit, University of Extremadura, Cáceres, Spain
| | - Nelson López-Sejas
- IMIBIC - Reina Sofia University Hospital - University of Cordoba, REIPI, Córdoba, Spain
| | - Fakhri Hassouneh
- IMIBIC - Reina Sofia University Hospital - University of Cordoba, REIPI, Córdoba, Spain
| | - Juan M Bergua
- Department of Haematology, Hospital San Pedro de Alcantara, Cáceres, Spain
| | - Maria Jose Arcos
- Department of Haematology, Hospital San Pedro de Alcantara, Cáceres, Spain
| | - Helena Bañas
- Department of Haematology, Hospital San Pedro de Alcantara, Cáceres, Spain
| | - Javier G Casado
- Immunology Unit, University of Extremadura, Cáceres, Spain
- Stem Cell Therapy Unit, Minimally Invasive Surgery Centre Jesus Uson, Cáceres, Spain
| | - Esther Durán
- Histology and Pathology Unit, Faculty of Veterinary, University of Extremadura, Cáceres, Spain
| | - Fernando Labella
- IMIBIC - Reina Sofia University Hospital - University of Cordoba, REIPI, Córdoba, Spain
| | - Rafael Solana
- IMIBIC - Reina Sofia University Hospital - University of Cordoba, REIPI, Córdoba, Spain.
- Department of Immunology, Facultad de Medicina Universidad de Córdoba, Avenida de Menéndez Pidal s/n, 14004, Córdoba, Spain.
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