1
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Yoshida R, Saigi M, Tani T, Springer BF, Shibata H, Kitajima S, Mahadevan NR, Campisi M, Kim W, Kobayashi Y, Thai TC, Haratani K, Yamamoto Y, Sundararaman SK, Knelson EH, Vajdi A, Canadas I, Uppaluri R, Paweletz CP, Miret JJ, Lizotte PH, Gokhale PC, Jänne PA, Barbie DA. MET-Induced CD73 Restrains STING-Mediated Immunogenicity of EGFR-Mutant Lung Cancer. Cancer Res 2022; 82:4079-4092. [PMID: 36066413 PMCID: PMC9627131 DOI: 10.1158/0008-5472.can-22-0770] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/27/2022] [Accepted: 08/29/2022] [Indexed: 12/14/2022]
Abstract
Immunotherapy has shown limited efficacy in patients with EGFR-mutated lung cancer. Efforts to enhance the immunogenicity of EGFR-mutated lung cancer have been unsuccessful to date. Here, we discover that MET amplification, the most common mechanism of resistance to third-generation EGFR tyrosine kinase inhibitors (TKI), activates tumor cell STING, an emerging determinant of cancer immunogenicity (1). However, STING activation was restrained by ectonucleosidase CD73, which is induced in MET-amplified, EGFR-TKI-resistant cells. Systematic genomic analyses and cell line studies confirmed upregulation of CD73 in MET-amplified and MET-activated lung cancer contexts, which depends on coinduction of FOSL1. Pemetrexed (PEM), which is commonly used following EGFR-TKI treatment failure, was identified as an effective potentiator of STING-dependent TBK1-IRF3-STAT1 signaling in MET-amplified, EGFR-TKI-resistant cells. However, PEM treatment also induced adenosine production, which inhibited T-cell responsiveness. In an allogenic humanized mouse model, CD73 deletion enhanced immunogenicity of MET-amplified, EGFR-TKI-resistant cells, and PEM treatment promoted robust responses regardless of CD73 status. Using a physiologic antigen recognition model, inactivation of CD73 significantly increased antigen-specific CD8+ T-cell immunogenicity following PEM treatment. These data reveal that combined PEM and CD73 inhibition can co-opt tumor cell STING induction in TKI-resistant EGFR-mutated lung cancers and promote immunogenicity. SIGNIFICANCE MET amplification upregulates CD73 to suppress tumor cell STING induction and T-cell responsiveness in TKI-resistant, EGFR-mutated lung cancer, identifying a strategy to enhance immunogenicity and improve treatment.
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Affiliation(s)
- Ryohei Yoshida
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Respiratory Center, Asahikawa Medical University, Hokkaido, Japan.,Corresponding authors: David A. Barbie, M.D., Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, LC4115, Boston, Massachusetts, 02215, USA, , Tel: 617-632-6036; Pasi A Jänne, M.D. Ph.D., Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, LC4114, Boston, Massachusetts, 02215, USA, , Tel: 617-632-6036; Ryohei Yoshida, M.D. Ph.D., Respiratory Center, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa, Hokkaido, 078-8510, Japan, , Tel: 81-166-69-3290
| | - Maria Saigi
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Department of Medical Oncology, Catalan Institute of Oncology (ICO), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - Tetsuo Tani
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - Benjamin F Springer
- Experimental Therapeutics Core and Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - Hirofumi Shibata
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - Shunsuke Kitajima
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Department of Cell Biology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Navin R Mahadevan
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Department of Pathology, Brigham and Women’s Hospital, Boston, MA 02115 USA
| | - Marco Campisi
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - William Kim
- Jong Wook Kim Ph.D., University of California San Diego, School of Medicine, Moores Cancer Center
| | - Yoshihisa Kobayashi
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Division of Molecular Pathology, National Cancer Center Research Institute, Tokyo, Japan
| | - Tran C Thai
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - Koji Haratani
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - Yurie Yamamoto
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Molecular Oncology and Therapeutics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Shriram K Sundararaman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - Erik H Knelson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - Amir Vajdi
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - Israel Canadas
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Blood Cell Development and Function Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Ravindra Uppaluri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - Cloud P Paweletz
- Experimental Therapeutics Core and Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - Juan J Miret
- Experimental Therapeutics Core and Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - Patrick H Lizotte
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Experimental Therapeutics Core and Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - Prafulla C Gokhale
- Experimental Therapeutics Core and Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA
| | - Pasi A Jänne
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Corresponding authors: David A. Barbie, M.D., Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, LC4115, Boston, Massachusetts, 02215, USA, , Tel: 617-632-6036; Pasi A Jänne, M.D. Ph.D., Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, LC4114, Boston, Massachusetts, 02215, USA, , Tel: 617-632-6036; Ryohei Yoshida, M.D. Ph.D., Respiratory Center, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa, Hokkaido, 078-8510, Japan, , Tel: 81-166-69-3290
| | - David A Barbie
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA.,Corresponding authors: David A. Barbie, M.D., Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, LC4115, Boston, Massachusetts, 02215, USA, , Tel: 617-632-6036; Pasi A Jänne, M.D. Ph.D., Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, LC4114, Boston, Massachusetts, 02215, USA, , Tel: 617-632-6036; Ryohei Yoshida, M.D. Ph.D., Respiratory Center, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa, Hokkaido, 078-8510, Japan, , Tel: 81-166-69-3290
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2
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Kitajima S, Tani T, Springer BF, Campisi M, Osaki T, Haratani K, Chen M, Knelson EH, Mahadevan NR, Ritter J, Yoshida R, Köhler J, Ogino A, Nozawa RS, Sundararaman SK, Thai TC, Homme M, Piel B, Kivlehan S, Obua BN, Purcell C, Yajima M, Barbie TU, Lizotte PH, Jänne PA, Paweletz CP, Gokhale PC, Barbie DA. MPS1 inhibition primes immunogenicity of KRAS-LKB1 mutant lung cancer. Cancer Cell 2022; 40:1128-1144.e8. [PMID: 36150391 PMCID: PMC9561026 DOI: 10.1016/j.ccell.2022.08.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 05/27/2022] [Accepted: 08/15/2022] [Indexed: 02/06/2023]
Abstract
KRAS-LKB1 (KL) mutant lung cancers silence STING owing to intrinsic mitochondrial dysfunction, resulting in T cell exclusion and resistance to programmed cell death (ligand) 1 (PD-[L]1) blockade. Here we discover that KL cells also minimize intracellular accumulation of 2'3'-cyclic GMP-AMP (2'3'-cGAMP) to further avoid downstream STING and STAT1 activation. An unbiased screen to co-opt this vulnerability reveals that transient MPS1 inhibition (MPS1i) potently re-engages this pathway in KL cells via micronuclei generation. This effect is markedly amplified by epigenetic de-repression of STING and only requires pulse MPS1i treatment, creating a therapeutic window compared with non-dividing cells. A single course of decitabine treatment followed by pulse MPS1i therapy restores T cell infiltration in vivo, enhances anti-PD-1 efficacy, and results in a durable response without evidence of significant toxicity.
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Affiliation(s)
- Shunsuke Kitajima
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA; Department of Cell Biology, Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, Japan.
| | - Tetsuo Tani
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA
| | - Benjamin F Springer
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA; Experimental Therapeutics Core, Dana-Farber Cancer Institute, Boston, MA, USA; Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Marco Campisi
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA
| | - Tatsuya Osaki
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Koji Haratani
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA
| | - Minyue Chen
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA; Department of Immunology, Harvard Medical School, Boston, MA, USA
| | - Erik H Knelson
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA
| | - Navin R Mahadevan
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA; Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - Jessica Ritter
- Breast Oncology Program, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA
| | - Ryohei Yoshida
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA
| | - Jens Köhler
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA
| | - Atsuko Ogino
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA
| | - Ryu-Suke Nozawa
- Department of Experimental Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shriram K Sundararaman
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA; Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Tran C Thai
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA
| | - Mizuki Homme
- Department of Cell Biology, Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, Japan
| | - Brandon Piel
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA
| | - Sophie Kivlehan
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA; Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Bonje N Obua
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA; Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Connor Purcell
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA; Division of Biology and Medicine, Brown University, Providence, RI, USA
| | - Mamiko Yajima
- Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI, USA
| | - Thanh U Barbie
- Breast Oncology Program, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Patrick H Lizotte
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA; Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Pasi A Jänne
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA
| | - Cloud P Paweletz
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA; Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Prafulla C Gokhale
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA; Experimental Therapeutics Core, Dana-Farber Cancer Institute, Boston, MA, USA; Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - David A Barbie
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA LC4115, USA.
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3
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Olson TL, Cheon H, Xing JC, Olson KC, Paila U, Hamele CE, Neelamraju Y, Shemo BC, Schmachtenberg M, Sundararaman SK, Toro MF, Keller CA, Farber EA, Onengut-Gumuscu S, Garrett-Bakelman FE, Hardison RC, Feith DJ, Ratan A, Loughran TP. Frequent somatic TET2 mutations in chronic NK-LGL leukemia with distinct patterns of cytopenias. Blood 2021; 138:662-673. [PMID: 33786584 PMCID: PMC8394905 DOI: 10.1182/blood.2020005831] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 03/30/2021] [Accepted: 03/18/2021] [Indexed: 02/07/2023] Open
Abstract
Chronic natural killer large granular lymphocyte (NK-LGL) leukemia, also referred to as chronic lymphoproliferative disorder of NK cells, is a rare disorder defined by prolonged expansion of clonal NK cells. Similar prevalence of STAT3 mutations in chronic T-LGL and NK-LGL leukemia is suggestive of common pathogenesis. We undertook whole-genome sequencing to identify mutations unique to NK-LGL leukemia. The results were analyzed to develop a resequencing panel that was applied to 58 patients. Phosphatidylinositol 3-kinase pathway gene mutations (PIK3CD/PIK3AP1) and TNFAIP3 mutations were seen in 5% and 10% of patients, respectively. TET2 was exceptional in that mutations were present in 16 (28%) of 58 patient samples, with evidence that TET2 mutations can be dominant and exclusive to the NK compartment. Reduced-representation bisulfite sequencing revealed that methylation patterns were significantly altered in TET2 mutant samples. The promoter of TET2 and that of PTPRD, a negative regulator of STAT3, were found to be methylated in additional cohort samples, largely confined to the TET2 mutant group. Mutations in STAT3 were observed in 19 (33%) of 58 patient samples, 7 of which had concurrent TET2 mutations. Thrombocytopenia and resistance to immunosuppressive agents were uniquely observed in those patients with only TET2 mutation (Games-Howell post hoc test, P = .0074; Fisher's exact test, P = .00466). Patients with STAT3 mutation, inclusive of those with TET2 comutation, had lower hematocrit, hemoglobin, and absolute neutrophil count compared with STAT3 wild-type patients (Welch's t test, P ≤ .015). We present the discovery of TET2 mutations in chronic NK-LGL leukemia and evidence that it identifies a unique molecular subtype.
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Affiliation(s)
- Thomas L Olson
- University of Virginia Cancer Center, Charlottesville, VA
- Division of Hematology/Oncology, Department of Medicine, and
| | - HeeJin Cheon
- University of Virginia Cancer Center, Charlottesville, VA
- Division of Hematology/Oncology, Department of Medicine, and
- Medical Scientist Training Program, University of Virginia School of Medicine, Charlottesville, VA
| | - Jeffrey C Xing
- University of Virginia Cancer Center, Charlottesville, VA
- Division of Hematology/Oncology, Department of Medicine, and
- Medical Scientist Training Program, University of Virginia School of Medicine, Charlottesville, VA
| | - Kristine C Olson
- University of Virginia Cancer Center, Charlottesville, VA
- Division of Hematology/Oncology, Department of Medicine, and
| | - Umadevi Paila
- Center for Public Health Genomics, University of Virginia, Charlottesville; VA
| | - Cait E Hamele
- University of Virginia Cancer Center, Charlottesville, VA
- Division of Hematology/Oncology, Department of Medicine, and
| | - Yaseswini Neelamraju
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, VA
| | - Bryna C Shemo
- University of Virginia Cancer Center, Charlottesville, VA
- Division of Hematology/Oncology, Department of Medicine, and
| | - Matt Schmachtenberg
- University of Virginia Cancer Center, Charlottesville, VA
- Division of Hematology/Oncology, Department of Medicine, and
| | - Shriram K Sundararaman
- University of Virginia Cancer Center, Charlottesville, VA
- Division of Hematology/Oncology, Department of Medicine, and
| | - Mariella F Toro
- University of Virginia Cancer Center, Charlottesville, VA
- Division of Hematology/Oncology, Department of Medicine, and
| | - Cheryl A Keller
- Department of Biochemistry and Molecular Biology, Center for Computational Biology & Bioinformatics, The Pennsylvania State University, State College, PA; and
| | - Emily A Farber
- Center for Public Health Genomics, University of Virginia, Charlottesville; VA
| | | | - Francine E Garrett-Bakelman
- University of Virginia Cancer Center, Charlottesville, VA
- Division of Hematology/Oncology, Department of Medicine, and
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, VA
| | - Ross C Hardison
- Department of Biochemistry and Molecular Biology, Center for Computational Biology & Bioinformatics, The Pennsylvania State University, State College, PA; and
| | - David J Feith
- University of Virginia Cancer Center, Charlottesville, VA
- Division of Hematology/Oncology, Department of Medicine, and
| | - Aakrosh Ratan
- Center for Public Health Genomics, University of Virginia, Charlottesville; VA
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA
| | - Thomas P Loughran
- University of Virginia Cancer Center, Charlottesville, VA
- Division of Hematology/Oncology, Department of Medicine, and
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Löffler AI, Gonzalez JA, Sundararaman SK, Mathew RC, Norton PT, Hagspiel KD, Kramer CM, Ragosta M, Rogers C, Shah NL, Salerno M. Coronary Computed Tomography Angiography Demonstrates a High Burden of Coronary Artery Disease Despite Low-Risk Nuclear Studies in Pre-Liver Transplant Evaluation. Liver Transpl 2020; 26:1398-1408. [PMID: 32772465 PMCID: PMC9014709 DOI: 10.1002/lt.25869] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/25/2020] [Accepted: 07/03/2020] [Indexed: 02/07/2023]
Abstract
We investigated the presence and severity of coronary artery disease (CAD) in orthotopic liver transplantation (OLT) candidates using coronary artery calcium score (CACS) and coronary computed tomography angiography (CCTA) as compared with the prevalence of normal and abnormal single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). A total of 140 prospective OLT candidates without known CAD underwent coronary artery calcium (CAC) scans with (n = 77) or without CCTA and coronary computed tomography angiography-derived fractional flow reserve (FFRCT ; n = 57) using a dual-source computed tomography (CT) and were followed for 2.6 ± 1.4 years. Coronary plaque was quantified using the segment-involvement score (SIS) and segment stenosis score (SSS). The mean age was 59 ± 6 years, and 65.0% of patients were male. Mean Agatston CACS was 367 ± 653, and 15.0% of patients had CACSs of 0; 83.6% received a SPECT MPI, of which 95.7% were interpreted as normal/probably normal. By CCTA, 9.1% had obstructive CAD (≥70% stenosis), 67.5% had nonobstructive CAD, and 23.4% had no CAD. Nonobstructive CAD was diffuse with mean SIS 3.0 ± 2.9 and SSS 4.5 ± 5.4. Only 14 patients had high risk-findings (severe 3v CAD, n = 4, CACS >1000 n = 10) that prompted X-ray angiography in 3 patients who had undergone CCTA, resulting in revascularization of a high-risk obstruction in 1 patient who had a normal SPECT study. Patients with end-stage liver disease have a high prevalence of nonobstructive CAD by CCTA, which is undiagnosed by SPECT MPI, potentially underestimating cardiovascular risk. Deferring X-ray angiography unless high-risk CCTA findings are present is a potential strategy for avoiding unnecessary X-ray angiography.
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Affiliation(s)
- Adrián I. Löffler
- Cardiovascular Division, Departments of Medicine, University of Virginia Health System, Charlottesville, VA
| | - Jorge A. Gonzalez
- Cardiovascular Division, Departments of Medicine, University of Virginia Health System, Charlottesville, VA,Division of Cardiovascular Disease, Scripps Clinic, La Jolla, CA
| | - Shriram K. Sundararaman
- Cardiovascular Division, Departments of Medicine, University of Virginia Health System, Charlottesville, VA
| | - Roshin C. Mathew
- Cardiovascular Division, Departments of Medicine, University of Virginia Health System, Charlottesville, VA
| | - Patrick T. Norton
- Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA
| | - Klaus D. Hagspiel
- Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA
| | - Christopher M. Kramer
- Cardiovascular Division, Departments of Medicine, University of Virginia Health System, Charlottesville, VA,Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA
| | - Michael Ragosta
- Cardiovascular Division, Departments of Medicine, University of Virginia Health System, Charlottesville, VA
| | | | - Neeral L. Shah
- Gastroenterology and Hepatology, University of Virginia Health System, Charlottesville, VA
| | - Michael Salerno
- Cardiovascular Division, Departments of Medicine, University of Virginia Health System, Charlottesville, VA,Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA,Biomedical Engineering, University of Virginia Health System, Charlottesville, VA
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5
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Campisi M, Sundararaman SK, Shelton SE, Knelson EH, Mahadevan NR, Yoshida R, Tani T, Ivanova E, Cañadas I, Osaki T, Lee SWL, Thai T, Han S, Piel BP, Gilhooley S, Paweletz CP, Chiono V, Kamm RD, Kitajima S, Barbie DA. Tumor-Derived cGAMP Regulates Activation of the Vasculature. Front Immunol 2020; 11:2090. [PMID: 33013881 PMCID: PMC7507350 DOI: 10.3389/fimmu.2020.02090] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/31/2020] [Indexed: 12/19/2022] Open
Abstract
Intratumoral recruitment of immune cells following innate immune activation is critical for anti-tumor immunity and involves cytosolic dsDNA sensing by the cGAS/STING pathway. We have previously shown that KRAS-LKB1 (KL) mutant lung cancer, which is resistant to PD-1 blockade, exhibits silencing of STING, impaired tumor cell production of immune chemoattractants, and T cell exclusion. Since the vasculature is also a critical gatekeeper of immune cell infiltration into tumors, we developed a novel microfluidic model to study KL tumor-vascular interactions. Notably, dsDNA priming of LKB1-reconstituted tumor cells activates the microvasculature, even when tumor cell STING is deleted. cGAS-driven extracellular export of 2'3' cGAMP by cancer cells activates STING signaling in endothelial cells and cooperates with type 1 interferon to increase vascular permeability and expression of E selectin, VCAM-1, and ICAM-1 and T cell adhesion to the endothelium. Thus, tumor cell cGAS-STING signaling not only produces T cell chemoattractants, but also primes tumor vasculature for immune cell escape.
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Affiliation(s)
- Marco Campisi
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
| | - Shriram K. Sundararaman
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
- University of Virginia School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Sarah E. Shelton
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Erik H. Knelson
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
| | - Navin R. Mahadevan
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, United States
| | - Ryohei Yoshida
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
| | - Tetsuo Tani
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
| | - Elena Ivanova
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
- Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Israel Cañadas
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
- Blood Cell Development and Function Program, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Tatsuya Osaki
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Sharon Wei Ling Lee
- Singapore-MIT Alliance for Research & Technology, BioSystems and Micromechanics, Singapore, Singapore
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tran Thai
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
| | - Saemi Han
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
| | - Brandon P. Piel
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
| | - Sean Gilhooley
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
| | - Cloud P. Paweletz
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
- Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Valeria Chiono
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Roger D. Kamm
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Shunsuke Kitajima
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
- Department of Cell Biology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - David A. Barbie
- Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, United States
- Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA, United States
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Campisi M, Sundararaman SK, Kitajima S, Chiono V, Kamm RD, Barbie DA. Abstract 958: Tumor-vascular interactions promote STING-driven inflammation in the tumor microenvironment. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The recruitment of T cells following intratumoral administration of Stimulation of Interferon Genes (STING) agonists in the tumor microenvironment (TME) is a critical event in the STING-driven antitumor immune response, a pathway with great relevance in the context of cancer immunotherapy. We have previously demonstrated that LKB1 mutation is associated with suppression of tumor cell STING levels and reduced production of T-cell chemoattractants such as CXCL10 in KRAS-driven non-small cell lung cancer (NSCLC). Consistent with this, immunohistochemical staining of patient samples showed poor infiltration of CD3, CD4, and CD8 T cells into LKB1 negative versus LKB1 intact cancer epithelium, and instead, retention of T-cells in stroma. To examine how LKB1 alters immune cell recruitment in a STING-dependent manner, we used a 3-D microfluidic co-culture system to study interactions between vasculature and tumor spheroids derived from a KRAS/LKB1 mutated (KL) cell line with LKB1 reconstitution +/- STING deletion. To form the vasculature, we co-cultured tumor spheroids with fibroblasts and endothelial cells for 7 days, and identified changes in morphology, cytokine production, and gene expression that occur in co-culture. We first observed that co-culture induced synergistic production of multiple immune cell chemo-attractants such as CXCL10, CCL2, CCL5, and G-CSF. Interestingly, this more physiologic ex vivo tumor model of LKB1 reconstitution revealed particularly strong cooperative production of STING-dependent cytokines such as CXCL10 in the vasculature. Moreover, STING depletion in LKB1 reconstituted tumor cells did not significantly attenuate production of CXCL10 and other cytokines in co-culture, suggesting that tumor/vessel interaction may promote STING activation in the vasculature regardless of cancer cell-intrinsic STING function. Furthermore, although there was no appreciable response after treatment of KL cancer cells with cGAMP based STING agonists, treatment of isolated 3-D vascular networks with cGAMP enhanced vascular permeability and increased production of CXCL10 and CCL5, possibly contributing to defective chemokine gradients that retain T cells near the vasculature. Thus, developing these more complex models that incorporate the vasculature may elucidate important aspects of STING biology and may ultimately aid further development of effective immunotherapies targeting this signaling axis.
Citation Format: Marco Campisi, Shriram K. Sundararaman, Shunsuke Kitajima, Valeria Chiono, Roger D. Kamm, David A. Barbie. Tumor-vascular interactions promote STING-driven inflammation in the tumor microenvironment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 958.
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Abstract
Type I interferon (IFN) production within the tumor microenvironment is important in shaping the immune response to the tumor. In this issue of Immunity, Marcus et al. (2018) reveal that tumor cells produce 2'3'-cGAMP, which activates the STING pathway in non-tumor cells and leads to type I IFN production and the priming of natural killer cells for tumor rejection.
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Affiliation(s)
| | - David A Barbie
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA.
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Kitajima S, Ivanova E, Guo S, Yoshida R, Campisi M, Sundararaman SK, Tange S, Mitsuishi Y, Thai TC, Masuda S, Piel BP, Sholl LM, Kirschmeier PT, Paweletz CP, Watanabe H, Yajima M, Barbie DA. Suppression of STING Associated with LKB1 Loss in KRAS-Driven Lung Cancer. Cancer Discov 2018; 9:34-45. [PMID: 30297358 DOI: 10.1158/2159-8290.cd-18-0689] [Citation(s) in RCA: 277] [Impact Index Per Article: 46.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/21/2018] [Accepted: 10/03/2018] [Indexed: 02/07/2023]
Abstract
KRAS-driven lung cancers frequently inactivate TP53 and/or STK11/LKB1, defining tumor subclasses with emerging clinical relevance. Specifically, KRAS-LKB1 (KL)-mutant lung cancers are particularly aggressive, lack PD-L1, and respond poorly to immune checkpoint blockade (ICB). The mechanistic basis for this impaired immunogenicity, despite the overall high mutational load of KRAS-mutant lung cancers, remains obscure. Here, we report that LKB1 loss results in marked silencing of stimulator of interferon genes (STING) expression and insensitivity to cytoplasmic double-strand DNA (dsDNA) sensing. This effect is mediated at least in part by hyperactivation of DNMT1 and EZH2 activity related to elevated S-adenylmethionine levels and reinforced by DNMT1 upregulation. Ectopic expression of STING in KL cells engages IRF3 and STAT1 signaling downstream of TBK1 and impairs cellular fitness, due to the pathologic accumulation of cytoplasmic mitochondrial dsDNA associated with mitochondrial dysfunction. Thus, silencing of STING avoids these negative consequences of LKB1 inactivation, while facilitating immune escape. SIGNIFICANCE: Oncogenic KRAS-mutant lung cancers remain treatment-refractory and are resistant to ICB in the setting of LKB1 loss. These results begin to uncover the key underlying mechanism and identify strategies to restore STING expression, with important therapeutic implications because mitochondrial dysfunction is an obligate component of this tumor subtype.See related commentary by Corte and Byers, p. 16.This article is highlighted in the In This Issue feature, p. 1.
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Affiliation(s)
- Shunsuke Kitajima
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Elena Ivanova
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Sujuan Guo
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Ryohei Yoshida
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Marco Campisi
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts.,Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Shriram K Sundararaman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,University of Virginia School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Shoichiro Tange
- Department of Human Genetics, Graduate School of Biomedical Science, Tokushima University, Tokushima, Japan
| | - Yoichiro Mitsuishi
- Department of Respiratory Medicine, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Tran C Thai
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Sayuri Masuda
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Brandon P Piel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Paul T Kirschmeier
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Cloud P Paweletz
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Hideo Watanabe
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mamiko Yajima
- MCB Department, Brown University, Providence, Rhode Island
| | - David A Barbie
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
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