Cancer Discovery · 2015 · 1.5K citations · 43 references
MedicineImmunologyOncologyImmunotherapyMolecular OncologyTumor ImmunologyAntitumor T Cell ResponsesCancer ImmunotherapyCheckpoint Inhibitor TherapyImmune Checkpoint InhibitorsImmune Checkpoint RegulationTherapeutic ResistanceCancer Immunotherapy ResistanceMelanoma ImmunotherapyMurine ModelsPhosphatidylinositol 3-Kinase-akt PathwayResistance To Checkpoint InhibitorsResistance To Immune Checkpoint InhibitionT Cell ExpansionTumor Resistance
T cell‑mediated immunotherapies hold promise for cancer treatment, yet most patients do not respond, and the molecular mechanisms underlying this resistance are poorly understood. The study investigates whether targeting the PI3K‑AKT pathway can overcome resistance in tumors with PTEN loss and thereby improve the efficacy of immunotherapy. PTEN loss in tumor cells diminishes T‑cell infiltration, impairs T‑cell–mediated killing, and correlates with worse outcomes to PD‑1 blockade; inhibition of PI3Kβ restores T‑cell activity and enhances anti‑PD‑1 and anti‑CTLA‑4 efficacy in murine models, supporting combination therapy.
T cell-mediated immunotherapies are promising cancer treatments. However, most patients still fail to respond to these therapies. The molecular determinants of immune resistance are poorly understood. We show that loss of PTEN in tumor cells in preclinical models of melanoma inhibits T cell-mediated tumor killing and decreases T-cell trafficking into tumors. In patients, PTEN loss correlates with decreased T-cell infiltration at tumor sites, reduced likelihood of successful T-cell expansion from resected tumors, and inferior outcomes with PD-1 inhibitor therapy. PTEN loss in tumor cells increased the expression of immunosuppressive cytokines, resulting in decreased T-cell infiltration in tumors, and inhibited autophagy, which decreased T cell-mediated cell death. Treatment with a selective PI3Kβ inhibitor improved the efficacy of both anti-PD-1 and anti-CTLA-4 antibodies in murine models. Together, these findings demonstrate that PTEN loss promotes immune resistance and support the rationale to explore combinations of immunotherapies and PI3K-AKT pathway inhibitors.This study adds to the growing evidence that oncogenic pathways in tumors can promote resistance to the antitumor immune response. As PTEN loss and PI3K-AKT pathway activation occur in multiple tumor types, the results support the rationale to further evaluate combinatorial strategies targeting the PI3K-AKT pathway to increase the efficacy of immunotherapy.
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