Journal of Clinical Investigation · 2019 · 168 citations · 70 references
MedicineImmunologyOncologyImmunotherapyTumor ImmunologyTumor MicroenvironmentAntitumor T Cell ResponsesCancer ImmunotherapyInflammatory SignalingT Cell Responses To TumorsTumor Immune MicroenvironmentTumor Microenvironment ModulationCancer Cell-intrinsic Immune ResistanceCancer-associated ImmunosuppressionImmune Inflamed TumorsT Cell ExclusionTumor Microenvironment EffectsTumor Microenvironment ResponsivenessTumor Suppression MechanismsTumor-associated Inflammation
Resistance to immunotherapy is one of the biggest problems of current oncotherapeutics. WhileT cell abundance is essential for tumor responsiveness to immunotherapy, factors that define the T cell inflamed tumor microenvironment are not fully understood. We conducted an unbiased approach to identify tumor-intrinsic mechanisms shaping the immune tumor microenvironment(TME), focusing on pancreatic adenocarcinoma because it is refractory to immunotherapy and excludes T cells from the TME. From human tumors, we identified EPHA2 as a candidate tumor intrinsic driver of immunosuppression. Epha2 deletion reversed T cell exclusion and sensitized tumors to immunotherapy. We found that PTGS2, the gene encoding cyclooxygenase-2, lies downstream of EPHA2 signaling through TGFβ and is associated with poor patient survival. Ptgs2 deletion reversed T cell exclusion and sensitized tumors to immunotherapy; pharmacological inhibition of PTGS2 was similarly effective. Thus, EPHA2-PTGS2 signaling in tumor cells regulates tumor immune phenotypes; blockade may represent a novel therapeutic avenue for immunotherapy-refractory cancers. Our findings warrant clinical trials testing the effectiveness of therapies combining EPHA2-TGFβ-PTGS2 pathway inhibitors with anti-tumor immunotherapy, and may change the treatment of notoriously therapy-resistant pancreatic adenocarcinoma.
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