CTLA4 blockade abrogates KEAP1/STK11-related resistance to PD-(L)1 inhibitors.

Details

Serval ID
serval:BIB_CF6BDAC4D159
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
CTLA4 blockade abrogates KEAP1/STK11-related resistance to PD-(L)1 inhibitors.
Journal
Nature
Author(s)
Skoulidis F., Araujo H.A., Do M.T., Qian Y., Sun X., Cobo A.G., Le J.T., Montesion M., Palmer R., Jahchan N., Juan J.M., Min C., Yu Y., Pan X., Arbour K.C., Vokes N., Schmidt S.T., Molkentine D., Owen D.H., Memmott R., Patil P.D., Marmarelis M.E., Awad M.M., Murray J.C., Hellyer J.A., Gainor J.F., Dimou A., Bestvina C.M., Shu C.A., Riess J.W., Blakely C.M., Pecot C.V., Mezquita L., Tabbó F., Scheffler M., Digumarthy S., Mooradian M.J., Sacher A.G., Lau SCM, Saltos A.N., Rotow J., Johnson R.P., Liu C., Stewart T., Goldberg S.B., Killam J., Walther Z., Schalper K., Davies K.D., Woodcock M.G., Anagnostou V., Marrone K.A., Forde P.M., Ricciuti B., Venkatraman D., Van Allen E.M., Cummings A.L., Goldman J.W., Shaish H., Kier M., Katz S., Aggarwal C., Ni Y., Azok J.T., Segal J., Ritterhouse L., Neal J.W., Lacroix L., Elamin Y.Y., Negrao M.V., Le X., Lam V.K., Lewis W.E., Kemp H.N., Carter B., Roth J.A., Swisher S., Lee R., Zhou T., Poteete A., Kong Y., Takehara T., Paula A.G., Parra Cuentas E.R., Behrens C., Wistuba I.I., Zhang J., Blumenschein G.R., Gay C., Byers L.A., Gibbons D.L., Tsao A., Lee J.J., Bivona T.G., Camidge D.R., Gray J.E., Lieghl N., Levy B., Brahmer J.R., Garassino M.C., Gandara D.R., Garon E.B., Rizvi N.A., Scagliotti G.V., Wolf J., Planchard D., Besse B., Herbst R.S., Wakelee H.A., Pennell N.A., Shaw A.T., Jänne P.A., Carbone D.P., Hellmann M.D., Rudin C.M., Albacker L., Mann H., Zhu Z., Lai Z., Stewart R., Peters S., Johnson M.L., Wong K.K., Huang A., Winslow M.M., Rosen M.J., Winters I.P., Papadimitrakopoulou V.A., Cascone T., Jewsbury P., Heymach J.V.
ISSN
1476-4687 (Electronic)
ISSN-L
0028-0836
Publication state
Published
Issued date
11/2024
Peer-reviewed
Oui
Volume
635
Number
8038
Pages
462-471
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
For patients with advanced non-small-cell lung cancer (NSCLC), dual immune checkpoint blockade (ICB) with CTLA4 inhibitors and PD-1 or PD-L1 inhibitors (hereafter, PD-(L)1 inhibitors) is associated with higher rates of anti-tumour activity and immune-related toxicities, when compared with treatment with PD-(L)1 inhibitors alone. However, there are currently no validated biomarkers to identify which patients will benefit from dual ICB <sup>1,2</sup> . Here we show that patients with NSCLC who have mutations in the STK11 and/or KEAP1 tumour suppressor genes derived clinical benefit from dual ICB with the PD-L1 inhibitor durvalumab and the CTLA4 inhibitor tremelimumab, but not from durvalumab alone, when added to chemotherapy in the randomized phase III POSEIDON trial <sup>3</sup> . Unbiased genetic screens identified loss of both of these tumour suppressor genes as independent drivers of resistance to PD-(L)1 inhibition, and showed that loss of Keap1 was the strongest genomic predictor of dual ICB efficacy-a finding that was confirmed in several mouse models of Kras-driven NSCLC. In both mouse models and patients, KEAP1 and STK11 alterations were associated with an adverse tumour microenvironment, which was characterized by a preponderance of suppressive myeloid cells and the depletion of CD8 <sup>+</sup> cytotoxic T cells, but relative sparing of CD4 <sup>+</sup> effector subsets. Dual ICB potently engaged CD4 <sup>+</sup> effector cells and reprogrammed the tumour myeloid cell compartment towards inducible nitric oxide synthase (iNOS)-expressing tumoricidal phenotypes that-together with CD4 <sup>+</sup> and CD8 <sup>+</sup> T cells-contributed to anti-tumour efficacy. These data support the use of chemo-immunotherapy with dual ICB to mitigate resistance to PD-(L)1 inhibition in patients with NSCLC who have STK11 and/or KEAP1 alterations.
Keywords
Kelch-Like ECH-Associated Protein 1/metabolism, Kelch-Like ECH-Associated Protein 1/genetics, Humans, Animals, Mice, Carcinoma, Non-Small-Cell Lung/drug therapy, Carcinoma, Non-Small-Cell Lung/genetics, Carcinoma, Non-Small-Cell Lung/pathology, Carcinoma, Non-Small-Cell Lung/immunology, Protein Serine-Threonine Kinases/metabolism, Protein Serine-Threonine Kinases/antagonists & inhibitors, Protein Serine-Threonine Kinases/genetics, Immune Checkpoint Inhibitors/pharmacology, Immune Checkpoint Inhibitors/therapeutic use, Drug Resistance, Neoplasm/drug effects, AMP-Activated Protein Kinase Kinases, Lung Neoplasms/drug therapy, Lung Neoplasms/genetics, Lung Neoplasms/immunology, Lung Neoplasms/pathology, CTLA-4 Antigen/antagonists & inhibitors, CTLA-4 Antigen/metabolism, B7-H1 Antigen/metabolism, B7-H1 Antigen/antagonists & inhibitors, Female, Male, Mutation, Antibodies, Monoclonal
Pubmed
Web of science
Open Access
Yes
Create date
11/10/2024 13:13
Last modification date
20/11/2024 7:16
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