[PDF][PDF] DUX4 suppresses MHC class I to promote cancer immune evasion and resistance to checkpoint blockade

GL Chew, AE Campbell, E De Neef, NA Sutliff… - Developmental cell, 2019 - cell.com
Developmental cell, 2019cell.com
Advances in cancer immunotherapies make it critical to identify genes that modulate antigen
presentation and tumor-immune interactions. We report that DUX4, an early embryonic
transcription factor that is normally silenced in somatic tissues, is re-expressed in diverse
solid cancers. Both cis-acting inherited genetic variation and somatically acquired mutations
in trans-acting repressors contribute to DUX4 re-expression in cancer. Although many DUX4
target genes encode self-antigens, DUX4-expressing cancers were paradoxically …
Summary
Advances in cancer immunotherapies make it critical to identify genes that modulate antigen presentation and tumor-immune interactions. We report that DUX4, an early embryonic transcription factor that is normally silenced in somatic tissues, is re-expressed in diverse solid cancers. Both cis-acting inherited genetic variation and somatically acquired mutations in trans-acting repressors contribute to DUX4 re-expression in cancer. Although many DUX4 target genes encode self-antigens, DUX4-expressing cancers were paradoxically characterized by reduced markers of anti-tumor cytolytic activity and lower major histocompatibility complex (MHC) class I gene expression. We demonstrate that DUX4 expression blocks interferon-γ-mediated induction of MHC class I, implicating suppressed antigen presentation in DUX4-mediated immune evasion. Clinical data in metastatic melanoma confirmed that DUX4 expression was associated with significantly reduced progression-free and overall survival in response to anti-CTLA-4. Our results demonstrate that cancers can escape immune surveillance by reactivating a normal developmental pathway and identify a therapeutically relevant mechanism of cell-intrinsic immune evasion.
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