[HTML][HTML] Heterogeneity of response to immune checkpoint blockade in hypermutated experimental gliomas

K Aslan, V Turco, J Blobner, JK Sonner… - Nature …, 2020 - nature.com
K Aslan, V Turco, J Blobner, JK Sonner, AR Liuzzi, NG Núñez, D De Feo, P Kickingereder
Nature communications, 2020nature.com
Intrinsic malignant brain tumors, such as glioblastomas are frequently resistant to immune
checkpoint blockade (ICB) with few hypermutated glioblastomas showing response.
Modeling patient-individual resistance is challenging due to the lack of predictive
biomarkers and limited accessibility of tissue for serial biopsies. Here, we investigate
resistance mechanisms to anti-PD-1 and anti-CTLA-4 therapy in syngeneic hypermutated
experimental gliomas and show a clear dichotomy and acquired immune heterogeneity in …
Abstract
Intrinsic malignant brain tumors, such as glioblastomas are frequently resistant to immune checkpoint blockade (ICB) with few hypermutated glioblastomas showing response. Modeling patient-individual resistance is challenging due to the lack of predictive biomarkers and limited accessibility of tissue for serial biopsies. Here, we investigate resistance mechanisms to anti-PD-1 and anti-CTLA-4 therapy in syngeneic hypermutated experimental gliomas and show a clear dichotomy and acquired immune heterogeneity in ICB-responder and non-responder tumors. We made use of this dichotomy to establish a radiomic signature predicting tumor regression after pseudoprogression induced by ICB therapy based on serial magnetic resonance imaging. We provide evidence that macrophage-driven ICB resistance is established by CD4 T cell suppression and Treg expansion in the tumor microenvironment via the PD-L1/PD-1/CD80 axis. These findings uncover an unexpected heterogeneity of response to ICB in strictly syngeneic tumors and provide a rationale for targeting PD-L1-expressing tumor-associated macrophages to overcome resistance to ICB.
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