TY - JOUR
T1 - Characterization of the Immune Landscape of EGFR-Mutant NSCLC Identifies CD73/Adenosine Pathway as a Potential Therapeutic Target
AU - Le, Xiuning
AU - Negrao, Marcelo V.
AU - Reuben, Alexandre
AU - Federico, Lorenzo
AU - Diao, Lixia
AU - McGrail, Daniel
AU - Nilsson, Monique
AU - Robichaux, Jacqulyne
AU - Munoz, Irene Guijarro
AU - Patel, Sonia
AU - Elamin, Yasir
AU - Fan, You Hong
AU - Lee, Won Chul
AU - Parra, Edwin
AU - Solis Soto, Luisa Maren
AU - Chen, Runzhe
AU - Li, Jun
AU - Karpinets, Tatiana
AU - Khairullah, Roohussaba
AU - Kadara, Humam
AU - Behrens, Carmen
AU - Sepesi, Boris
AU - Wang, Ruiping
AU - Zhu, Mingrui
AU - Wang, Linghua
AU - Vaporciyan, Ara
AU - Roth, Jack
AU - Swisher, Stephen
AU - Haymaker, Cara
AU - Zhang, Jianhua
AU - Wang, Jing
AU - Wong, Kwok Kin
AU - Byers, Lauren A.
AU - Bernatchez, Chantale
AU - Zhang, Jianjun
AU - Wistuba, Ignacio I.
AU - Gibbons, Don L.
AU - Akbay, Esra A.
AU - Heymach, John V.
N1 - Publisher Copyright:
© 2021 International Association for the Study of Lung Cancer
PY - 2021/4
Y1 - 2021/4
N2 - Introduction: Lung adenocarcinomas harboring EGFR mutations do not respond to immune checkpoint blockade therapy and their EGFR wildtype counterpart. The mechanisms underlying this lack of clinical response have been investigated but remain incompletely understood. Methods: We analyzed three cohorts of resected lung adenocarcinomas (Profiling of Resistance Patterns of Oncogenic Signaling Pathways in Evaluation of Cancer of Thorax, Immune Genomic Profiling of NSCLC, and The Cancer Genome Atlas) and compared tumor immune microenvironment of EGFR-mutant tumors to EGFR wildtype tumors, to identify actionable regulators to target and potentially enhance the treatment response. Results: EGFR-mutant NSCLC exhibited low programmed death-ligand 1, low tumor mutational burden, decreased number of cytotoxic T cells, and low T cell receptor clonality, consistent with an immune-inert phenotype, though T cell expansion ex vivo was preserved. In an analysis of 75 immune checkpoint genes, the top up-regulated genes in the EGFR-mutant tumors (NT5E and ADORA1) belonged to the CD73/adenosine pathway. Single-cell analysis revealed that the tumor cell population expressed CD73, both in the treatment-naive and resistant tumors. Using coculture systems with EGFR-mutant NSCLC cells, T regulatory cell proportion was decreased with CD73 knockdown. In an immune-competent mouse model of EGFR-mutant lung cancer, the CD73/adenosine pathway was markedly up-regulated and CD73 blockade significantly inhibited tumor growth. Conclusions: Our work revealed that EGFR-mutant NSCLC has an immune-inert phenotype. We identified the CD73/adenosine pathway as a potential therapeutic target for EGFR-mutant NSCLC.
AB - Introduction: Lung adenocarcinomas harboring EGFR mutations do not respond to immune checkpoint blockade therapy and their EGFR wildtype counterpart. The mechanisms underlying this lack of clinical response have been investigated but remain incompletely understood. Methods: We analyzed three cohorts of resected lung adenocarcinomas (Profiling of Resistance Patterns of Oncogenic Signaling Pathways in Evaluation of Cancer of Thorax, Immune Genomic Profiling of NSCLC, and The Cancer Genome Atlas) and compared tumor immune microenvironment of EGFR-mutant tumors to EGFR wildtype tumors, to identify actionable regulators to target and potentially enhance the treatment response. Results: EGFR-mutant NSCLC exhibited low programmed death-ligand 1, low tumor mutational burden, decreased number of cytotoxic T cells, and low T cell receptor clonality, consistent with an immune-inert phenotype, though T cell expansion ex vivo was preserved. In an analysis of 75 immune checkpoint genes, the top up-regulated genes in the EGFR-mutant tumors (NT5E and ADORA1) belonged to the CD73/adenosine pathway. Single-cell analysis revealed that the tumor cell population expressed CD73, both in the treatment-naive and resistant tumors. Using coculture systems with EGFR-mutant NSCLC cells, T regulatory cell proportion was decreased with CD73 knockdown. In an immune-competent mouse model of EGFR-mutant lung cancer, the CD73/adenosine pathway was markedly up-regulated and CD73 blockade significantly inhibited tumor growth. Conclusions: Our work revealed that EGFR-mutant NSCLC has an immune-inert phenotype. We identified the CD73/adenosine pathway as a potential therapeutic target for EGFR-mutant NSCLC.
KW - Adenosine
KW - CD73
KW - EGFR-mutant lung cancer
KW - Immune microenvironment
KW - T cells
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UR - http://www.scopus.com/inward/citedby.url?scp=85102652007&partnerID=8YFLogxK
U2 - 10.1016/j.jtho.2020.12.010
DO - 10.1016/j.jtho.2020.12.010
M3 - Article
C2 - 33388477
AN - SCOPUS:85102652007
SN - 1556-0864
VL - 16
SP - 583
EP - 600
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
IS - 4
ER -