Jenkins et al. showed in mouse mammary carcinoma models that tumor exclusion of CD8+ T cells correlated positively with abundance of αSMA+ cancer-associated fibroblasts (CAFs), which express collagen-binding endocytic receptor Endo180. Endo180 KO mice lacked αSMA+ CAFs and showed impaired tumor progression. Endo180+ CAF co-implantation reduced numbers of and peripheralized CD8+ T cells in tumors. Tumors implanted into Endo180 KO mice had increased CD8+ T cells and sensitivity to anti-CTLA-4 + anti-PD-L1. In a clinical trial, poor patient response to anti-PD-1 was associated with high Endo180 mRNA expression in melanomas.

Contributed by Paula Hochman

ABSTRACT: Immune checkpoint blockade (ICB) promotes anti-tumor immune responses and can result in durable patient benefit. However, response rates in breast cancer patients remain modest, stimulating efforts to discover novel treatment options. Cancer-associated fibroblasts (CAF) represent a major component of the breast tumor microenvironment and have known immunosuppressive functions in addition to their well-established roles in directly promoting tumor growth and metastasis. Here we utilized paired syngeneic mouse mammary carcinoma models to show that CAF abundance is associated with insensitivity to combination _CTLA-4 and _PD-L1 ICB. CAF-rich tumors exhibited an immunologically cold tumor microenvironment, with transcriptomic, flow cytometric, and quantitative histopathological analyses demonstrating a relationship between CAF density and a CD8+ T cell-excluded tumor phenotype. The CAF receptor Endo180 (Mrc2) is predominantly expressed on myofibroblastic CAFs, and its genetic deletion depleted a subset of _SMA-expressing CAFs and impaired tumor progression in vivo. Addition of wild-type, but not Endo180-deficient, CAFs in co-implantation studies restricted CD8+ T cell intratumoral infiltration, and tumors in Endo180 knockout mice exhibited increased CD8+ T cell infiltration and enhanced sensitivity to ICB compared to tumors in wild-type mice. Clinically, in a trial of melanoma patients, high MRC2 mRNA levels in tumors was associated with a poor response to _PD-1 therapy, highlighting the potential benefits of therapeutically targeting a specific CAF subpopulation in breast and other CAF-rich cancers to improve clinical responses to immunotherapy.

Author Info: (1) Institute of Cancer Research, London, United Kingdom. (2) University of Bath, Bath, United Kingdom. (3) Institut de Recerca Sant Joan de Dðu, Esplugues de Llobregat, Spain. (4)

Author Info: (1) Institute of Cancer Research, London, United Kingdom. (2) University of Bath, Bath, United Kingdom. (3) Institut de Recerca Sant Joan de Dðu, Esplugues de Llobregat, Spain. (4) Institute of Cancer Research, London, United Kingdom. (5) Institute of Cancer Research, London, United Kingdom. (6) Institute of Cancer Research, London, United Kingdom. (7) AstraZeneca (United Kingdom), Cambridge, United Kingdom. (8) Institute of Cancer Research, London, United Kingdom.