Focusing on identifying treatments to improve the effectiveness of anti-PD-1, Porte et al. examined the impact of iron supplementation on tumor growth in vitro and in mouse models. Dietary iron supplementation significantly enhanced T cell activation, proliferation, and IFNγ production, and led to metabolic T cell reprogramming, which was dependent on lipid oxidation. The addition of iron significantly slowed tumor growth in vivo, and resulted in improved efficacy in combination with anti-PD-1. In human patients, plasma ferritin levels directly correlated with antitumor efficacy following a single dose of anti-PD-1, suggesting iron may also modulate anti-PD-1 responses in humans.

Contributed by Katherine Turner

ABSTRACT: Cancers only develop if they escape immunosurveillance, and the success of cancer immunotherapies relies in most cases on their ability to restore effector T-cell functions, particularly IFN-γ production. Revolutionizing the treatment of many cancers, immunotherapies targeting immune checkpoints such as PD1 can increase survival and cure patients. Unfortunately, although immunotherapy has greatly improved the prognosis of patients, not all respond to anti-PD1 immunotherapy, making it crucial to identify alternative treatments that could be combined with current immunotherapies to improve their effectiveness. Here, we show that iron supplementation significantly boosts T-cell responses in vivo and in vitro. This boost is associated with a metabolic reprogramming of T cells in favor of lipid oxidation. We also found that the "adjuvant" effect of iron led to a marked slowdown of tumor-cell growth after tumor-cell line transplantation in mice. Specifically, our results suggest that iron supplementation promotes anti-tumor responses by increasing IFN-γ production by T cells. In addition, iron supplementation considerably improves the efficacy of anti-PD1 cancer immunotherapy in mice. Finally, our study suggests that, in cancer patients, the quality and efficacy of the anti-tumor response following anti-PD1 immunotherapy may be modulated by plasma ferritin levels. In summary, our results suggest the benefits of iron supplementation on the reactivation of anti-tumor responses and support the relevance of a fruitful association between immunotherapy and iron supplementation.

Author Info: (1) Institut Cochin, Paris, France. (2) Institut Cochin, France. (3) Institut Cochin, Paris, France. (4) Institut Cochin, Paris, France. (5) Institut Cochin, Paris, France. (6) Ins

Author Info: (1) Institut Cochin, Paris, France. (2) Institut Cochin, France. (3) Institut Cochin, Paris, France. (4) Institut Cochin, Paris, France. (5) Institut Cochin, Paris, France. (6) Institut Cochin, PARIS, France. (7) Institut Cochin, Paris, France. (8) Institut Cochin, Paris, France. (9) Institut Cochin, PARIS, France. (10) Institut Cochin, Paris, France. (11) Institut Cochin, France. (12) Institut Cochin, Paris, France. (13) Institut Cochin, France. (14) Cochin hospital, AP-HP, Paris, France. (15) Institut Cochin, France. (16) Institut Cochin, France. (17) Institut Cochin, Paris, France. (18) Institut Cochin, paris, France. (19) Institut Cochin, Paris, France.