Torres-Mejia et al. showed that tumor cell-intrinsic SOX2 expression correlated with low T cell infiltration in NSCLC. Overexpression of SOX2 in tumor cells induced CD8+ T cell exclusion from the tumor core, and promoted tumor growth and resistance to anti-PD-1 and anti-CTLA-4 in the KP lung tumor model. SOX2 signaling upregulated CCL2 in tumor cells, resulting in increased recruitment of Tregs, which suppressed tumor vasculature, leading to CD8+ T cell exclusion from the tumor core. Anti-GITR treatment reduced Treg density within the TME, improved CD8+ T cell infiltration, and suppressed tumor growth when combined with checkpoint blockade.
Contributed by Shishir Pant
ABSTRACT: Tumor cell-intrinsic signaling pathways can drastically affect the tumor immune microenvironment, promoting tumor progression and resistance to immunotherapy by excluding immune cell populations from the tumor. Several tumor cell-intrinsic pathways have been reported to modulate myeloid-cell and T-cell infiltration, creating "cold" tumors. However, clinical evidence suggests that excluding cytotoxic T cells from the tumor core also mediates immune evasion. In this study, we find that tumor cell-intrinsic SOX2 signaling in non-small cell lung cancer induces the exclusion of cytotoxic T cells from the tumor core and promotes resistance to checkpoint blockade therapy. Mechanistically, tumor cell-intrinsic SOX2 expression upregulates CCL2 in tumor cells, resulting in increased recruitment of regulatory T cells (Treg). CD8+ T-cell exclusion depended on Treg-mediated suppression of tumor vasculature. Depleting tumor-infiltrating Tregs via glucocorticoid-induced TNF receptor-related protein restored CD8+ T-cell infiltration and, when combined with checkpoint blockade therapy, reduced tumor growth. These results show that tumor cell-intrinsic SOX2 expression in lung cancer serves as a mechanism of immunotherapy resistance and provide evidence to support future studies investigating whether patients with non-small cell lung cancer with SOX2-dependent CD8+ T-cell exclusion would benefit from the depletion of glucocorticoid-induced TNFR-related protein-positive Tregs.