4.6 Review

Turning cold tumors hot: from molecular mechanisms to clinical applications

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Cancer-cell-derived GABA promotes beta-catenin-mediated tumour growth and immunosuppression

De Huang et al.

Summary: Huang et al. report that cancer cells can rewire glutamine metabolism to synthesize the neurotransmitter GABA, which activates beta-catenin and suppresses T-cell infiltration, promoting tumor growth and leading to resistance to immune checkpoint blockade therapy. Targeting GAD1 or GABA(B)R can overcome this resistance and improve treatment outcomes.

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Summary: Combining intermittent PI3K inhibition with immune checkpoint therapy can overcome tumor intrinsic immunosuppression and activate anti-tumor immunity, paving the way for successful cancer treatment.

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Fasting- Mimicking Diet Is Safe and Reshapes Metabolism and Antitumor Immunity in Patients with Cancer

Claudio Vernieri et al.

Summary: Cyclic fasting or fasting-mimicking diets (FMD) enhance antineoplastic treatments by modulating systemic metabolism and boosting antitumor immunity. In a clinical trial, the five-day FMD was found to be safe and resulted in consistent decrease of blood glucose and growth factor concentration, recapitulating metabolic changes observed in preclinical experiments. The FMD also reshapes anticancer immunity and improves clinical outcomes in patients with cancer.

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Neoadjuvant STING Activation, Extended Half-life IL2, and Checkpoint Blockade Promote Metastasis Clearance via Sustained NK-cell Activation

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Summary: Combination therapy using STING agonist, IL2, and anti-PD-1 checkpoint blockade can stimulate a more complete immune response in triple-negative breast cancer models, leading to tumor regression and long-term remission. NK cells play a crucial role in preventing metastatic relapse, and the combination of STING agonists with IL2/anti-PD-1 enhances the activity of lung-infiltrating NK cells.

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T and NK cell abundance defines two distinct subgroups of renal cell carcinoma

Moon Hee Lee et al.

Summary: This study investigated the immunological heterogeneity of renal cell carcinoma (RCC) tumors. The results revealed that RCC tumors can be categorized into two subgroups based on the abundance of tumor infiltrating lymphocytes and PD-1 expression on CD8+ T cells, as well as the infiltration of NK cells. Transcriptomic and genomic analysis showed distinct differences between the two subgroups. These findings provide insights into the immunological heterogeneity of RCC and its potential impact on treatment responses to immunological therapies.

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Distribution and density of tertiary lymphoid structures predict clinical outcome in intrahepatic cholangiocarcinoma

Guang-Yu Ding et al.

Summary: The prognostic value and functional involvement of tertiary lymphoid structures (TLSs) in intrahepatic cholangiocarcinoma (iCCA) were evaluated. The study found that the spatial distribution and abundance of TLSs significantly correlated with prognosis and provided a useful immune classification for iCCA. T follicular helper and regulatory T cells were identified as critical factors in determining the functional orientation of spatially different TLSs.

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Fully automated hybrid approach to predict the IDH mutation status of gliomas via deep learning and radiomics

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DNA Sensing in Mismatch Repair-Deficient Tumor Cells Is Essential for Anti-tumor Immunity

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Summary: This study demonstrates the importance of DNA sensing within tumor cells in triggering anti-tumor immunity in dMLH1 tumors, providing new mechanisms and biomarkers for anti-dMMR-cancer immunotherapy.

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Tumor Mutational Burden as a Predictor of Immunotherapy Response: Is More Always Better?

John H. Strickler et al.

Summary: While high tumor mutational burden (TMB-H) has shown promise as a biomarker in lung cancer, its broad applicability across all solid tumors is unclear. The FDA has approved the PD-1 inhibitor, pembrolizumab, as a therapy for all solid tumors with TMB equal to or greater than 10 mutations. However, there are risks and unanswered questions regarding the use of TMB as a biomarker.

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Microbiota triggers STING-type I IFN-dependent monocyte reprogramming of the tumor microenvironment

Khiem C. Lam et al.

Summary: This study reveals how the microbiota influences the immune components of the TME to improve cancer therapy. Modulating the microbiota can trigger the IFN-I-NK cell-DC axis within tumors, enhancing the efficacy of immune checkpoint blockade (ICB).
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Personal neoantigen vaccines induce persistent memory T cell responses and epitope spreading in patients with melanoma

Zhuting Hu et al.

Summary: Personal neoantigen peptide vaccines induce long-lasting T cell responses in melanoma patients, broadening the spectrum of tumor-specific cytotoxicity and resulting in diverse T cell clones with cytotoxic gene signatures.

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Fecal microbiota transplant promotes response in immunotherapy-refractory melanoma patients

Erez N. Baruch et al.

Summary: This study conducted a phase 1 clinical trial and found that FMT treatment in patients with anti-PD-1-refractory metastatic melanoma, along with reinduction of anti-PD-1 immunotherapy, resulted in clinical responses in some patients. This suggests that modulating the gut microbiota could be a promising approach in cancer treatment.

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Microbiota-specific T follicular helper cells drive tertiary lymphoid structures and anti-tumor immunity against colorectal cancer

Abigail E. Overacre-Delgoffe et al.

Summary: The study showed that introducing specific intestinal bacteria can enhance anti-colorectal cancer immunity and promote tumor control. This anti-tumor immunity is dependent on CD4(+) T cells, B cells, and NK cells.

IMMUNITY (2021)

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Inhibitory CD161 receptor identified in glioma-infiltrating T cells by single-cell analysis

Nathan D. Mathewson et al.

Summary: This study utilized single-cell RNA sequencing to uncover the gene expression and clonal landscape of T cells in diffuse gliomas, identifying potential effectors of anti-tumor immunity. The research revealed that KLRB1 and its associated transcriptional program play an inhibitory role in tumor immunity, and blocking its function enhances T cell killing of glioma cells.
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Meta-analysis of tumor- and T cell-intrinsic mechanisms of sensitization to checkpoint inhibition

Kevin Litchfield et al.

Summary: Checkpoint inhibitors (CPIs) enhance adaptive immunity, with clonal tumor mutation burden (TMB) identified as the strongest predictor of CPI response. Dinucleotide variants may serve as a source of immunogenic epitopes, while copy-number alterations and HLA evolutionary divergence lack pan-cancer significance.
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CD36-mediated ferroptosis dampens intratumoral CD8+ T cell effector function and impairs their antitumor ability

Xingzhe Ma et al.

Summary: Understanding the mechanisms of how T cells become dysfunctional in a tumor microenvironment is crucial for cancer immunotherapy. This study found that CD36 expression in tumor-infiltrating CD8(+) T cells, induced by TME cholesterol, is associated with tumor progression and poor survival, and that genetic ablation of Cd36 in these T cells leads to enhanced tumor eradication. Targeting CD36 or inhibiting ferroptosis could restore T cell function and enhance antitumor efficacy, especially in combination with anti-PD-1 antibodies.

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Global analysis of shared T cell specificities in human non-small cell lung cancer enables HLA inference and antigen discovery

Shin-Heng Chiou et al.

Summary: Through analyzing a large number of T cell receptor sequences, we identified T cell receptors with shared antigen specificity in a subset of non-small cell lung cancer patients and identified some specificity groups enriched in tumors. Using a yeast peptide-HLA display library, we confirmed the antigenic epitopes of one tumor-enriched specificity group, indicating that pathogen cross-reactivity may be a feature of multiple cancers.

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B cell-derived GABA elicits IL-10+ macrophages to limit anti-tumour immunity

Baihao Zhang et al.

Summary: This study reveals that small metabolites like GABA derived from B-lineage cells can influence immune responses by promoting anti-inflammatory macrophages and enhancing anti-tumour responses. The findings suggest that targeting these metabolites may offer a new approach to immunoregulation.

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Tumour DDR1 promotes collagen fibre alignment to instigate immune exclusion

Xiujie Sun et al.

Summary: The study identifies a new mechanism of immune exclusion mediated by DDR1-ECD through promoting collagen fiber alignment. Inhibition of DDR1 promotes intratumoral penetration of T cells and eradicates tumor growth in TNBC.

NATURE (2021)

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CTLA-4 blockade drives loss of Treg stability in glycolysis-low tumours

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Summary: By blocking CTLA-4, metabolic fitness and immune cell infiltration in tumours, especially those with low glycolytic activity, can be enhanced. This improves therapeutic outcomes, particularly in tumours with defective glycolysis, by destabilizing T-reg cells and promoting the activity of tumour-specific CD8(+) T cells.

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Summary: T-reg cells exhibit broad heterogeneity in glucose metabolism within normal and transformed tissues, utilizing an alternative metabolic pathway to maintain their suppressive function and proliferation. Glucose uptake is correlated with poorer suppressive function and long-term instability, while high-glucose conditions impair T-reg cell function and stability. Additionally, T-reg cells upregulate pathways involved in the metabolism of lactic acid, with lactate uptake being dispensable for peripheral T-reg cells but required intratumorally for slowed tumor growth and increased response to immunotherapy.

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Lipid signalling enforces functional specialization of Treg cells in tumours

Seon Ah Lim et al.

Summary: Regulatory T cells play a crucial role in immune tolerance and immunosuppression in the tumor microenvironment. Inhibiting lipid synthesis dependent on SREBPs in T-reg cells can enhance antitumor immune responses without autoimmune toxicity, and deletion of SCAP in these cells inhibits tumor growth and enhances immunotherapy. SCAP and SREBPs signaling regulate lipid synthesis and inhibitory receptor signaling in T-reg cells, pointing to new ways of targeting these cells for cancer therapy.

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Survival and biomarker analyses from the OpACIN-neo and OpACIN neoadjuvant immunotherapy trials in stage III melanoma

E. A. Rozeman et al.

Summary: The combination of neoadjuvant ipilimumab plus nivolumab showed high pathologic response rates (pRRs) in patients with macroscopic stage III melanoma. High tumor mutational burden (TMB) and high interferon-gamma-related gene expression signature score (IFN-gamma score) were associated with pathologic response and a low risk of relapse. These findings support the potential predictive value of TMB and IFN-gamma score in the treatment of melanoma patients.

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Nivolumab plus Cabozantinib versus Sunitinib for Advanced Renal-Cell Carcinoma

T. K. Choueiri et al.

Summary: The study demonstrates that nivolumab plus cabozantinib has significant advantages over sunitinib in the treatment of previously untreated advanced renal-cell carcinoma, including progression-free survival, overall survival, and likelihood of response.

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Pan-cancer single cell landscape of tumor-infiltrating T cells

Liangtao Zheng et al.

Summary: This study constructed a pan-cancer atlas of T cells across 21 cancer types, revealing different composition patterns and state-transition paths of T cells. The correlation between certain T cell populations and patient characteristics sheds light on possible determinants of the tumor microenvironment, providing new insights into T cell immunity and precision immunotherapy.

SCIENCE (2021)

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Therapeutically Increasing MHC-I Expression Potentiates Immune Checkpoint Blockade

Shengqing Stan Gu et al.

Summary: This study identified that the SMAC mimetic birinapant can upregulate MHC-I expression and enhance cancer cell sensitivity to immunotherapy. The findings provide preclinical rationale for using SMAC mimetics to improve immunotherapy efficacy in tumors with low MHC-I expression.

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High tumor mutation burden fails to predict immune checkpoint blockade response across all cancer types

D. J. McGrail et al.

Summary: Analysis of over 10,000 patient tumors from The Cancer Genome Atlas showed that TMB-H tumors had significantly higher response rates to immune checkpoint blockade in certain cancer types, while showing no significant benefit in others. These results do not support the use of TMB-H as a biomarker for ICB treatment across all solid cancer types, indicating the need for further tumor type-specific studies.

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Stanniocalcin 1 is a phagocytosis checkpoint driving tumor immune resistance

Heng Lin et al.

Summary: Immunotherapy can induce durable clinical responses in some cancer patients, but resistance poses a major challenge. The expression of tumor STC1 is correlated with immunotherapy efficacy and negatively associated with patient survival across different cancer types. This study suggests that tumor STC1 may inhibit APC phagocytosis and contribute to tumor immune evasion and immunotherapy resistance.

CANCER CELL (2021)

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Turning tumors from cold to inflamed to improve immunotherapy response

C. L. Gerard et al.

Summary: Immune checkpoint inhibitors have revolutionized cancer treatment, but many patients still do not respond to these therapies. By examining the immune phenotypes in the tumor microenvironment, researchers aim to predict patient-specific responses. Strategies to reprogram the tumor microenvironment are being explored to enhance the efficacy of immunotherapies, along with combinations with other therapeutic options.

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Gut microbial metabolites facilitate anticancer therapy efficacy by modulating cytotoxic CD8+ T cell immunity

Yao He et al.

Summary: Recent studies suggest that gut microbial metabolite butyrate can enhance the efficacy of oxaliplatin by modulation of CD8(+) T cell immunity through an ID2-dependent mechanism. This finding has important implications for cancer therapy in patients responding to oxaliplatin.

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The inhibitory receptor TIM-3 limits activation of the cGAS-STING pathway in intra-tumoral dendritic cells by suppressing extracellular DNA uptake

Alvaro de Mingo Pulido et al.

Summary: Blockade of the inhibitory receptor TIM-3 has shown efficacy in clinical trials of cancer immunotherapy, specifically in enhancing antitumor immunity in mammary carcinomas by increasing CXCL9 expression by cDC1 cells. This increased expression required type I interferons and extracellular DNA, with DNA uptake and efficacy of TIM-3 blockade being dependent on HMGB1 and galectin-9-induced cell surface clustering of TIM-3, suggesting a potential mechanism for TIM-3 immunotherapy.

IMMUNITY (2021)

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Tumor-infiltrating plasmacytoid dendritic cells are associated with survival in human colon cancer

Maximilian Kiessler et al.

Summary: The study found that higher densities of tumor-infiltrating pDCs are associated with lower UICC staging, increased progression-free and overall survival in colon cancer patients. A lower number of colon cancer-infiltrating pDCs was independently linked to worse prognosis, while the colocalization of activated pDCs and T cells in tumor stroma and within TLS may contribute to the correlation between higher pDC densities and better prognosis.

JOURNAL FOR IMMUNOTHERAPY OF CANCER (2021)

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Single-cell analysis defines a pancreatic fibroblast lineage that supports anti-tumor immunity

Colin Hutton et al.

Summary: This study used mass cytometry to analyze the stromal composition in murine tissues and tumors, revealing extensive stromal heterogeneity and coordinated relationships between mesenchymal and immune cell subsets in pancreatic ductal adenocarcinoma. The research identified two stable and functionally distinct pancreatic fibroblast lineages marked by CD105 expression, with CD105-positive fibroblasts promoting tumor growth and CD105-negative fibroblasts suppressing tumors, dependent on adaptive immunity. These findings highlight the importance of mesenchymal and immune cell interactions in restricting tumor growth.

CANCER CELL (2021)

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Secreted gelsolin inhibits DNGR-1-dependent cross-presentation and cancer immunity

Evangelos Giampazolias et al.

Summary: The study reveals that secretion of gelsolin decreases the binding of DNGR-1 to F-actin, leading to reduced cross-presentation of dead cell-associated antigens by conventional dendritic cells. Mice deficient in gelsolin show increased resistance to transplantable tumors and improved responsiveness to cancer immunotherapy. In human cancers, lower levels of intratumoral gelsolin transcripts and mutations in actin cytoskeleton-associated proteins are linked to enhanced anti-cancer immunity and improved patient survival.
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Early Use of High-Dose Glucocorticoid for the Management of irAE Is Associated with Poorer Survival in Patients with Advanced Melanoma Treated with Anti-PD-1 Monotherapy

Xue Bai et al.

Summary: A multicenter retrospective analysis found that early high-dose GCC use was associated with poorer survival outcomes in melanoma patients after anti-PD-1 monotherapy, highlighting the need for cautious use of GCC. These findings were validated in a combined validation cohort, confirming the association between high-dose GCC use and worse prognosis.

CLINICAL CANCER RESEARCH (2021)

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Uptake of oxidized lipids by the scavenger receptor CD36 promotes lipid peroxidation and dysfunction in CD8+ T cells in tumors

Shihao Xu et al.

Summary: The accumulation of lipids in the tumor microenvironment is associated with dysfunction of CD8(+) T cells, mediated in part by the CD36 receptor and its promotion of lipid uptake and peroxidation. Inhibiting p38 kinase or resolving lipid peroxidation may restore effector T cell functions and provide a potential therapeutic avenue for immunotherapies.

IMMUNITY (2021)

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Phenotype, specificity and avidity of antitumour CD8+ T cells in melanoma

Giacomo Oliveira et al.

Summary: The authors demonstrate through single-cell profiling and T cell receptor specificity screening that tumour antigen recognition influences the phenotypes of CD8(+) T cells and antitumour immune responses. Non-tumour-reactive T cells show a non-exhausted memory phenotype, while melanoma-reactive lymphocytes exhibit an exhausted state, providing insights into the properties of the anti-melanoma TCR repertoire.

NATURE (2021)

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Targeting regulator of G protein signaling 1 in tumor-specific T cells enhances their trafficking to breast cancer

Di Huang et al.

Summary: Effective tumor control relies on inflammatory helper and cytotoxic T cells. The protein RGS1 negatively regulates effector T cell homing to tumors, leading to tumor immune evasion and decreased patient survival. Targeting RGS1 may offer a new strategy for tumor immunotherapy.

NATURE IMMUNOLOGY (2021)

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BATF and IRF4 cooperate to counter exhaustion in tumor-infiltrating CAR T cells

Hyungseok Seo et al.

Summary: BATF and IRF4 cooperate to counter T cell exhaustion in mouse tumor models, promoting better tumor control by CAR T cells.

NATURE IMMUNOLOGY (2021)

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Analysis of multispectral imaging with the AstroPath platform informs efficacy of PD-1 blockade

Sneha Berry et al.

Summary: A comprehensive platform for multispectral imaging and mapping of multiple parameters in tumor tissue sections was introduced, allowing high-fidelity single-cell analysis. This platform identified key features in pretreatment melanoma specimens that predicted response to anti-PD-1 therapy, and stratified long-term survival after anti-PD-1 blockade. The signature was validated in an independent cohort of melanoma patients from a different institution.

SCIENCE (2021)

Review Medicine, Research & Experimental

Tumor innervation: peripheral nerves take control of the tumor microenvironment

Stefan M. Gysler et al.

Summary: Recent cancer research has shifted focus from abnormal cell division to the complex interactions between cancer and noncancer cells in the tumor microenvironment. The recruitment of peripheral nerves to the TME by tumors has been linked to enhanced tumor growth and aggressive tumor behavior, suggesting a potential role for the peripheral nervous system in cancer development. Emerging evidence also suggests that exosomes may mediate neural regulation of the TME through cell-cell communication.

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The IRENA lncRNA converts chemotherapy-polarized tumor-suppressing macrophages to tumor-promoting phenotypes in breast cancer

Jiang Liu et al.

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