Lymphocyte-activation gene 3 (LAG3): The next immune checkpoint receptor
Open accessAbstract
Immune checkpoint therapy has revolutionized cancer treatment by blocking inhibitory pathways in T cells that limits the an effective anti-tumor immune response. Therapeutics targeting CTLA-4 and PD1/PDL1 have progressed to first line therapy in multiple tumor types with some patients exhibiting tumor regression or remission. However, the majority of patients do not benefit from checkpoint therapy emphasizing the need for alternative therapeutic options. Lymphocyte Activation Gene 3 (LAG3) or CD223 is expressed on multiple cell types including CD4+ and CD8+ T cells, and T regs, and is required for optimal T cell regulation and homeostasis. Persistent antigen-stimulation in cancer or chronic infection leads to chronic LAG3 expression, promoting T cell exhaustion. Targeting LAG3 along with PD1 facilitates T cell reinvigoration. A substantial amount of pre-clinical data and mechanistic analysis has led to LAG3 being the third checkpoint to be targeted in the clinic with nearly a dozen therapeutics under investigation. In this review, we will discuss the structure, function and role of LAG3 in murine and human models of disease, including autoimmune and inflammatory diseases, chronic viral and parasitic infections, and cancer, emphasizing new advances in the development of LAG3-targeting immunotherapies for cancer that are currently in clinical trials.
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The expression of PD-L1 and MHC II is regulated by tumor IFN signaling.
“The expression of PD-L1 and MHC II, which may cause exhaustion by binding to T-cell programmed cell death protein 1 (PD-1) and lymphocyte activation gene 3 (LAG-3), respectively, is regulated by tumor interferon (IFN) signaling.”
From Tumor interferon signaling and suppressive myeloid cells are associated with CAR T-cell failure in large B-cell lymphoma (2021) · cites this paper as [25]
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- Authors
- Ruffo, E., Wu, R. C., Bruno, T. C., Workman, C. J., & Vignali, D. A. A.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Vignali, Dario A.A.
- Venue
- Seminars in Immunology
- Publisher
- Elsevier BV
- Published
- 2019-04
- Volume
- 42
- Pages
- 101305
- ISSN
- 1044-5323 (ISSN-L)
- PMC
- PMC6920665
- OpenAlex
- W2979790494
- Cited by
- 381
- References
- 75
- Citations by year
- 2026: 42 · 2025: 55 · 2024: 82 · 2023: 70 · 2022: 73 · 2021: 46 · 2020: 13
- FWCI
- 3.14
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Seminars in Immunology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Associazione Italiana per la Ricerca sul Cancro
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Keywords
- LAG-3, immune checkpoint, cancer immunotherapy, T cell exhaustion, T cell reinvigoration, PD-1, CTLA-4, regulatory T cells, chronic viral infection, parasitic infection, autoimmune disease
- MeSH terms
- Lymphocyte Activation Gene 3 Protein, Animals, Humans, Immunotherapy, Ligands, Neoplasms, Receptors, Immunologic, Antigens, CD, Tumor Microenvironment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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