CDK4/6 inhibition triggers anti-tumour immunity
Open accessAbstract
Cyclin-dependent kinases 4 and 6 (CDK4/6) are fundamental drivers of the cell cycle and are required for the initiation and progression of various malignancies. Pharmacological inhibitors of CDK4/6 have shown significant activity against several solid tumours. Their primary mechanism of action is thought to be the inhibition of phosphorylation of the retinoblastoma tumour suppressor, inducing G1 cell cycle arrest in tumour cells. Here we use mouse models of breast carcinoma and other solid tumours to show that selective CDK4/6 inhibitors not only induce tumour cell cycle arrest, but also promote anti-tumour immunity. We confirm this phenomenon through transcriptomic analysis of serial biopsies from a clinical trial of CDK4/6 inhibitor treatment for breast cancer. The enhanced anti-tumour immune response has two underpinnings. First, CDK4/6 inhibitors activate tumour cell expression of endogenous retroviral elements, thus increasing intracellular levels of double-stranded RNA. This in turn stimulates production of type III interferons and hence enhances tumour antigen presentation. Second, CDK4/6 inhibitors markedly suppress the proliferation of regulatory T cells. Mechanistically, the effects of CDK4/6 inhibitors both on tumour cells and on regulatory T cells are associated with reduced activity of the E2F target, DNA methyltransferase 1. Ultimately, these events promote cytotoxic T-cell-mediated clearance of tumour cells, which is further enhanced by the addition of immune checkpoint blockade. Our findings indicate that CDK4/6 inhibitors increase tumour immunogenicity and provide a rationale for new combination regimens comprising CDK4/6 inhibitors and immunotherapies as anti-cancer treatment.
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In a mouse model of breast cancer, CDK4/6 inhibition-driven cellular senescence also triggered antitumour immunity, mediated by suppression of regulatory T cells and re-expression of endogenous retroviral elements, which elicited an interferon response.
“Moreover, in a mouse model of breast cancer, CDK4/6 inhibition- driven cellular senescence also triggered antitumour immunity, mediated by suppression of regulatory Tcells and re- expression of endogenous retroviral elements, which elicited an interferon response 106,153 .”
From Senescence and cancer — role and therapeutic opportunities (2022) · cites this paper as [153]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredCDK4/6 inhibitor-induced senescent non-malignant and malignant cells largely lack pro-inflammatory SASP factors.
“CDK4/6 inhibitor- induced senescent non- malignant and malignant cells largely lack pro- inflammatory SASP factors 111,153 .”
From Senescence and cancer — role and therapeutic opportunities (2022) · cites this paper as [153]
The main text (indexed under Abstract; page unavailable) says abemaciclib induced senescence-like features in tumor cells without increasing key SASP factors, as detailed in Extended Data Figure 8. The paper does not establish the same finding for non-malignant cells, so that extension is unsupported by this source. (LLM, conf=0.88)
Experimental — accuracy not yet measuredDespite the marked reduction in the inflammatory SASP response, CDK4/6 inhibition triggers antitumour immunity and favours senescent cell removal.
“Importantly, despite the marked reduction in the inflammatory SASP response, CDK4/6 inhibition triggers antitumour immunity and favours senescent cell removal 111,153 .”
From Senescence and cancer — role and therapeutic opportunities (2022) · cites this paper as [153]
The paper reports that CDK4/6 inhibition promotes antitumour immunity and cytotoxic T-cell-mediated clearance of tumour cells (Abstract; page unavailable). It describes a senescence-like phenotype without increased expression of key SASP factors (main text and Extended Data Figure 8; pages unavailable), but does not establish a marked reduction in SASP or specifically show removal of senescent cells. (LLM, conf=0.86)
Experimental — accuracy not yet measuredTargeted therapies such as EGFR inhibitors and CDK4/6 inhibitors can induce a strong reactivation of repeated elements in cancer cells, which results in cell death.
“Interestingly, targeted therapies such as EGFR inhibitors and CDK4/6 inhibitors can induce a strong reactivation of repeated elements in cancer cells, which results in cell death [24,102].”
From Emerging Insights into Targeted Therapy-Tolerant Persister Cells in Cancer (2021) · cites this paper as [102]
CDK4/CDK6 inhibitors stimulate immunity by promoting secretion of pro-inflammatory cytokines such as type III interferon and CCL5.
“CDK4/CDK6 inhibitors mediate immunostimulatory effects by favoring the secretion of pro-inflammatory cytokines such as type III interferon (Goel et al., 2017) and CC-chemokine ligand 5 (CCL5) (Vilgelm et al., 2016).”
From Immunomodulation by targeted anticancer agents (2021) · cites this paper as Goel et al., 2017
In several preclinical tumor models, abemaciclib-mediated CDK4/CDK6 inhibition stimulates immunity by increasing MHC class I exposure on cancer cells.
“In various preclinical tumor models, CDK4/CDK6 inhibition with abemaciclib mediates immunostimulatory effects by promoting the exposure of MHC class I molecules on the cancer cell surface (Goel et al., 2017; Schaer et al., 2018).”
From Immunomodulation by targeted anticancer agents (2021) · cites this paper as Goel et al., 2017
This cytokine secretion occurs either after endogenous retrovirus derepression and nucleic acid sensing or after permanent cell cycle blockage with a senescence-associated secretory phenotype.
“This occurs either upon the derepression of endogenous retroviruses and consequent nucleic acid sensing (Goel et al., 2017; Vanpouille-Box et al., 2019) or following the establishment of a permanent cell cycle blockage (i.e., cellular senescence) characterized by an abundant secretory component, the so-called senescence-associated secretory phenotype (SASP) (Jerby-Arnon et al., 2018).”
From Immunomodulation by targeted anticancer agents (2021) · cites this paper as Goel et al., 2017
TREG cells express CDK4/CDK6 and VEGF receptors, making them especially sensitive to CDK4/CDK6 inhibitors and bevacizumab.
“TREG cells express CDK4/CDK6 as well as VEGF receptors (Goel et al., 2017; Terme et al., 2013) and hence are particularly sensitive to CDK4/CDK6 inhibitors and bevacizumab”
From Immunomodulation by targeted anticancer agents (2021) · cites this paper as Goel et al., 2017
The CDK4/CDK6-DNMT1-endogenous retroviral element-type III interferon pathway can be targeted with clinically used CDK4/CDK6 inhibitors.
“a pathway that can be actioned with clinically employed CDK4/ CDK6 inhibitors”
From Immunomodulation by targeted anticancer agents (2021) · cites this paper as Goel et al., 2017
Active CDK4/CDK6 signaling restricts DNMT1-driven expression of endogenous retroviral elements that would otherwise promote type III interferon secretion.
“active CDK4/CDK6 signaling limits the ability of DNMT1 to drive the expression of endogenous retroviral elements that would otherwise promote type III IFN secretion”
From Immunomodulation by targeted anticancer agents (2021) · cites this paper as Goel et al., 2017
Treatment raises the count of CD3+ cells that enter the tumor mass, enabling cytotoxic T-cell stimulation.
“Consistent with this, the number of CD3+ cells recruited into the tumor mass increases after treatment, allowing for the stimulation of cytotoxic T-cells (CTLs).”
From CDK4/6 Inhibitors: The Mechanism of Action May Not Be as Simple as Once Thought (2018) · cites this paper as Goel et al., 2017
CDK4 activity is needed for generating CD4+FOXP3+ regulatory T cells capable of inhibiting cytotoxic T-lymphocyte responses.
“Additionally, CDK4 is necessary for the development of CD4+FOXP3+ Treg cells that can suppress CTL responses.”
From CDK4/6 Inhibitors: The Mechanism of Action May Not Be as Simple as Once Thought (2018) · cites this paper as Goel et al., 2017
In several breast cancer models, including patient-derived xenografts and an MMTV-HER2 mouse, abemaciclib or palbociclib causes growth arrest and increased antigen processing and presentation in tumor cells.
“Recently, in a variety of breast cancer models, including patient-derived xenografts and an MMTV-HER2 mouse, it was demonstrated that abemaciclib or palbociclib induces growth arrest and up-regulation of antigen processing and presentation in the tumor cells (Goel et al., 2017).”
From CDK4/6 Inhibitors: The Mechanism of Action May Not Be as Simple as Once Thought (2018) · cites this paper as Goel et al., 2017
Animals with CDK4 deficiency, with or without tumors, have lower numbers of infiltrating and circulating CD4+FOXP3+ regulatory T cells, while other T-cell subsets are largely unaffected.
“In both tumor bearing and non-tumor bearing animals, CDK4 deficiency is associated with a reduced number of infiltrating and circulating CD4+FOXP3+ Treg cells with minimal impact on other T-cell subsets (Chow et al., 2010; Goel et al., 2017).”
From CDK4/6 Inhibitors: The Mechanism of Action May Not Be as Simple as Once Thought (2018) · cites this paper as Goel et al., 2017
PI3K inhibitors and CDK4/6 inhibitors have been tested in preclinical models to reverse signaling defects and metabolic stress to enhance immune checkpoint blockade response.
“Several other strategies have been tested in preclinical models to reverse signaling defects and metabolic stress in order to enhance response to ICB including PI3K inhibitors (Marijt et al., 2019), and cyclin-dependent kinase 4 and 6 (CDK4/6) (Goel et al., 2017)”
From Hallmarks of response, resistance, and toxicity to immune checkpoint blockade (2021) · cites this paper as Goel et al., 2017
Novel approved drugs, including PARP inhibitors and CDK4/6 inhibitors, might potentiate the effectiveness of immunotherapies, in part, by vascular normalization.
“novel approved drugs, including poly [ADP-ribose] polymerase inhibitors and cyclin-dependent kinase 4 (CDK4) and CDK6 inhibitors, might potentiate the effectiveness of immunotherapies, in part, by vascular normalization119.”
From Enhancing cancer immunotherapy using antiangiogenics: opportunities and challenges (2018) · cites this paper as [119]
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- Authors
- Goel, S., DeCristo, M. J., Watt, A. C., BrinJones, H., Sceneay, J., Li, B. B., Khan, N., Ubellacker, J. M., Xie, S., Metzger-Filho, O., Hoog, J., Ellis, M. J., Ma, C. X., Ramm, S., Krop, I. E., Winer, E. P., Roberts, T. M., Kim, H.-J., McAllister, S. S., & Zhao, J. J.
- Affiliations
- Dana-Farber Cancer Institute (US)
- Brigham and Women's Hospital (US)
- Washington University in St. Louis (US)
- Baylor College of Medicine (US)
- Harvard University (US)
- Broad Institute (US)
- Corresponding author
- Goel, Shom
- McAllister, Sandra S.
- Zhao, Jean J.
- ORCID
- Venue
- Nature
- Published
- 2017-08
- Volume
- 548
- Issue
- 7668
- Pages
- 471-475
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- PMC
- PMC5570667
- OpenAlex
- W2750328162
- Cited by
- 1,513
- References
- 29
- Citations by year
- 2026: 132 · 2025: 165 · 2024: 187 · 2023: 190 · 2022: 219 · 2021: 203 · 2020: 171 · 2019: 129 · 2018: 100 · 2017: 16
- FWCI
- 50.16
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- National Institutes of Health
- National Cancer Institute (R01CA166284, R01CA172461, R01CA187918, P50CA168504, R35CA210057)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Advanced Breast Cancer Therapies
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Keywords
- CDK4/6 inhibitors, antitumor immunity, breast cancer, tumor immunogenicity, tumor antigen presentation, regulatory T cells, DNMT1, DNA methylation, endogenous retroviruses, interferon lambda, double-stranded RNA, immune checkpoint blockade, cytotoxic T lymphocytes, E2F transcription factors, combination immunotherapy
- MeSH terms
- Biological Mimicry, Animals, Breast Neoplasms, Disease Models, Animal, Female, Humans, Interferons, Phosphorylation, Repressor Proteins, RNA, Double-Stranded, Viruses, Signal Transduction, Antigen Presentation, Cell Line, Tumor, Protein Kinase Inhibitors, Cell Proliferation, T-Lymphocytes, Regulatory, Cyclin-Dependent Kinase 4, Cyclin-Dependent Kinase 6, Mice, Cell Cycle Checkpoints, Transcriptome
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