Therapeutically Increasing MHC-I Expression Potentiates Immune Checkpoint Blockade
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Abstract
Immune checkpoint blockade (ICB) therapy revolutionized cancer treatment, but many patients with impaired MHC-I expression remain refractory. Here, we combined FACS-based genome-wide CRISPR screens with a data-mining approach to identify drugs that can upregulate MHC-I without inducing PD-L1. CRISPR screening identified TRAF3, a suppressor of the NFκB pathway, as a negative regulator of MHC-I but not PD-L1. The Traf3-knockout gene expression signature is associated with better survival in ICB-naïve patients with cancer and better ICB response. We then screened for drugs with similar transcriptional effects as this signature and identified Second Mitochondria-derived Activator of Caspase (SMAC) mimetics. We experimentally validated that the SMAC mimetic birinapant upregulates MHC-I, sensitizes cancer cells to T cell–dependent killing, and adds to ICB efficacy. Our findings provide preclinical rationale for treating tumors expressing low MHC-I expression with SMAC mimetics to enhance sensitivity to immunotherapy. The approach used in this study can be generalized to identify other drugs that enhance immunotherapy efficacy. Significance: MHC-I loss or downregulation in cancer cells is a major mechanism of resistance to T cell–based immunotherapies. Our study reveals that birinapant may be used for patients with low baseline MHC-I to enhance ICB response. This represents promising immunotherapy opportunities given the biosafety profile of birinapant from multiple clinical trials. This article is highlighted in the In This Issue feature, p. 1307
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Various critical transcription factors, including HIF-1α, c-MYC, NF-kB, STAT3, c-JUN, and miR-138-5p, have been shown to transcriptionally regulate PD-L1 expression.
“Various critical transcription factors, including HIF-1α, c-MYC, NF-kB, STAT3, c-JUN, and miR-138-5p have been shown to transcriptionally regulate PD-L1 expression25–30.”
From PRDM1/BLIMP1 induces cancer immune evasion by modulating the USP22-SPI1-PD-L1 axis in hepatocellular carcinoma cells (2022) · cites this paper as [27]
The Introduction (page unavailable) says IFNγ induces PD-L1, but does not identify the listed factors as its transcriptional regulators. The Results section on TRAF3 depletion discusses NF-κB regulation of MHC-I and reports no change in PD-L1 transcription after TRAF3 knockout. Searches for the listed factors and PD-L1 transcriptional regulation found no passage establishing the attributed claim. (LLM, conf=0.76)
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Cites
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Turning cold tumors hot: from molecular mechanisms to clinical applications
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Li, Q., Zhang, L., You, W., Xu, J., Dai, J., Hua, D., Zhang, R., Yao, F., Zhou, S., Huang, W., et al. (2022) · Nature Communications · doi:10.1038/s41467-022-35469-x · Cited by 128 · see citing works
Self-citation
- Authors
- Gu, S. S., Zhang, W., Wang, X., Jiang, P., Traugh, N., Li, Z., Meyer, C., Stewig, B., Xie, Y., Bu, X., Manos, M. P., Font-Tello, A., Gjini, E., Lako, A., Lim, K., Conway, J., Tewari, A. K., Zeng, Z., Sahu, A. D., Tokheim, C., Weirather, J. L., Fu, J., Zhang, Y., Kroger, B., Liang, J. H., Cejas, P., Freeman, G. J., Rodig, S., Long, H. W., Gewurz, B. E., Hodi, F. S., Brown, M., & Liu, X. S.
- Affiliations
- Harvard University (US)
- Tongji University (CN)
- Dana-Farber Cancer Institute (US)
- National Cancer Institute (US)
- 6Center for Functional Cancer Epigenetics, Dana-Farber Cancer Institute, Boston, Massachusetts.
- The University of Texas Southwestern Medical Center (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Brown, Myles
- Liu, X. Shirley
- ORCID
- Gu, Shengqing Stan
- Zhang, Wubing
- Wang, Xiaoqing
- Jiang, Peng
- Traugh, Nicole
- Li, Ziyi
- Meyer, Clifford
- Stewig, Blair
- Xie, Yingtian
- Bu, Xia
- Manos, Michael P.
- Gjini, Evisa
- Lako, Ana
- Lim, Klothilda
- Conway, Jake
- Tewari, Alok K.
- Zeng, Zexian
- Sahu, Avinash Das
- Tokheim, Collin
- Weirather, Jason L.
- Fu, Jingxin
- Zhang, Yi
- Kroger, Benjamin
- Liang, Jin Hua
- Cejas, Paloma
- Freeman, Gordon J.
- Rodig, Scott
- Long, Henry W.
- Gewurz, Benjamin E.
- Hodi, F. Stephen
- Brown, Myles
- Liu, X. Shirley
- Venue
- Cancer Discovery
- Published
- 2021-02-15
- Volume
- 11
- Issue
- 6
- Pages
- 1524-1541
- ISSN
- 2159-8274 (ISSN-L)
- 2159-8290
- PMC
- PMC8543117
- OpenAlex
- W3131183594
- Cited by
- 273
- References
- 18
- Citations by year
- 2026: 37 · 2025: 59 · 2024: 72 · 2023: 51 · 2022: 43 · 2021: 11
- FWCI
- 16.30
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cancer Discovery (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH (R01CA234018, R01AI137337, P50CA101942-12, P50CA206963)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Keywords
- MHC class I upregulation, immune checkpoint blockade, TRAF3, NF-κB signaling, IAP antagonists, birinapant, PD-L1, cancer immunotherapy resistance, CRISPR screen, drug repurposing
- MeSH terms
- Immune Checkpoint Inhibitors, Humans, Immunotherapy, Neoplasms, Histocompatibility Antigens Class I, Gene Expression Profiling, Data Mining, Tumor Microenvironment, B7-H1 Antigen
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