Cited by 273Cancer Immunotherapy and BiomarkersImmunotherapy and Immune ResponsesT-cell and B-cell Immunology

Therapeutically Increasing MHC-I Expression Potentiates Immune Checkpoint Blockade

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Gu, Shengqing Stan, Zhang, Wubing, Wang, Xiaoqing, Jiang, Peng, Traugh, Nicole, Li, Ziyi, Meyer, Clifford, Stewig, Blair +25 more·2021·Cancer Discovery

Published version of a preprint

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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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
Venue
Cancer Discovery
Published
2021-02-15
Volume
11
Issue
6
Pages
1524-1541
ISSN
  • 2159-8274 (ISSN-L)
  • 2159-8290
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
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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