Intrinsic Immunogenicity of Small Cell Lung Carcinoma Revealed by Its Cellular Plasticity
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Abstract
Small cell lung carcinoma (SCLC) is highly mutated, yet durable response to immune checkpoint blockade (ICB) is rare. SCLC also exhibits cellular plasticity, which could influence its immunobiology. Here we discover that a distinct subset of SCLC uniquely upregulates MHC I, enriching for durable ICB benefit. In vitro modeling confirms epigenetic recovery of MHC I in SCLC following loss of neuroendocrine differentiation, which tracks with derepression of STING. Transient EZH2 inhibition expands these nonneuroendocrine cells, which display intrinsic innate immune signaling and basally restored antigen presentation. Consistent with these findings, murine nonneuroendocrine SCLC tumors are rejected in a syngeneic model, with clonal expansion of immunodominant effector CD8 T cells. Therapeutically, EZH2 inhibition followed by STING agonism enhances T-cell recognition and rejection of SCLC in mice. Together, these data identify MHC I as a novel biomarker of SCLC immune responsiveness and suggest novel immunotherapeutic approaches to co-opt SCLC's intrinsic immunogenicity. Significance: SCLC is poorly immunogenic, displaying modest ICB responsiveness with rare durable activity. In profiling its plasticity, we uncover intrinsically immunogenic MHC Ihi subpopulations of nonneuroendocrine SCLC associated with durable ICB benefit. We also find that combined EZH2 inhibition and STING agonism uncovers this cell state, priming cells for immune rejection. This article is highlighted in the In This Issue feature, p. 1861
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Tumor cell-intrinsic STING activity is an important contributor to antitumor immune responses.
“recent studies have provided compelling evidence that tumor cell-intrinsic STING activity is also an important contributor34–36.”
From Epigenetic state determines the in vivo efficacy of STING agonist therapy (2023) · cites this paper as [36]
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- Authors
- Mahadevan, N. R., Knelson, E. H., Wolff, J. O., Vajdi, A., Saigí, M., Campisi, M., Hong, D., Thai, T. C., Piel, B., Han, S., Reinhold, B. B., Duke-Cohan, J. S., Poitras, M. J., Taus, L. J., Lizotte, P. H., Portell, A., Quadros, V., Santucci, A. D., Murayama, T., Cañadas, I., Kitajima, S., Akitsu, A., Fridrikh, M., Watanabe, H., Reardon, B., Gokhale, P. C., Paweletz, C. P., Awad, M. M., Van Allen, E. M., Lako, A., Wang, X.-T., Chen, B., Hong, F., Sholl, L. M., Tolstorukov, M. Y., Pfaff, K., Jänne, P. A., Gjini, E., Edwards, R., Rodig, S., Reinherz, E. L., Oser, M. G., & Barbie, D. A.
- Affiliations
- Brigham and Women's Hospital (US)
- Dana-Farber Cancer Institute (US)
- Politecnico di Torino (IT)
- Harvard University (US)
- 6Laboratory of Immunobiology, Dana-Farber Cancer Institute, Boston, Massachusetts.
- Fox Chase Cancer Center (US)
- Tisch Cancer Institute (US)
- 1Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
- Bristol-Myers Squibb (United States) (US)
- 14Translational Pathology, Bristol Myers Squibb, Trenton, New Jersey.
- Corresponding author
- Oser, Matthew G.
- Barbie, David A.
- ORCID
- Mahadevan, Navin R.
- Knelson, Erik H.
- Wolff, Jacquelyn O.
- Vajdi, Amir
- Saigí, Maria
- Campisi, Marco
- Hong, Deli
- Thai, Tran C.
- Piel, Brandon
- Han, Saemi
- Duke-Cohan, Jonathan S.
- Taus, Luke J.
- Lizotte, Patrick H.
- Portell, Andrew
- Quadros, Victor
- Santucci, Alison D.
- Murayama, Takahiko
- Cañadas, Israel
- Kitajima, Shunsuke
- Akitsu, Aoi
- Watanabe, Hideo
- Reardon, Brendan
- Gokhale, Prafulla C.
- Paweletz, Cloud P.
- Awad, Mark M.
- Lako, Ana
- Hong, Fangxin
- Sholl, Lynette M.
- Tolstorukov, Michael Y.
- Pfaff, Kathleen
- Gjini, Evisa
- Edwards, Robin
- Rodig, Scott
- Reinherz, Ellis L.
- Oser, Matthew G.
- Barbie, David A.
- Venue
- Cancer Discovery
- Published
- 2021-03-11
- Volume
- 11
- Issue
- 8
- Pages
- 1952-1969
- ISSN
- 2159-8274 (ISSN-L)
- 2159-8290
- PMC
- PMC8338750
- OpenAlex
- W3134054679
- Cited by
- 227
- References
- 69
- Citations by year
- 2026: 47 · 2025: 53 · 2024: 55 · 2023: 35 · 2022: 29 · 2021: 8
- FWCI
- 11.93
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cancer Discovery (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH (R01CA190294, T32HL7627-35, T32CA251062, T32 CA009172, 5 P30 CA06516, S10OD018522, S10OD026880)
- NCI NIH (K08CA222657)
- Topics
- Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Keywords
- small cell lung cancer, cellular plasticity, MHC class I upregulation, immune checkpoint blockade, EZH2 inhibition, neuroendocrine differentiation, epigenetic reprogramming, antigen presentation, CD8+ T cells, tumor immunogenicity, combination immunotherapy
- MeSH terms
- Cell Plasticity, Animals, Disease Models, Animal, Humans, Lung Neoplasms, Cohort Studies, Mice, Small Cell Lung Carcinoma, Electronic Health Records
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