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  • Therapeutically Increasing ...
    Gu, Shengqing Stan; Zhang, Wubing; Wang, Xiaoqing; Jiang, Peng; Traugh, Nicole; Li, Ziyi; Meyer, Clifford; Stewig, Blair; Xie, Yingtian; Bu, Xia; Manos, Michael P; Font-Tello, Alba; 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

    Cancer discovery, 06/2021, Letnik: 11, Številka: 6
    Journal Article

    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 -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. .