Combined BRAF, MEK, and CDK4/6 inhibition depletes intratumoral immune-potentiating myeloid populations in melanoma

Lelliott, EJ; Mangiola, S; Ramsbottom, KM; Zethoven, M; Lim, L; Lau, PKH; Oliver, AJ; Martelotto, LG; Kirby, L; Martin, C; Patel, RP; SLATER, A; Cullinane, C; Papenfuss, AT; Haynes, NM; McArthur, GA; Oliaro, J; Sheppard, KE

Author(s): Lelliott, EJ; Mangiola, S; Ramsbottom, KM; Zethoven, M; Lim, L; Lau, PKH; Oliver, AJ; Martelotto, LG; Kirby, L; Martin, C; Patel, RP; SLATER, A; Cullinane, C; Papenfuss, AT; Haynes, NM; McArthur, GA; Oliaro, J; Sheppard, KE;
Details: Publication Year 2021-12-01,Volume 9,Issue #2,Page 136-146
Journal Title: Cancer Immunol Res
Publication Type: Journal Article
Abstract: Combined inhibition of BRAF, MEK, and CDK4/6 is currently under evaluation in clinical trials for patients with melanoma harboring a BRAF(V600) mutation. While this triple therapy has potent tumor-intrinsic effects, the impact of this combination on antitumor immunity remains unexplored. Here, using a syngeneic Braf(V600E)Cdkn2a(-/-)Pten(-/-) melanoma model, we demonstrated that triple therapy promoted durable tumor control through tumor-intrinsic mechanisms and promoted immunogenic cell death and T-cell infiltration. Despite this, tumors treated with triple therapy were unresponsive to immune checkpoint blockade (ICB). Flow cytometric and single-cell RNA sequencing analyses of tumor-infiltrating immune populations revealed that triple therapy markedly depleted proinflammatory macrophages and cross-priming CD103(+) dendritic cells, the absence of which correlated with poor overall survival and clinical responses to ICB in patients with melanoma. Indeed, immune populations isolated from tumors of mice treated with triple therapy failed to stimulate T-cell responses ex vivo. While combined BRAF, MEK, and CDK4/6 inhibition demonstrates favorable tumor-intrinsic activity, these data suggest that collateral effects on tumor-infiltrating myeloid populations may impact antitumor immunity. These findings have important implications for the design of combination strategies and clinical trials that incorporate BRAF, MEK, and CDK4/6 inhibition with immunotherapy for the treatment of patients with melanoma.
Publisher: AACR
Research Division(s): Bioinformatics
PubMed ID: 33303574
Publisher's Version: https://doi.org/10.1158/2326-6066.Cir-20-0401
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2021-02-01 12:08:27

Last Modified: 2021-03-02 03:08:25