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Inhibition of DNMTs increases neoantigen-reactive T-cell toxicity against microsatellite-stable colorectal cancer in combination with radiotherapy - 23/07/24

Doi : 10.1016/j.biopha.2024.116958 
Kevin Chih-Yang Huang a, b, c, , Tao-Wei Ke d, e, Chia-Ying Lai b, f, Wei-Ze Hong b, f, Hsin-Yu Chang b, f, Chien-Yueh Lee g, h, Chia-Hsin Wu f, i, Shu-Fen Chiang j, Ji-An Liang k, l, Jhen-Yu Chen a, b, Pei-Chen Yang f, William Tzu-Liang Chen e, m, n, Eric Y. Chuang o, p, K.S. Clifford Chao f, k, l,
a Department of Biomedical Imaging and Radiological Science, China Medical University, Taiwan 
b Translation Research Core, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan 
c Cancer Biology and Precision Therapeutics Center, China Medical University, Taichung 40402, Taiwan 
d School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan 
e Department of Colorectal Surgery, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan 
f Center of Proton therapy and Science, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan 
g Innovation Frontier Institute of Research for Science and Technology, National Taipei University of Technology, Taipei 106344, Taiwan 
h Department of Electrical Engineering, National Taipei University of Technology, Taipei 106344, Taiwan 
i Bioinformatics and Biostatistics Core, Centers of Genomic and Precision Medicine, National Taiwan University, Taipei 10055, Taiwan 
j Lab of Precision Medicine, Feng-Yuan Hospital, Taichung 42055, Taiwan 
k Department of Radiation Oncology, School of Medicine, China Medical University, Taichung 40402, Taiwan 
l Department of Radiation Oncology, China Medical University Hospital, China Medical University, Taichung, Taiwan 
m Department of Surgery, School of Medicine, China Medical University, Taichung 40402, Taiwan 
n Department of Colorectal Surgery, China Medical University HsinChu Hospital, China Medical University, Hsinchu 302, Taiwan 
o Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan 
p Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan 

Correspondence to: Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 40402, Taiwan.Department of Biomedical Imaging and Radiological Science, China Medical UniversityTaichung40402Taiwan⁎⁎Corresponding author at: Center of Proton Therapy and Science, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan.Center of Proton Therapy and Science, China Medical University Hospital, China Medical UniversityTaichung40402Taiwan

Abstract

The therapeutic efficacy of immunotherapy is limited in the majority of colorectal cancer patients due to the low mutational and neoantigen burdens in this immunogenically “cold” microsatellite stability-colorectal cancer (MSS-CRC) cohort. Here, we showed that DNA methyltransferase (DNMT) inhibition upregulated neoantigen-bearing gene expression in MSS-CRC, resulting in increased neoantigen presentation by MHC class I in tumor cells and leading to increased neoantigen-specific T-cell activation in combination with radiotherapy. The cytotoxicity of neoantigen-reactive T cells (NRTs) to DNMTi-treated cancer cells was highly cytotoxic, and these cells secreted high IFNγ levels targeting MSS-CRC cells after ex vivo expansion of NRTs with DNMTi-treated tumor antigens. Moreover, the therapeutic efficacy of NRTs further increased when NRTs were combined with radiotherapy in vivo. Administration of DNMTi-augmented NRTs and radiotherapy achieved an ∼50 % complete response and extended survival time in an immunocompetent MSS-CRC animal model. Moreover, remarkably, splenocytes from these mice exhibited neoantigen-specific T-cell responses, indicating that radiotherapy in combination with DNMTi-augmented NRTs prolonged and increased neoantigen-specific T-cell toxicity in MSS-CRC patients. In addition, these DNMTi-augmented NRTs markedly increase the therapeutic efficacy of cancer vaccines and immune checkpoint inhibitors (ICIs). These data suggest that a combination of radiotherapy and epi-immunotherapeutic agents improves the function of ex vivo-expanded neoantigen-reactive T cells and increases the tumor-specific cytotoxic effector population to enhance therapeutic efficacy in MSS-CRC.

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Graphical Abstract




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Highlights

Demethylation agents upregulate neoantigen-bearing genes to increase cancer immunogenicity for antitumor immunity.
Combination of radiotherapy and demethylation agents improves the cytotoxicity of neoantigen-reactive T cells against MSS-CRC.
Neoantigen-reactive T cells and radiotherapy enhance the therapeutic efficacy of neoantigen-based cancer vaccines as well as immunotherapy.

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Keywords : MSS-CRC, Neoantigen-reactive T cells, Immune checkpoint inhibitor, DNMT1


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