Title | Increased p53 expression induced by APR-246 reprograms tumor-associated macrophages to augment immune checkpoint blockade. |
Publication Type | Journal Article |
Year of Publication | 2022 |
Authors | Ghosh A, Michels J, Mezzadra R, Venkatesh D, Dong L, Gomez R, Samaan F, Ho Y-J, Campesato LFelipe, Mangarin L, Fak J, Suek N, Holland A, Liu C, Abu-Akeel M, Bykov Y, Zhong H, Fitzgerald K, Budhu S, Chow A, Zappasodi R, Panageas KS, de Henau O, Ruscetti M, Lowe SW, Merghoub T, Wolchok JD |
Journal | J Clin Invest |
Volume | 132 |
Issue | 18 |
Date Published | 2022 Sep 15 |
ISSN | 1558-8238 |
Keywords | Animals, Immune Checkpoint Inhibitors, Mice, Quinuclidines, Tumor Microenvironment, Tumor Suppressor Protein p53, Tumor-Associated Macrophages |
Abstract | In addition to playing a major role in tumor cell biology, p53 generates a microenvironment that promotes antitumor immune surveillance via tumor-associated macrophages. We examined whether increasing p53 signaling in the tumor microenvironment influences antitumor T cell immunity. Our findings indicate that increased p53 signaling induced either pharmacologically with APR-246 (eprenetapopt) or in p53-overexpressing transgenic mice can disinhibit antitumor T cell immunity and augment the efficacy of immune checkpoint blockade. We demonstrated that increased p53 expression in tumor-associated macrophages induces canonical p53-associated functions such as senescence and activation of a p53-dependent senescence-associated secretory phenotype. This was linked with decreased expression of proteins associated with M2 polarization by tumor-associated macrophages. Our preclinical data led to the development of a clinical trial in patients with solid tumors combining APR-246 with pembrolizumab. Biospecimens from select patients participating in this ongoing trial showed that there was a suppression of M2-polarized myeloid cells and increase in T cell proliferation with therapy in those who responded to the therapy. Our findings, based on both genetic and a small molecule-based pharmacological approach, suggest that increasing p53 expression in tumor-associated macrophages reprograms the tumor microenvironment to augment the response to immune checkpoint blockade. |
DOI | 10.1172/JCI148141 |
Alternate Journal | J Clin Invest |
PubMed ID | 36106631 |
PubMed Central ID | PMC9479603 |
Grant List | K99 CA241110 / CA / NCI NIH HHS / United States R01 CA215136 / CA / NCI NIH HHS / United States P30 CA008748 / CA / NCI NIH HHS / United States R01 CA056821 / CA / NCI NIH HHS / United States K08 CA248723 / CA / NCI NIH HHS / United States |