Increased p53 expression induced by APR-246 reprograms tumor-associated macrophages to augment immune checkpoint blockade.

TitleIncreased p53 expression induced by APR-246 reprograms tumor-associated macrophages to augment immune checkpoint blockade.
Publication TypeJournal Article
Year of Publication2022
AuthorsGhosh 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
JournalJ Clin Invest
Volume132
Issue18
Date Published2022 Sep 15
ISSN1558-8238
KeywordsAnimals, 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.

DOI10.1172/JCI148141
Alternate JournalJ Clin Invest
PubMed ID36106631
PubMed Central IDPMC9479603
Grant ListK99 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