Pharmacologic LDH inhibition redirects intratumoral glucose uptake and improves antitumor immunity in solid tumor models.

TitlePharmacologic LDH inhibition redirects intratumoral glucose uptake and improves antitumor immunity in solid tumor models.
Publication TypeJournal Article
Year of Publication2024
AuthorsVerma S, Budhu S, Serganova I, Dong L, Mangarin LM, Khan JF, Bah MA, Assouvie A, Marouf Y, Schulze I, Zappasodi R, Wolchok JD, Merghoub T
JournalJ Clin Invest
Volume134
Issue17
Date Published2024 Sep 03
ISSN1558-8238
KeywordsAnimals, Cell Line, Tumor, Colonic Neoplasms, Enzyme Inhibitors, Female, Glucose, Glucose Transporter Type 1, Glycolysis, Humans, Immune Checkpoint Inhibitors, Immunotherapy, L-Lactate Dehydrogenase, Lymphocytes, Tumor-Infiltrating, Melanoma, Experimental, Mice, T-Lymphocytes, Regulatory, Tumor Microenvironment
Abstract

Tumor reliance on glycolysis is a hallmark of cancer. Immunotherapy is more effective in controlling glycolysis-low tumors lacking lactate dehydrogenase (LDH) due to reduced tumor lactate efflux and enhanced glucose availability within the tumor microenvironment (TME). LDH inhibitors (LDHi) reduce glucose uptake and tumor growth in preclinical models, but their impact on tumor-infiltrating T cells is not fully elucidated. Tumor cells have higher basal LDH expression and glycolysis levels compared with infiltrating T cells, creating a therapeutic opportunity for tumor-specific targeting of glycolysis. We demonstrate that LDHi treatment (a) decreases tumor cell glucose uptake, expression of the glucose transporter GLUT1, and tumor cell proliferation while (b) increasing glucose uptake, GLUT1 expression, and proliferation of tumor-infiltrating T cells. Accordingly, increasing glucose availability in the microenvironment via LDH inhibition leads to improved tumor-killing T cell function and impaired Treg immunosuppressive activity in vitro. Moreover, combining LDH inhibition with immune checkpoint blockade therapy effectively controls murine melanoma and colon cancer progression by promoting effector T cell infiltration and activation while destabilizing Tregs. Our results establish LDH inhibition as an effective strategy for rebalancing glucose availability for T cells within the TME, which can enhance T cell function and antitumor immunity.

DOI10.1172/JCI177606
Alternate JournalJ Clin Invest
PubMed ID39225102
PubMed Central IDPMC11364391