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Cancer Immunotherapy

Immunotherapy is the most promising new cancer treatment of the last years. By re-awakening and enhancing the immune system to fight cancer, such strategies have achieved impressive clinical responses. However, many cancer types still do not respond to immunotherapy and many patients do not receive durable benefit, eventually developing resistance.

Broadening the clinical applicability of cancer immunotherapy requires a deep understanding of the molecular and genetic mechanisms that influence whether cancer cells resist or respond. With the ultimate goal to expand the benefits of immunotherapy and find actionable strategies to combat therapeutic resistance, an increasing number of studies are now testing in pre-clinical models different combinations with other therapies, including targeted therapies, and nanoparticle-based approaches. Furthermore, significant efforts are underway to identify reliable predictive biomarkers of response and resistance to immunotherapy such as checkpoint inhibitors.

Our collection, which has been curated by the Cancer editorial  team at Nature Communications, brings together cutting-edge important research in the field of cancer immunotherapy published in our journal. The collection is divided into four research areas; mechanisms of resistance, combination therapies, nanocomplex, and predictors of response. We aim to provide insights on future directions for new therapeutic development in this important area, recognizing the value of bench-based and pre-clinical studies as a first step to translation to the clinic and patient care.

Mechanisms of resistance

Blocking PD-1 function on T cells is thought to be a viable strategy to prevent virus-induced or tumor-induced T cell exhaustion. Here the authors link the zinc-finger transcription factor SALL4 with miR-200c inhibition of PD-L1 expression by hepatocytes in patients with HBV-induced hepatocellular carcinoma.

Article | Open Access | | Nature Communications

Neoantigen load has been associated with tumour immune infiltration. Here, the authors show that while this is true for tumours with recurrent mutations, cancers with recurrent CNAs show neoantigen-independent infiltration driven by cytokine production downstream of the DNA damage sensor ATM.

Article | Open Access | | Nature Communications

A critical determinant of tumor eradication by adoptive immunotherapy is the tumor associated antigen recognized by cytotoxic T lymphocytes. Here the authors generate ex vivo autologous cytotoxic T lymphocytes by exposure to antigens induced by DNA demethylation and report the results of a phase 1 trial of 25 patients with recurrent glioblastoma multiforme with tumor regression in three patients.

Article | Open Access | | Nature Communications

Tumors often develop resistance to radiotherapy. Here the authors show that irradiation leads to a CCR2-dependent infiltration by myeloid derived suppressor cells that promote radio-resistance through inhibition of adaptive immune responses and that the use of CCR2 antibodies in mice reduces such resistance.

Article | Open Access | | Nature Communications

TGFβ secretion in the tumor microenvironment inhibits T cell-mediated anti-tumor immune responses. Here the authors show that a mutation predisposing to autoimmune diseases confers T cells resistance to TGFβ inhibitory action and could be exploited to engineer immunotherapies for TGFβ secreting tumors.

Article | Open Access | | Nature Communications

Grail is an E3 ubiquitin ligase that inhibits T-cell receptor signalling in CD4+ T cells. Here the authors show Grail also limits IL-21 receptor expression and function in CD8+ T cells, is overactive in these cells in patients with lymphoma, and promotes tumour development in a lymphoma transplant mouse model.

Article | Open Access | | Nature Communications

IFNγ secretion by CD8+T cells is critical for immunotherapy efficacy. In this study, the authors show that melanoma patients can become resistant to immunotherapy by acquiring chromosomal alterations and subsequent inactivating mutations in genes of the IFNγ signalling cascade, most often JAK1 or JAK2.

Article | Open Access | | Nature Communications

CAR-T targeting CD19 have been successfully used in a variety of B-cell malignancies but patients may eventually relapse. Here, the authors show that CD19 CAR-T resistance in pre-B cell ALL can be due to the induction of a myeloid lineage switch through an epigenetic alterations in master regulators of B cell development.

Article | Open Access | | Nature Communications

Galectin-3 is a sugar-binding protein that can inhibit antitumour cytotoxic immunity. Here the authors show that Galectin-3 expressed by tumour cells inhibits LFA-1 on cytotoxic lymphocytes, impairing immunological synapse formation, IFNg secretion, and target cell killing.

Article | Open Access | | Nature Communications

Cytotoxic T lymphocytes recognise and eliminate tumour cells. Here, the authors show that on contact with these immune cells melanoma cells can resist T cell cytotoxicity by modulating the trafficking of their lysosomal compartment, this results in the degradation of the T cell protein perforin by the protease cathepsin B.

Article | Open Access | | Nature Communications

Blocking immune checkpoints is a promising strategy to treat lung cancer, but patients often become resistant to the therapy. Here, the authors analyse resistance in mouse models of lung cancer and show in mice and two patients, an increase in the expression of TIM3, which is also involved in the immune response to cancer.

Article | Open Access | | Nature Communications

Combination therapies

A critical determinant of tumor eradication by adoptive immunotherapy is the tumor associated antigen recognized by cytotoxic T lymphocytes. Here the authors generate ex vivo autologous cytotoxic T lymphocytes by exposure to antigens induced by DNA demethylation and report the results of a phase 1 trial of 25 patients with recurrent glioblastoma multiforme with tumor regression in three patients.

Article | Open Access | | Nature Communications

Immune checkpoints blockade (ICB) is a viable anti-cancer strategy. Here the authors show that nuclear receptor NR2F6 acts as an immune checkpoint in T cells and, using mouse models and human T cells, they show NR2F6 inhibition might improve current ICB therapy or work as an alternative therapeutic strategy.

Article | Open Access | | Nature Communications

Antitumor T cells can be inhibited by a TGFβ rich tumor microenvironment. The authors develop bifunctional proteins comprising CTLA-4 or PD-L1 immune checkpoint-targeted antibodies fused to a “TGFβ trap” and show that they counteract tumor immune tolerance and enhance the efficacy of these antibodies.

Article | Open Access | | Nature Communications

Immunotherapy often fails as a single option treatment in cancer. Here, the authors show that targeting of DNA methyltransferases, such as DNMT1, can potentiate anti-tumor immunity and response to checkpoint inhibition by increasing MHC gene expression and the recruitment of CD8+ T cells.

Article | Open Access | | Nature Communications

Treatment options for metastatic melanoma are limited. Here the authors show that combining an immunostimulant adenovirus, currently in clinical trials for leukemia, with immune checkpoints blockade (ICB) results in systemic eradication of ICB resistant melanoma tumours from both skin and brain of mice.

Article | Open Access | | Nature Communications

MEK inhibition in breast cancer is associated with increased tumour infiltrating lymphocytes (TILs), however, MAPK activity is required for T cells function. Here the authors show that TILs activity following MEK inhibition can be enhanced by agonist immunotherapy resulting in synergic therapeutic effects.

Article | Open Access | | Nature Communications

Oncolytic viruses (OV) and second mitochondrial activator of caspase (Smac)-mimetic compounds (SMC) synergistically kill cancer cells directly. Here, the authors show that SMC and OV therapies combination also synergize in vivo by promoting anticancer immunity through an increase in CD8+ T-cell response.

Article | Open Access | | Nature Communications

Tumour repopulating cells (TRC) are stem-like cells that can escape immune-mediated killing. Here, the authors show IFN-γ results in either dormancy or apoptosis of TRC depending on the activation of the IDO1 metabolic pathway, and that combining IFN-γ with IDO1 inhibitors results in enhanced tumour regression.

Article | Open Access | | Nature Communications

Anti-PD-L1 therapy often fails in cancers with minimal lymphocytic infiltrates and low PD-L1 expression. Here, the authors show that an oncolytic virus increases PD-L1 expression in cancer models and that the combination with an anti-PD-L1 antibody enhances therapy by increasing the infiltration of activated T cells, and reducing exhausted T cells.

Article | Open Access | | Nature Communications

Viruses are promising anti-tumour therapeutics due to induction of an immune response and/or oncolytic activity. Here, Kalkavanet al. show that LCMV replicates in tumour cells, without inducing cell lysis, and that its anti-tumour activity is largely mediated by recruitment of interferon-producing monocytes.

Article | Open Access | | Nature Communications

Smac mimetics sensitize cancer cells to the extrinsic cell death pathway and stimulate anti-tumour immunity. In this study, the authors show that Smac mimetics can synergize with immune checkpoint inhibitors to control tumour growth in mouse cancer models, including aggressive CNS tumours, in a cytotoxic CD8+ T-cell- and TNFα-dependent manner.

Article | Open Access | | Nature Communications

Oncolytic viruses induce a variety of immune targets in the infected tumours. Here, the authors show that Newcastle Disease Virus (NDV) upregulates the inducible co-stimulator (ICOS) on T cells and that intratumoral targeting of ICOS with engineered NDV in combination with CTLA-4 blockade induces systemic anti-tumour immunity in mice.

Article | Open Access | | Nature Communications

Tissue regeneration is of great interest; however the number of times a given tissue can regenerate is unknown. Now, Eguchiet al. demonstrate that the lens of the Japanese newt—Cynops pyrrhogaster—can regenerate 18 times over a 16-year period, and that the new lenses are similar to those of control adult animals.

Article | Open Access | | Nature Communications

High-affinity IL-2Rα expressed by Tregs mitigates the potential of IL-2 use in cancer therapy. Here, the authors fuse IL-2 with an NKDG2 binding domain, and show that it induces IL-2 signalling selectively in NKG2D+cells, delaying tumour growth in mice without the side effects of conventional IL-2 therapy.

Article | Open Access | | Nature Communications

Combination therapy with α-CTLA-4 and α-PD-1 is showing improved therapeutic effects in clinical trials. Here, the authors report that mechanistically in bladder cancer such effect depends upon an upregulation of T cell activity mediated by the IL-7/IL-7R and IFN-γ/IFN-γR signalling pathways.

Article | Open Access | | Nature Communications

Dendritic cells instruct different types of T cell responses depending on the types of microbial ligands sensed. Here the authors show that dendritic cells stimulated via Dectin-1 receptor upregulate TNFSF15 and OX40L and induce T helper 9 response and efficient antitumour immunity in mouse models.

Article | Open Access | | Nature Communications

T-cell responses are dysregulated in aged humans and mice, which leads to poor antitumour responses. Here, the authors demonstrate that this phenomenon is at least partially due to an overproduction of IL-6 caused by ageing and its inhibitory effect on Th1 differentiation of tumour-specific CD4 T cells.

Article | Open Access | | Nature Communications

The c-Jun transcription factor can mediate a cell's response to TNFa. Here, Riesenberg et al. show in melanoma cells that c-Jun has an inverse relationship with the key melanocyte transcription factor MITF and that high c-Jun levels contribute to melanoma heterogeneity and an inflammatory microenvironment.

Article | Open Access | | Nature Communications

Nanocomplex

Immunostimulatory agents used in cancer treatment often elicit serious toxicities, limiting their clinical application. Here, the authors show that the use of liposomes to intravenously deliver surface-anchored IL-2 and anti-CD137 proteins enables anti-cancer immunity and reduces the toxic side effects.

Article | Open Access | | Nature Communications

Pancreatic cancer remains difficult to treat mainly due to the drug delivery challenges posed by a strong stromal component. Here the authors develop nanocarriers that improve drug delivery efficiency and engage the host immune system against the tumor resulting in reduction of tumor growth and metastasis.

Article | Open Access | | Nature Communications

Targeted delivery of immunomodulatory compounds to defined subsets of endogenous immune cells may improve the efficacy of combination immunotherapies. Here, the authors use PD-1-targeting nanoparticles containing a TGFβ inhibitor or a TLR7/8 agonist to deliver these payloads to T cells or via T cells to the tumor microenvironment, respectively, leading to anti-tumor efficacy in vivo.

Article | Open Access | | Nature Communications

Nucleic acid nanomedicines are promising for cancer drug delivery. Here, the authors show using a mouse model the tumor immunotherapeutic efficacy of nanovaccines based on intertwining DNA-RNA nanocapsules loaded with DNA CpG, Stat3-silencing short hairpin RNA and tumor-specific peptide neoantigens.

Article | Open Access | | Nature Communications

MnO2 nanostructures are promising TME-responsive theranostic agents in cancer. Here, the authors develop a nano-platform based on hollow H-MnO2 nanoshells able to modulate the tissue microenvironment, release a drug and inhibit tumor growth alone or in combination with check-point blockade therapy.

Article | Open Access | | Nature Communications

Fluid shear stress plays a critical role in receptor-mediated signalling and has been shown to sensitize cancer cells to apoptosis. Here, Mitchellet al. introduce polymer micro- and nanoparticles tethered to tumour cells to amplify fluid shear stress effects, and find that they can enhance immune cytokine-mediated apoptosis of tumour cells in vitro and in vivo.

Article | Open Access | | Nature Communications

Photothermal therapy can induce an anti-tumour immune response by producing tumour-associated antigens. Here, the authors design a nanoparticle that simultaneously acts as a photothermal agent and an immune-adjuvant and demonstrate the anti-tumour efficacy in combination with anti-CTLA4 therapy in preclinical murine cancer models.

Article | Open Access | | Nature Communications

Blockade of PD-L1 is usually not very effective in colon cancer patients. Here, the authors show the efficacy of PD-L1 blockade in combination with coordination polymer nanoparticles carrying oxaliplatin and a photosensitizer to induce anti-tumor immunity in metastatic models of colon cancer.

Article | Open Access | | Nature Communications

Predictors of response

Epithelial ovarian cancer (EOC) has low mutational load. Here the authors analyze circulating and tumor-infiltrating lymphocytes (TILs) from 19 EOC patients and report frequent recovery of neo-antigen-reactive T cells from both compartments but with distinct TCR repertoires that have higher affinity in TILs.

Article | Open Access | | Nature Communications

Adoptive T cell therapy (ACT) has yielded high response rates in melanoma, however 50–60% of patients experience no clinical benefit. Here, the authors identify predictive biomarkers, high non-synonymous mutation and high expressed neoantigen load, that associate with clinical benefit in ACT melanoma patients.

Article | Open Access | | Nature Communications

IFNγ secretion by CD8+T cells is critical for immunotherapy efficacy. In this study, the authors show that melanoma patients can become resistant to immunotherapy by acquiring chromosomal alterations and subsequent inactivating mutations in genes of the IFNγ signalling cascade, most often JAK1 or JAK2.

Article | Open Access | | Nature Communications

The clinical management of metastatic melanoma requires predictors of the response to checkpoint blockade. Here, the authors use immunological assays to identify potential prognostic/predictive biomarkers in circulating blood cells and in tumor-infiltrating lymphocytes from patients with resected stage III melanoma.

Article | Open Access | | Nature Communications

PD-L1, the ligand for T-cell inhibitory receptor PD-1, can be expressed by various cell types in the tumour microenvironment. Here, the authors show that, in mouse models, the expression of PD-L1 from both cancerous and normal host immune cells is important for suppressing anti-tumour immune responses.

Article | Open Access | | Nature Communications