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Loss of tumor cell MHC class II drives MAPK inhibitor insensitivity of BRAF-mutant anaplastic thyroid cancers
Vera Tiedje, Jillian Greenberg, Tianyue Qin, Soo-Yeon Im, Gnana P. Krishnamoorthy, Laura Boucai, Bin Xu, Jena D. French, Eric J. Sherman, Alan L. Ho, Elisa de Stanchina, Nicholas D. Socci, Jian Jin, Ronald A. Ghossein, Jeffrey A. Knauf, Richard P. Koche, James A. Fagin
Vera Tiedje, Jillian Greenberg, Tianyue Qin, Soo-Yeon Im, Gnana P. Krishnamoorthy, Laura Boucai, Bin Xu, Jena D. French, Eric J. Sherman, Alan L. Ho, Elisa de Stanchina, Nicholas D. Socci, Jian Jin, Ronald A. Ghossein, Jeffrey A. Knauf, Richard P. Koche, James A. Fagin
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Research Article Endocrinology Immunology

Loss of tumor cell MHC class II drives MAPK inhibitor insensitivity of BRAF-mutant anaplastic thyroid cancers

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Abstract

Cancer cells present neoantigens dominantly through MHC class I (MHCI) to drive tumor rejection through cytotoxic CD8+ T cells. There is growing recognition that a subset of tumors express MHC class II (MHCII), causing recognition of antigens by TCRs of CD4+ T cells that contribute to the antitumor response. We found that mouse BrafV600E-driven anaplastic thyroid cancers (ATCs) responded markedly to the RAF plus MEK inhibitors dabrafenib and trametinib (dab/tram) and that this was associated with upregulation of MhcII in cancer cells and increased CD4+ T cell infiltration. A subset of recurrent tumors lost MhcII expression due to silencing of Ciita, the master transcriptional regulator of MhcII, despite preserved IFN-γ signal transduction, which could be rescued by EZH2 inhibition. Orthotopically implanted Ciita–/– and H2-Ab1–/– ATC cells into immune-competent mice became unresponsive to the MAPK inhibitors. Moreover, depletion of CD4+, but not CD8+, T cells also abrogated the response to dab/tram. These findings implicate MHCII-driven CD4+ T cell activation as a key determinant of the response of Braf-mutant ATCs to MAPK inhibition.

Authors

Vera Tiedje, Jillian Greenberg, Tianyue Qin, Soo-Yeon Im, Gnana P. Krishnamoorthy, Laura Boucai, Bin Xu, Jena D. French, Eric J. Sherman, Alan L. Ho, Elisa de Stanchina, Nicholas D. Socci, Jian Jin, Ronald A. Ghossein, Jeffrey A. Knauf, Richard P. Koche, James A. Fagin

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Figure 3

MhcII expression is suppressed in recurrent ATCs.

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MhcII expression is suppressed in recurrent ATCs.
(A) Oncoprint of ATC s...
(A) Oncoprint of ATC specimens from 28 patients from the Memorial Sloan Kettering clinical cohort sequenced by MSK-IMPACT and subjected to HLA-DR IHC. (B) Percentage of ATC cells expressing HLA-DR in specimens from patients prior to MAPK inhibitor therapy (MAPKi naive, n = 17), at the time of structural response (MAPKi PR, n = 5), or during disease progression (MAPKi PD, n = 10) under therapy with dab/tram (n = 22), vemurafenib (n = 1), dabrafenib (n = 1), or PLX8394 (n = 1). (C) Representative IHC images of HLA-DR IHC. (D) Representative MRIs of a primary ATCs (+dox), the response 4 weeks after dox withdrawal (-dox), and a recurrence at 10 weeks (–dox). (E) MhcII flow cytometry of cell lines generated from primary ATCs (B92 and B16509) and recurrent tumors (B36244, B36934, B34286, B34838, and B37933) treated for 96 hours with vehicle (Veh), IFN-γ (20 ng/mL), trametinib (10 nM), or IFN-γ + trametinib in vitro. Plasma membrane MhcII levels were not induced by IFN-γ + trametinib in the recurrent ATC cell lines B36244 and B36934. B: Multiple Mann Whitney Tests. Mean with SEM. Bounds of the boxes represent interquartile ranges (IQR), interior lines represent the median, whiskers extend to minimum and maximum values, and outlying dots represent values 1.5 times the IQR. MAPKi, MAPK inhibitor; PR, partial response; PD, progressive disease.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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