MCT4-dependent lactate secretion suppresses antitumor immunity in LKB1-deficient lung adenocarcinoma

Y Qian, A Galan-Cobo, I Guijarro, M Dang… - Cancer Cell, 2023 - cell.com
Y Qian, A Galan-Cobo, I Guijarro, M Dang, D Molkentine, A Poteete, F Zhang, Q Wang
Cancer Cell, 2023cell.com
Inactivating STK11/LKB1 mutations are genomic drivers of primary resistance to
immunotherapy in KRAS-mutated lung adenocarcinoma (LUAD), although the underlying
mechanisms remain unelucidated. We find that LKB1 loss results in enhanced lactate
production and secretion via the MCT4 transporter. Single-cell RNA profiling of murine
models indicates that LKB1-deficient tumors have increased M2 macrophage polarization
and hypofunctional T cells, effects that could be recapitulated by the addition of exogenous …
Summary
Inactivating STK11/LKB1 mutations are genomic drivers of primary resistance to immunotherapy in KRAS-mutated lung adenocarcinoma (LUAD), although the underlying mechanisms remain unelucidated. We find that LKB1 loss results in enhanced lactate production and secretion via the MCT4 transporter. Single-cell RNA profiling of murine models indicates that LKB1-deficient tumors have increased M2 macrophage polarization and hypofunctional T cells, effects that could be recapitulated by the addition of exogenous lactate and abrogated by MCT4 knockdown or therapeutic blockade of the lactate receptor GPR81 expressed on immune cells. Furthermore, MCT4 knockout reverses the resistance to PD-1 blockade induced by LKB1 loss in syngeneic murine models. Finally, tumors from STK11/LKB1 mutant LUAD patients demonstrate a similar phenotype of enhanced M2-macrophages polarization and hypofunctional T cells. These data provide evidence that lactate suppresses antitumor immunity and therapeutic targeting of this pathway is a promising strategy to reversing immunotherapy resistance in STK11/LKB1 mutant LUAD.
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