Tag: Melanoma

  • Cancer cells impair monocyte-mediated T cell stimulation to evade immunity

    Cancer cells impair monocyte-mediated T cell stimulation to evade immunity

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    Cell lines

    YUMM1.7 and YUMM3.3 mouse melanoma62 cell lines (obtained from M. Bosenberg, Yale University) were cultured in Dulbecco’s modified Eagle’s medium (DMEM)–F12 produced in-house. A375, M249 (ref. 63) (obtained from J. Massague, MSKCC), KPAR64 (obtained from J. Downward, Francis Crick Institute) and EPP2 (ref. 65) (obtained from J. Zuber, IMP) cell lines were cultured in DMEM (Gibco). LOX48 (obtained from J. Massague, MSKCC), CT-26 (ref. 66) and NCI-H358 cell lines were purchased from the American Type Culture Collection and cultured in RPMI-1640 (Gibco). The NCI-H358 RTT derivative was generated by culturing NCI-H358 parental cells in the presence of 1 μM KRAS inhibitor (Amgen) for 90 days until cells became resistant. YUMM1.7OVA clones and all NTT and RTT derivatives were generated as previously described15. RTT BRAFi-resistant cancer cells (YUMM1.7 and YUMM3.3 model) and all genetically engineered derivatives were cultured continuously in 100 nM dabrafenib (Selleckchem). MEKi-resistant cancer cells were cultured continuously in 10 nM trametinib (Selleckchem). Human NTT and RTT melanoma cell line derivatives (A375, M249 and LOX) were generated as previously described48, and RTT cells were maintained in culture on 1 µM vemurafenib (LC-Labs). HEK-293T cells were purchased from Takara (Lenti-X 293T, 632180) and cultured in DMEM high-glucose produced in-house. BMDCs were cultured according to an adapted version of a previously described protocol67. In brief, for the first 6–7 days, cells were cultured at a density of 1 × 106 cells per ml. On day 4, fresh medium was added to minimize cell death. After that, cells were either seeded for assays or counted and re-seeded at a density of 300,000 cells per ml. BMDCs were cultured in full T cell medium supplemented with 200 ng ml–1 FLT3L-Ig (BioXcell) and 5 ng ml–1 GM-CSF (in-house produced). Bone-marrow-derived Ly6C+ monocytes were cultured in DMEM medium (Gibco). Human MONO-MAC-1 (obtained from J. Zuber, IMP) and BLaER-1 (ref. 68) (obtained from M. Gaidt, IMP) cell lines were cultured in RPMI-1640 (Gibco). All media for cell lines were supplemented with 10% FBS, 2 mM l-glutamine (Gibco) and 100 IU ml–1 penicillin–streptomycin (Thermo Fisher). BLaER-1 and NCI-H358 cells were additionally supplemented with 1× sodium pyruvate. CD8+ T cells were cultured in full T cell medium containing RPMI-1640 supplemented with 10% FBS, 2 mM l-glutamine and 100 IU ml–1 penicillin–streptomycin, 1× sodium pyruvate (Gibco), 1× non-essential amino acids (Gibco), 20 mM HEPES (produced in-house) and 0.05 mM β-mercaptoethanol (Millipore). All cells were cultured at 37 °C and 5% CO2. Cells were routinely tested negative for mycoplasma contamination. STR Profiling was performed in-house for the YUMM1.7, YUMM3.3, EPP2 and KPAR cell lines. Moreover, sensitivity to MAPK inhibitors was confirmed for A375, M249 and LOX (BRAFi), CT-26 (MEKi) and for NCI-H358 (KRAS inhibitor).

    Animal experiments and ethics

    All mice were bred and housed in pathogen-free conditions with a housing temperature of 22 ± 1 °C, 55 ± 5% humidity and a photoperiod of 14 h of light and 10 h of dark. Within each experiment, age-matched and sex-matched groups were used. B6.129S(C)-Batf3tm1Kmm/J (Batf3–/–) mice, B6(Cg)-Zbtb46tm1(HBEGF)Mnz/J (zDC-DTR) mice, B6.Cg-Tg(Itgax-cre)1-1Reiz/J (Cd11ccre) mice and NOD.Cg-Prkdcscid Il2rgtm1Wjl/SzJ (NSG) mice were purchased from Jackson Laboratories. B6.Cg-Rag2tm1.1Cgn/J Ly5.2 (Rag2–/–), BALB/c and C57BL/6J mice were obtained from the Vienna Biocenter in-house breeding facility. ItgaxcrePtger2−/−Ptger4fl/fl mice were provided by J. Boettcher (TUM, Munich). For Rag2–/–Batf3–/– strain generation, Batf3–/– mice were crossed to Rag2–/– mice, and homozygous offspring (Rag2–/– × Batf3–/–) were confirmed by genotyping and used in subsequent experiments to evaluate the lack of cDC1s in the context of ACT. For Rag2–/– zDC-DTR strain generation, zDC-DTR mice were crossed to Rag2–/– mice and homozygous offspring were confirmed by genotyping and used in subsequent experiments to evaluate the effects of DC depletion. For ACT experiments and injection of YUMM1.7OVA cell lines, Rag2–/– mice were used. For the injection of YUMM3.3, KPAR and EPP2 cell lines, C57BL/6 mice were used. For the injection of the CT-26 cell line, BALB/c mice were used. For the generation of BMDCs and Ly6C+ monocytes, bones (femurs and tibias) were collected from in-house-bred C57BL/6 mice. For all above strains, mice were used between 6 and 12 weeks old. For OT-1Luc CD8+ T cell isolation, 6–24-week-old OT-1Luc Thy1.1 mice69 were used. All mouse experiments were performed according to our licence approved by the Austrian Ministry (GZ: MA58-2260492-2022-22; GZ: 340118/2017/25; BMBWF-66.015/0009-V/3b/2019; GZ: 801161/2018/17; and GZ: 2021-0.524.218 and their amendments). Mice were euthanized when the humane end point was reached (for example, weight loss > 20%, signs of distress and pain), when tumours displayed signs of continuous necrosis or when tumours reached the maximum allowed tumour volume of 1,500 mm3.

    Tumour cell injections

    For subcutaneous injections, mice were anaesthetized with 2–4% isoflurane. For the YUMM1.7OVA model and all its derivatives, 0.5–1 × 106 YUMM1.7OVA cancer cells were subcutaneously injected into the flank of each mouse in a volume of 50 µl. For contralateral experiments, alternating flanks were used for the injection of NTT and RTT cells to avoid preferential growth biases. For the YUMM3.3 model, 0.3–1 × 106 cells were subcutaneously injected in a volume of 50 µl. For the CT-26 model, 0.25 × 106 cells were subcutaneously injected in 50 µl. For the KPAR model 0.35 × 106 cells were subcutaneously injected in 50 µl. For the EPP2Luc cell line derivative, orthotopic injections were performed as previously described65. In brief, surgeries were performed under isoflurane (2–4%) anaesthesia on a heated plate. A small incision on the upper left quadrant of the shaved abdomen was made and the was spleen identified. After externalization of the pancreas, 1 × 106 cells were intrapancreatically injected. Organs were re-situated, and the peritoneum closed with a resorbable 6-0 Vicryl suture, followed by skin closure with sterile wound clips. Animals received intraperitoneal (i.p.) injections of 5 mg kg–1 carprofen pre-emptively and every 12–48 h after surgery. The health status of mice was monitored daily, and the tumour burden was assessed by BLI. All cell lines were resuspended in PBS mixed 1:1 with Matrigel (Corning) in the final injection volume. Subcutaneous tumours were monitored by calliper measurements every 2–4 days, and tumour volume was calculated according to the following formula: volume = (D × d2)/2, in which D and d are the long and short tumour diameters, respectively.

    Isolation and activation of naive OT-1Luc CD8+ T cells

    Spleen and lymph nodes were isolated from OT-1Luc mice, and red blood cell lysis was performed with ammonium–chloride–potassium lysis buffer (Thermo Fisher) according to the manufacturer’s protocol. T cell isolation was performed using a Magnisort mouse CD8+ naive T cell enrichment kit (Thermo Fisher) according to the manufacturer’s protocol. T cells were activated for the first 24 h by seeding them on a plate coated with 2 µg ml–1 anti-CD3 (145-2C11, eBioscience) overnight, and adding 1 µg ml–1 anti-CD28 (37.51, eBioscience) and 20 ng ml–1 carrier-free IL-2 (BioLegend). T cells were expanded for approximately 6–7 days in the presence of IL-2 and maintained daily at a concentration of 1 × 106 cells per ml in fresh T cell medium.

    ACT, intratumoral injection and BLI

    Unless otherwise specified, when tumours reached a volume of 100–150 mm3, 4 × 106 in vitro-activated OT-1Luc CD8+ T cells were i.v. injected into mice in a volume of 100 µl PBS. For i.t. injections, 4 × 106 in vitro-activated OT-1Luc CD8+ T cells were injected in a volume of 50 µl PBS. For measuring T cell infiltration by BLI, d-luciferin (150 mg kg–1, Goldbio) was injected retro-orbitally or by tail vein injection into anaesthetized mice, and mice were imaged with an IVIS machine (Caliper Life Sciences) and analysed using Living Image software (v.4.4; Caliper Life Sciences). In NTT tumours, T cell recruitment to the tumour is detectable by BLI within 24–48 h. This initial recruitment is followed by a phase of T cell expansion, with peak BLI signals between 96 and 120 h. Hence, we depict 96 h post-ACT images (unless otherwise specified in figure legends) as a suitable time point to assess T cell expansion in immune-permissive TMEs.

    In vivo treatments

    For treatment with ICB, mice were i.p. injected with anti-PD1 (clone RMP1-14, BioXcell) and anti-CTLA4 (clone 9D9, BioXcell) in 100 µl of PBS when tumours reached a volume of 150–200 mm3 (usually between 6 and 8 days after injection). The YUMM3.3 model was treated with 200 µg anti-PD1/anti-CTLA4, the CT-26 model with 100 µg anti-PD1, and the EPP2 model with 100 µg anti-PD1. ICB treatment was administered every 3 days and continued for at least for 3 weeks, as indicated in the figure legends. Control mice were treated with an isotype control antibody (rat IgG2a anti-trinitrophenol, clone 2A3, BioXcell, and mouse IgG2b, clone MPC-11, BioXcell). For COX2i treatment, celecoxib (LC Laboratories) was reconstituted in a 60:40 (DMSO to PEG400, dH2O) mixture as previously described53. Etoricoxib (Sellekchem) was dissolved first in a small volume of DMSO and then in 1% sodium carboxymethyl cellulose. COX2i was given by oral gavage every day (30 mg kg–1) in a volume of 200 µl. For both COX2i regiments (celecoxib and etoricoxib), the treatment was started at day 3 after injection, when tumours were palpable, and continued every day until the termination of the experiment. 5-AZA (Sigma-Aldrich) was reconstituted in DMSO to a stock concentration of 10 mg ml–1 and further diluted in PBS for in vivo treatments and given as i.p. injections (1 mg kg–1) in 100–250 µl every 3 days, as previously described54. For NK cell depletion, 200 µg anti-NK1.1 (clone PK136, BioXcell) was administered every 3 days through i.p. injections, starting at day 1 after tumor induction. NK cell depletion was confirmed by flow cytometry. For blocking T cell egress from the lymph node, mice were given an i.p. injection of 20 µg per mouse of FTY720 (Sigma) in 100 µl saline. Treatment was started on the day of T cell transfer and administered for 5–7 consecutive days. Control mice received saline injection. FLT3L (recombinant FLT3L-Ig, hum/hum, BioXCell) treatment (30 µg per mouse in 100 µl PBS i.p.) was started at day 3 after injection and administered every day for 9 consecutive days. In vivo IFNAR blockade was performed with InVivoMab anti-mouse IFNAR-1 (clone MAR1-5A3, BioXcell) and was administered i.p. (200 µg per mouse) in 100 µl. For IFNγ, the neutralizing anti-mouse IFNγ monoclonal antibody was used (clone XMG1.2, BioXcell). Treatment was started on the day of tumour engraftment and administered every 3 days. InVivoMab IgG1 isotype control (BioXCell) was used as the control. For experiments in which CD8 depletion was performed, mice were treated with 50 µg anti-CD8 (clone 2.43, in-house produced), whereas control mice were treated with isotype control (rat IgG2b anti-keyhole limpet haemocyanin, clone LTF-2) starting the day before tumour engraftment and then every 3 days.

    DC vaccination with BMDCs

    BMDCs were cultured with FLT3L and GM-CSF as described above. At day 10–12 after isolation, DCs were activated overnight with polyI:C (5 µg ml–1, Invitrogen), pulsed with recombinant SIINFEKL peptide (5 µg ml–1, Genscript) and sorted by FACS on the basis of alive MHCII+CD103+CD11c+ cells. Next, 1 × 106 cells in a volume of 50 µl PBS were i.t. injected. Control mice received 50 µl PBS. For DC vaccinations, 2 doses of i.t. injections were administered on day 4 and day 6 after tumour engraftment.

    In vivo depletion of DCs with diphtheria toxin

    For generation of bone marrow chimeras, Rag2–/– Ly5.1 mice were preconditioned (2×5 Gy), before transferring back 10 × 106 bone marrow cells by i.v. injection. As donor mice, Rag2–/– Ly5.2 zDC-DTR mice were used. After 8 weeks of reconstitution, mice were used for experiments. NTT cells were injected, and DCs were depleted by injecting 25 µg kg–1 of body weight of diphtheria toxin (Sigma-Aldrich) i.p. in PBS, starting on the day of tumour engraftment and then every 3 days for 3–4 doses. Reconstitution efficiency and depletion of intratumoral DCs was confirmed by flow cytometry.

    Lentivirus generation and cell transduction

    Lenti-X (HEK-293T) cells were transfected with 4,000 ng of the plasmid of interest, 2,000 ng of VSV-G plasmid and 1,000 ng of PAX2 plasmid using polyethylenimine (Avantor). Virus-containing supernatant was collected 24 h and 48 h after transfection and subsequently filtered through a 0.45 µm filter. The cell lines of interest were transduced with the collected virus mixed with 8 µg ml–1 polybrene (Merck).

    Generation of CRISPR–Cas9 KO and overexpression cell lines

    Doxycycline-inducible Cas9 (iCas9) clones from parental cell lines were generated to allow inducible expression of Cas9. sgRNAs were chosen on the basis of the best VBC score70 (Supplementary Table 7) and were cloned into a vector containing a puromycin selection marker and mCherry or eGFP (hU6-sgRNA–PuroR–mCherry/eGFP). sgRNAs targeting the ROSA26 locus were used as controls for KO cell lines. After transduction, cells were selected with puromycin (5–8 µg ml–1) for 5 days. All sgRNA sequences are provided in Supplementary Table 7. For the generation of single-cell-derived clonal cell lines, cells were FACS sorted on the basis of the fluorescent marker on the sgRNA backbone, at 1 cell per well into 96-well plates. To avoid immunogenicity caused by antibiotic selection markers or fluorophores in the YUMM3.3 model, we transiently transfected the cell lines with an all-in-one vector containing Cas9, the sgRNA of interest and eGFP (U6-IT-EF1As-Cas9-P2A-eGFP). For transient transfection, 7,000 ng of the plasmid with polyethylenimine was used, and single-cell clones were established. For IRF3/7 overexpression, synthesized cDNA sequences were ordered from Twist Biosciences and cloned into two different expression vectors with distinctive selection/fluorescent markers (SFFV-IRF3–mCherry and SFFV-IRF7–PuroR). After transduction, cells were selected with puromycin (5–8 µg ml–1 for 5 days) and bulk FACS-sorted on the basis of mCherry expression. The same cell line engineered with an empty vector containing an mCherry and a puromycin resistance cassette was used as a control. KO and overexpression of the target proteins was confirmed by genotyping, western blotting or quantitative PCR with reverse transcription (RT–qPCR). For the YUMM1.7 and YUMM3.3 Ptgs2 KO cell lines, single-cell-derived clonal cell lines were generated, and several were tested in vivo for growth kinetics.

    EP2 and EP4 KO in T cells

    sgRNAs targeting the Ptger2 and Ptger4 mouse genes were designed according to the VBC score70 and cloned into a dual hU6-sgRNA-mU6-sgRNA-EF1α-mCherry-PuroR backbone (Supplementary Table 7). As a control, we used a sgRNA targeting a gene desert in chromosome 1. The lentiviral vector was produced as described above. T cells were isolated from Cas9–OT-1 mice, which were a gift from J. Zuber (IMP), as described above. Twelve hours after CD3/CD28 activation, T cells were spin-infected with the lentiviral vector containing the sgRNAs in a 1:1 ratio for 1 h at 32 °C and 800g. At 12 h after infection, T cells were removed from the activation plate, washed with PBS and cultured in the presence of 20 ng ml–1 IL-2. Selection with puromycin was performed 30 h after viral transduction. Before ACT, mCherry levels were assessed, and KO was confirmed by functional in vitro assays.

    Flow cytometry and cell sorting

    For flow-cytometry-based characterization of the TME, tumours were isolated between day 7 and 11 after injection, cut into pieces and digested for 1.5 h at 37 °C with collagenase A (1 mg ml–1, Roche) and DNAse (20 µg ml–1, Worthington) in unsupplemented RPMI-1640 medium. Digested tumours were strained through a 70 µm filter and resuspended in FACS buffer (0.5% BSA and 2 mM EDTA in PBS). Fc-block was performed with anti-CD16/32 (clone 2.4G2, Pharmingen) for 10 min at 4 °C to avoid Fc-specific antibody capture, and staining for cell surface markers was performed for 30 min at 4 °C. For intracellular staining, a Foxp3 Transcription Factor staining kit was used (eBioscience). Live/dead exclusion was performed by staining with the fixable viability dye eFluor780 (1:1,000, eBioscience). DCs were defined in most experiments as MHCII+CD11c+CD24+ out of alive CD45+ cells. cDC1s were identified as CD103+CD11b out of the total DCs, cDC2s as CD103CD11b+ and inflammatory cDC2 as CD103CD11b+AXL+. AXL was previously described to identify inflammatory cDC2s37. Monocytes were defined as Ly6C+CD11b+F4/80, and inflammatory monocytes were identified as monocytes that were Ly6A+. Ly6A was previously described to identify monocytes expressing high levels of ISGs38. Macrophages were defined as Ly6CF4/80+Cd11b+. Acquisition of the samples was performed using a BD LSR Fortessa machine (BD Biosciences) with FACS Diva software (v.9.0.1), and analysis was conducted using FlowJo software (v.10.8 or newer). For cell sorting, a BD Aria cell sorter (BD Biosciences) with FACS Diva software (v.9.0.1) was used.

    Antibodies for flow cytometry

    The following antibodies (all anti-mouse) were used for flow cytometry stainings (target (clone, catalogue number, manufacturer, dilution)): AXL PE-Cy7 (MAXL8DS, 25-1084-82, eBioscience, 1:200); CD103 PerCP/cyanine5.5 (2E7, 121415, BioLegend, 1:100); CD103 PE (2E7, BioLegend, 121405, 1:100); CD11b APC (M1/70,17-0112-81, eBioscience, 1:200); CD11b PerCP/cyanine5.5 (M1/70, 101229, BioLegend, 1:200); CD11c BV605 (HL3, 563057, BD Pharmigen, 1:100); CD11c FITC (N418, 117305, BioLegend, 1:100); CD24 BV510 (M1/69, 101831, BioLegend, 1:100); CD24 FITC (M1/69, 11-0242-82, eBioscience, 1:100); CD279/PD-1 BV785 (29F.1A12, 135225, BioLegend, 1:200); CD279/PD-1 FITC (29F.1A12, 135213, BioLegend, 1:200); CD40 APC (3/23, 124611, BioLegend, 1:200); CD45 BV711 (30-F11, 103147, BioLegend, 1:500); CD45 FITC (30-F11, 103107, BioLegend, 1:500); CD86 BV510 (GL-1, 105039, BioLegend, 1:100); CD3 BV605 (17A2, 564009, BD Horizon, 1:100); CD3 AF647 (17A2, 100209, BD Horizon, 1:100); CD3 AF488 (17A2, 100212, BD Horizon, 1:100); CD8a eFluor 450 (53-6.7, 48-0081-80, eBioscience, 1:100); CD8a AF647 (53-6.7, 128041, BioLegend, 1:100); MHCI (H-2Kb) APC (AF6-88.5.5.3, 17-5958-82, Bioscience, 1:200); MHCI (H-2Kb) PE (AF6-88.5.5.3, 17-5958-80, Bioscience, 1:200); MHCII (I-A/I-E) eFluor450 (M5/114.15.2, 48-5321-80, eBioscience, 1:200); MHCII (I-A/I-E) APC (M5/114.15.2, 107613, BioLegend, 1:200); NK-1.1 BV711 (PK136, 108745, BioLegend, 1:100); TCF1 PE (S33-966, 564217, BD Pharmigen, 1:50); TIM3 BV711 (RMT3-23, 119727, BioLegend, 1:100); CD88 PE (20/70, 135805, BioLegend, 1;100); Ly-6A/E (Sca-1) FITC (D7, 108105, BioLegend, 1:100); SIINFEKL-HK2B PE (25-D1.16, 12-5743-81, Invitrogen, 1:100); F4/80 PE (BM8, B123110, BioLegend, 1:200); and rat IgG1, K Isotype control PE (R3-34, 5546, BD Pharmigen). Further information is provided in Supplementary Table 8.

    RNA extraction of cancer cells sorted from tumours, in vitro cell lines and myeloid cells

    Tumours were surgically removed between days 10 and 12 after injection. The tissue was processed as described above, and cancer cells were isolated by flow cytometry on the basis of alive, CD45 cells and a fluorescent marker. For cancer cell lines and in vitro assays with myeloid cells, cells were washed with PBS and snap-frozen in liquid nitrogen and kept at −70 °C until further processing. RNA was extracted using a magnetic bead-based RNA extraction protocol (in-house produced). In brief, cells were lysed and incubated with beads together with DNase I (NEB) followed by magnetic isolation. RNA was purified by further elution with nuclease-free water.

    RT–qPCR

    Reverse transcription was performed for cDNA formation with 1 µg of RNA per sample utilizing a LunaScript RT SuperMix kit (NEB) according to the manufacturer’s instructions. RT–qPCR was performed with 10 ng cDNA per sample either with Luna Universal qPCR master mix (NEB) or an in-house produced MTD qPCR Dye 2× HS master mix according to the manufacturer’s protocol. Each sample included four technical replicates. The RT–qPCR reaction was carried out in a Bio-Rad CFX384 real‐time cycler and contained 1 min of initial denaturation (95 °C) and 45 annealing cycles lasting 15 s at 95 °C and 30 s at 60 °C. The analysis of gene expression levels was determined by the quantification cycles (Cq). Internal controls and the housekeeping gene GAPDH were used to correct for differences in sample quality and to normalize expression values. qPCR primer pair sequences are listed in Supplementary Table 7.

    In vitro assays with BMDCs

    For cancer cell CM experiments, supernatants (in full T cell medium) from confluent cancer cells were collected after 48 h, filtered through a 45 µm filter and frozen at −70 °C until further use. Full T cell medium was supplemented with 20 µM of the COX1/2i indomethacin (Selleckchem) or 5 nM of the MEKi trametinib (Selleckchem) for the evaluation of MAPK and COX1/2 activity before media conditioning. BMDCs were differentiated as described above and collected at day 6. Next, 0.5–1 × 106 cells were seeded in triplicate in a 12-well plate in CM and treated with 10 µg ml–1 InVivoMab anti-mouse IFNAR-1 antibody or InVivoMab IgG1 isotype control (BioXCell). Cells were cultured for 24 h, collected and processed for flow cytometry analysis or RNA extraction. For treatment with PGE2 and IFNβ, cells were collected at day 6 and seeded at a concentration of 0.5–1 × 106 cells per ml. Cells were treated for 24–48 h with recombinant PGE2 (100 ng ml–1, Sigma-Aldrich) and recombinant mouse/human IFNβ (R&D Systems) at the concentrations indicated in the corresponding figures. Same volumes of acetone and PBS were used as a control for PGE2 and IFNβ, respectively.

    Isolation of bone-marrow-derived Ly6C+ monocytes for intratumoral injection and in vitro assays

    Ly6C+ monocytes were directly isolated from the bone marrow of CD45.1+ C57BL/6 mice using a monocyte isolation kit (Miltenyi Biotec) following the manufacturer’s instructions. For intratumoral monocyte transfer, 1 × 106 monocytes were i.t. injected into NTT and RTT tumours established in CD45.2+ Rag2–/– mice. Tumours were isolated for FACS analysis 72 h after intratumoral transfer. For in vitro assays to assess effects of PGE2, Ly6C+ monocytes were seeded at a density of 1 × 106 cells per ml and cultured in recombinant IL-4 and GM-CSF (both produced in-house) and exposed to 200 ng ml–1 PGE2 or vehicle for 3 or 5 days. For CM experiments, monocytes were seeded at a density of 1 × 106 cells per ml in CM obtained from NTT, RTT or RTT IRF3/7 cells with or without 20 µM COX1/2i (indomethacin) during media conditioning and subsequently supplemented with or without 10 µg ml–1 InVivoMab anti-mouse IFNAR1 anti-mouse (BioXCell) or isotype IgG1 control (BioXCell).

    In vitro monocyte co-culture assay

    Ly6C+Ly6A+ or Ly6C+Ly6A monocytes were FACS-sorted from NTT tumours grown in Rag2–/– mice or BALB/c mice and co-cultured for 72 h with naive OT-1 T cells (1:3 ratio: 100,000 monocytes for 300,000 naive OT-1 cells) previously labelled with 0.25 µM CFSE for 30 min at 37 °C.

    In vitro human monocyte assays

    BLaER-1 cells were transdifferentiated into monocytes as previously described68. In brief, BlaER-1 transdifferentiation medium was freshly prepared by adding 10 ng ml–1 human recombinant (hr-)IL-3 (PeproTech), 10 ng ml–1 hr-M-CSF (PeproTech) and 100 nM β-oestradiol (Sigma-Aldrich) to complete RPMI medium. Cells were resuspended in transdifferentiation medium and plated in a 12-well plate at 0.7 × 106 cells per ml. Cells were incubated at 37 °C for 5–6 days until mature monocytes were differentiated. For CM experiments, BLaER-1 or MONO-MAC-1 human monocytes were seeded at a density of 0.7 × 106 cells per ml in CM obtained from NTT or RTT cells from the human melanoma cell lines A375, M249 and LOX or the human NSCLC cell line NCI-H358 with or without 20 µM COX1/2i (indomethacin) during media conditioning. Cells were cultured in CM for 24 h and collected for RNA extraction, as described above.

    Evaluation of pMHCI cross-dressing on monocytes

    For mismatched MHCI haplotype experiments, 1 × 106 YUMM1.7OVA NTT cells from C57BL/6 origin (H-2Kb) were injected in the flank of BALB/c (H2-Kd) mice. BALB/c mice were treated with anti-CD8 (50 µg in 100 µl, in-house produced), whereas control mice were treated with isotype control (rat IgG2b anti-keyhole limpet haemocyanin, clone LTF-2) starting the day before tumour engraftment and then every 3 days to avoid T cell-mediated mismatched MHCI rejection of YUMM1.7 cells. On day 10, tumours were collected and processed for flow cytometry staining of H2-Kb or FACS-sorted on the basis of Ly6A expression for in vitro assays.

    Sample preparation for scRNA-seq

    For scRNA-seq experiments involving TME characterization, tumours were isolated at day 10 after injection (72 h after ACT) and were processed as described above. The CD45+ live fraction was isolated by FACS, and approximately 1 × 105 cells were collected. For scRNA-seq of OT-1 T cells, tumours were isolated 5 days after i.t. injection of 4 × 106 T cells. Alive T cells were isolated from tumours by FACS for CD45+CD3+CD8+ markers. Dissociated cell concentrations were measured using NucleoCounter NC250 (Chemometec) following the manufacturer’s instructions. For scRNA-seq samples from experiments 3 and 4 (see below), a Chromium Next GEM Single Cell Fixed RNA Sample preparation kit was used according to the manufacturer’s protocol. In brief, 1 × 106 cells were fixed for 22 h at 4 °C, quenched and long-term stored at –80 °C according to 10x Genomics Fixation of Cells & Nuclei for Chromium Fixed RNA profiling (CG000478) using a Chromium Next GEM Single Cell Fixed RNA Sample preparation kit (PN-1000414, 10x Genomics). About 250,000 cells per sample were used for probe hybridization using a Chromium Fixed RNA Kit, Mouse Transcriptome, 4rxn × 4BC (PN-1000496, 10x Genomics), pooled equally and washed following the Pooled Wash Workflow as described in the Chromium Fixed RNA Profiling Reagent kit protocol (CG000527, 10x Genomics). For all the other scRNA-seq samples, a Chromium Next GEM Single cell 3′ kit with Dual Index was used according to the manufacturer’s instructions. GEMs were generated on Chromium X (10x Genomics) with a target of 10,000 cells recovered, and libraries prepared according to the manufacturer’s instructions (CG000527, 10x Genomics). Sequencing was performed on NovaSeq S4 lane PE150 (Illumina) with a target of 15,000 reads per cell.

    scRNA-seq analysis of CD45+ TME

    CD45+ immune cells were collected in four different 10x Genomics sequencing experiments. Experiment 1, Chromium Single Cell 3′ scRNA-seq samples were pre-processed using cellranger count (v.6.1.1) (YUMM3.3 samples: NTT/108155 and RTT/108157). Experiment 2, 3′ CellPlex multiplex experiment with 4 samples pre-processed using cellranger multi (v.6.1.1) (YUMM1.7OVA samples: NTT + ACT, RTT + ACT, RTT Ptgs1/2 KO + ACT, RTT CTRL ROSA26 + ACT). Experiments 3 and 4, Chromium Flex multiplex experiments with 4 samples each pre-processed using cellranger multi (v.7.1.0) and the built-in Probe Set (v.1.0.1 mm10-2020-A). Experiment 3, YUMM1.7OVA samples: RTT mCherry CTRL, RTT IRF3/7, RTT COX2i and RTT COX2i + 5-AZA, all ACT treated. Experiment 4, YUMM1.7OVA contained biological replicates of experiment 2 samples and untreated YUMM1.7OVA samples (noA): NTTnoA/271221, RTTnoA/271222, NTT/271223 ACT, RTT/271224 ACT. The prebuilt 10x Genomics mm10 reference refdata-gex-mm10-2020-A was used. Further processing was performed in R (v.4.2.2) with Seurat (v.4.3.0). For generating a CD45+ immune reference map, we integrated cells from the first three experiments as follows. The cellranger filtered feature–barcode matrices were used, retaining cells with more than 1,000 detected genes and less than 15% of mitochondrial and less than 40% of ribosomal RNA reads. An integrated feature–barcode matrix from the three experimental batches was generated accounting for the inclusion of a probe-based assay by keeping genes found in at least five cells in each experiment and excluding ribosomal and mitochondrial genes. Data were log-normalized, scaled (regressing out the difference between the G2M and S phase signature scores), dimensionality reduction was performed using principal component analysis on the top 3,000 most variable genes, and batch correction across batches was performed using Harmony71 (v.0.1.1). The 40 harmony embeddings were used for UMAP visualizations. The first 40 harmony dimensions were used to identify immune cell subclusters with a resolution of 0.5 that were further assigned to cell types using known markers and publicly available myeloid reference datasets21,72. Cells were scored for the expression of published signatures using the AddModuleScore function73. Wilcoxon rank-sum test implemented in Presto (v.1.0.0) was used to identify differentially expressed genes (DEGs). Seurat’s reference-based mapping was used to predict cell-type identity and map cells of the biological replicate experiment to our annotated reference set using the FindTransferAnchors and MapQuery functions after a quality control process retaining cells between 1,000 and 4,500 detected genes for 27,1222 and 27,1224 cells, respectively, and 1,300 and 8,000 detected genes for 27,1221 and 27,1223 cells, respectively, and limiting count tables to the gene universe of the reference. Depth-normalized counts for pseudobulk and GSEA functional analyses of this experiment were generated using cellranger aggr. Differences between ACT and untreated conditions (no ACT) from the replicate experiment (experiment 4) were explored on a pseudo-bulk level in an unsupervised clustering analysis with heatmap visualization. The fibroblast cluster was removed before further processing. Sum aggregation on the depth-normalized UMI counts was followed by variance stabilizing transformation, selection of the 300 most variable genes, standardization, k-means clustering (k = 3) and Enrichr analysis against the Reactome_2022 using Enrichr. The relative frequency bar plots depict the changes in the relative abundance of a cell type across different experimental conditions. For each condition, we calculated the normalized abundance of a specific cell type by comparing the absolute number of the cell type to the absolute number of all cells in the same condition. This normalization accounts for differences in total number of cells captured between conditions. We then calculated the relative cell abundance of the cell type in all conditions of the experiment. This was done by comparing the normalized abundance of the cell type to the sum of normalized abundances of the same cell type across conditions of the experiment. This step produces values between 0 and 1 for each condition for each cell type, with the sum of these values across all conditions of the experiment equalling 1 for each cell type.

    scRNA-seq analysis intratumoral CD8+ OT-1Luc T cells

    Single-cell gene expression of isolated NTT and RTT T cells was assayed in a Chromium Flex experiment, and read processing was performed using cellranger multi (v.7.1.0) using probeset (v.1.0.1 mm10-2020-A). Cellranger-filtered feature–barcode matrices were used and further filtered to retain cells with more than 800 detected genes, less than 10% of mitochondrial and less than 10% of ribosomal RNAs reads, and removal of cells of contaminant clusters was identified using SingleR and ImmGen reference (fibroblasts, MoMac populations). Data were log-normalized and scaled, and dimensionality reduction was performed using principal component analysis on the top 2,000 most variable genes. Harmony was used for the integration of cells from different samples, and 15 harmony embeddings were used for UMAP visualizations. Published tumour single-cell data were used for signature scoring29. Gene lists are provided in Supplementary Table 2.

    RNA velocity analysis

    To understand differentiation trajectories of myeloid cells within the TME, we performed RNA velocity analysis74 of the MoMac compartment. Loom files containing the splicing annotation were created for each sample using the velocyto run command from the package velocyto (0.17,17) with default parameters and with no masked intervals. The loom files were combined with the scRNA-seq object that had been filtered to keep the data for monocyte and macrophage populations (Monocyte_1, Monocyte_2, Infl_Mono, TAM_CCL6, TAM_Ctsk, TAM_C1q, TAM_H2-Ab1, TAM_Spp1 and TAM_cycling) and for each condition (NTT, RTT and RTT Ptgs1/2 KO). First-order and second-order moments were computed using scvelo (0.2.5) pp.moments (n_pcs = 30, n_neighbors = 30), and the dynamical model was run with default parameters. Python (v.3.8.12) was used.

    SCENIC analysis

    Gene regulatory networks for each cell population in each condition were calculated using SCENIC75. The motif database used was mm9-tss-centered-10kb-7species.mc9nr.feather. The co-expression network was calculated using GENIE3. The gene regulatory network was built using SCENIC wrapper functions.

    Analysis of publicly available myeloid datasets and inflammatory signatures

    For the melanoma and lung samples from a previously published23 dataset (Gene Expression Omnibus (GEO) identifier GSE154763), the raw counts were pre-processed as described in the publication, and clustering was calculated using a resolution of 0.8. The monocyte and inflammatory monocyte gene set was derived by using the wilcoxauc() function from presto and by selecting the genes with a log fold change > 0.6 (Supplementary Table 2). Then, the gene symbols were converted to human symbols. The human inflammatory monocyte gene set was used to calculate an enrichment score per cluster. In brief, the gene average expression was calculated for each cluster in the LUNG and MEL datasets on normalized data. Then, an enrichment score was calculated using GSVA with the following parameters: minSize = 5, maxSize = 500, kcdf = “Gaussian”. The projection of the signature on the UMAP embedding was done using the function AddModuleScore() and then plotting the resulting score using FeaturePlot() with min.cutoff = 0.3 for the inflammatory monocyte score and min.cutoff = 0.4 for the Monocyte_1 score. For another dataset43, the annotated seurat-object for myeloid populations corresponding to the original figure 4a was obtained, and gene sets were analysed as described above. For querying published inflammatory gene signatures, a previously published ISG+ DC signature37 was generated by taking the top DEGs in the cDC2 cluster37. The Bosteels Inf-cDC2 DC signature was previously generated37 and was obtained by re-analysing the scRNA-seq dataset (GEO identifier GSM4505993), in which the top 20 DEGs were taken in the identified inflammatory cDC2 cluster. All of them were subsequently scored in our dataset using the AddModuleScore73, and the resulting score was plotted using FeaturePlot(). Gene lists are provided in Supplementary Table 2.

    Single-cell spatial transcriptomics of human melanoma samples

    Single-cell spatial transcriptomics profiling was performed using the CosMx technology (Nanostring). Biopsy samples were obtained from patients with an age at diagnosis that ranged from 24 to 85 years with a median of 66 years; 34% were women and 66% were men. We obtained cell-segmented data for 74 FOVs (an area of 500 × 500 µm) from tissue microarray cores of 34 melanoma metastases, in total consisting of 980 genes × 171,536 cells. Tumour samples were obtained from 21 lymph nodes, 7 subcutaneous metastases, 1 lung metastasis and 1 brain metastasis and 4 not annotated, from 31 patients containing 72 FOVs. Two FOVs were from tonsils as control. Most tumour tissue were from patients who were treatment-naive at the time of surgery. Tissue collection was approved by the Regional Ethics committee at Lund University (numbers 191/2007 and 101/2013). Patients provided informed consent. The majority of tissue microarray cores contained tertiary lymphoid structures, and FOVs were preferentially directed to these regions. Low-quality FOVs, cells with <20 counts and potential multiplets of cells (area exceeding the sample geometric mean + 5 standard deviation) were discarded. Using Seurat, genes for which the mean expression was below 3× the median of the negative probe mean expression, and genes with the highest 99% quantile expression, MALAT1 and IGKC (due to potential spillover to neighbouring cells), were removed, which retained 641 genes. The data were normalized using SCTransform76, counts that were zero before SCTransform were restored, and counts were log-transformed as log2(counts+1). The top 30 principal components were used for UMAP reduction and clustering (k.param = 15, resolution = 0.5, Louvain algorithm). Resulting clusters were assigned to biological annotations using known marker genes, and annotations were mapped back to FOV coordinates. Expression of C1QC, CXCL9 or CXCL10 > 0 was considered as positive. Cell-type fractions were derived for each FOV. Pearson correlation values between cell-type fractions across FOVs were determined and displayed. In Fig. 2i, CXCL9+CXCL10+ macrophage/DCs (number 9 and number 10) were either CXCL9+ or CXCL10+. Macrophage/DCs (number 5) were negative for CXCL9, CXCL10 and C1qC.

    Generation of the TME-COX and TME-IRF3/7 signature

    For the TME-COX signature, the FindMarkers function was used in Seurat, with tresh.use = 0.25 and min.pct = 0.1, to compare RTT CTRL (ROSA26) and RTT Ptgs1/2 KO scRNA-seq samples. The top DEGs (log2 fold change ≤ 1.5, adjusted P value < 0.05) were used and converted to human orthologues using DIOPT77. For the TME-IRF3/7 signature, the FindMarkers function was used in Seurat, comparing RTT CTRL (mCherry) and RTT IRF3/7 and taking the top 40 DEGs.

    TME signatures in immunotherapy-treated human samples

    Gene expression data for patients receiving ICB were obtained from a previous study49 (NCBI BioProject accession number PRJEB23709). The TME-COX, TME-IRF3/7 and CD8+ T cell scores for each tumour sample were defined as the geometric mean of the expression values of each of the gene sets, respectively (Supplementary Table 4). The univariate Cox proportional hazards models, in which the TME-COX and TME-IRF3/7 scores were included as continuous variables, were used for testing the statistical association between gene signature expression and patient survival, separately for both signatures. The tumour samples were then divided into three groups on the basis of the signature score (bottom third, mid-third and top third) and Kaplan–Meier plots were generated for visualization. The association between signature expression and CD8+ T cell abundance was evaluated by calculating the Person’s correlation coefficient between the signature score and a CD8+ score for each signature separately. For this, all scores were normalized to a median of zero and standard deviation of one. The two overlapping genes were removed from the CD8+ signature before comparing it to TME-IRF3/7 signature expression. For evaluating the enrichment of TME-COX and TME-IRF37 gene signatures in responder and non-responder patients to TIL therapy (baseline) from a previous study43, mouse gene identifiers were first converted to human orthologues (with DIOPT v.9; best dcore = yes, best score reverse = yes, DIOPT score > 7) and single-cell level signature enrichment scores for the ‘humanized’ gene sets were calculated using AddModuleScore_UCell78.

    Analysis of transcriptomics data

    For plots shown in Fig. 3a, a cut-off of adjusted P value < 0.05 and log2 fold change > 2 and < –2 was used on DEGs expressed in YUMM1.7OVA NTT and RTT GFP+ cancer cells FACS-sorted out of tumours (Supplementary Table 3). Pathway enrichment analysis was performed using Enrichr79,80. For the plot in Extended Data Fig. 5i, upstream regulator analysis (Ingenuity)81 was used to identify upstream regulators using DEGs with an adjusted P value < 0.05.

    Quantification of PGE2 and IFNβ by ELISA

    For in vitro analysis of PGE2 production, 2 × 106 cells were seeded in 10 ml medium, and supernatants were collected after 48 h and kept at −70 °C until analysis. For IFNβ, 0.3 × 106 cells were seeded, and 1 ml of supernatant was collected from confluent cells in a 6-well plate after 48 h of culture and kept at –70 °C until analysis. For analysis of PGE2 and IFNβ from mouse tumours, whole tumours were isolated between days 4 and 10 after engraftment, accurately weighed and immediately snap-frozen in liquid nitrogen. They were stored at −70 °C until further processing. For PGE2 analysis, tumours were subsequently digested using a MACS dissociator according to the manufacturer’s protocol in PBS supplemented with 1 mM EDTA and 10 µM indomethacin. Lysate was further diluted in dissociation buffer depending on the tumour condition and weight (100 µl per mg of tumour) and further quantified using a PGE2 ELISA kit (Cayman) or a mouse IFNβ Quantikine ELISA kit (Biotechne) according to the manufacturer’s protocol. Values were normalized by taking into account dilution factors and tumour weight. For human IFNβ analysis from human cells, 1 × 106 A375, M249, LOX or NCI-H358 cells were injected into NSG mice and collected on day 21. Tumours were processed as described above and quantified using a Human IFNβ Quantikine ELISA kit (Biotechne) according to the manufacturer’s protocol.

    Eicosanoid analysis from tumours by HPLC–MS

    YUMM1.7OVA NTT and RTT tumours were isolated at day 10 after injection and weighed, and a solution of isopropanol and methanol (1:1, v/v) was added to the tissue for metabolite extraction. The material was subsequently homogenized and incubated for 1 h at −20 °C. The samples were then centrifuged at 14,000g for 3 min. A second extraction round was performed by adding 80% methanol and H2O (v/v) to the pellet and centrifuged, and both supernatants were combined. Finally, the samples were incubated for another 2 h at −20 °C, and after final centrifugation, the supernatants were stored at −70 °C until further analysis. Samples were subsequently measured on a ZIC-pHILIC column or a RP column. Metabolites were annotated using the compound discoverer 3.0 software (Thermo Fisher) using an internal database or the mzCloud database (at least 75% match on the basis of measured molecular weight and MS2 spectra). For filtering, a RSD of corrected quality control areas was used, being less than or equal to 25%. Group CV of at least 1 group is less than or equal to 40%.

    Western blotting

    Cells were lysed with RIPA buffer (Cell Signaling Technology) supplemented with complete Protease Inhibitor Cocktail (Sigma Aldrich) and HALT phosphatase inhibitor (Thermo Fisher Scientific). Lysates were sonicated and cleared by centrifugation at 14,000g for 10 min at 4 °C. Protein concentrations were quantified according to the manufacturer’s instructions using a BCA Protein Assay kit (Pierce, Thermo Fisher Scientific). Immunoblotting was conducted according to standard protocols. The primary antibodies used for immunoblotting were as follows: anti-vinculin (Sigma-Aldrich, 1:1,000), anti-COX2 (CST,1:1,000) and anti-H3 (acetyl K27) (Abcam, 1:5,000). The secondary antibodies used were as follows: anti-rabbit IgG HRP-linked (Cell Signaling Technology, 1:10,000) and anti-mouse IgG HRP-linked (Cell Signaling Technology, 1:10,000).

    Volumetric IF microscopy and image analysis

    Volumetric microscopy of mouse tumours was performed as previously described9. In brief, tumours were fixed in Antigenfix solution (Diapath) for 6–8 h, dehydrated in 30% sucrose overnight, embedded in TissueTek OCT freezing medium (Sakura Finetek) and stored at −80 °C. Using a Leica CM3050 S cryostat, consecutive sections of 50 µm thickness were generated, subsequently permeabilized, blocked and stained in 0.1 M Tris (Carl Roth) supplemented with 1% BSA, 0.3% Triton X-100 (Merck), normal mouse serum (Merck) and donkey serum (Merck). Stained sections were mounted in Mowiol (Merck) and imaged on an inverted TCS SP8 confocal microscope (Leica) using a HC PL APO CS2 ×20/0.75 NA objective. Images were acquired as tiled image stacks, covering whole tumour sections in the xy plane, with 2 µm z-spacing to provide 3D image volumes of at least 20 µm depth. For further analyses, images were adaptively deconvoluted using the Leica TCS SP8 LIGHTNING tool (v.3.5.7.23225) and analysed using Imaris 9.9 software (Oxford Instruments). The Imaris surface generation tool was used to reconstruct and visualize 3D objects for individual cells. Where indicated, signals outside rendered cells were masked to visualize intracellular proteins. For analysis of immune cell infiltration by histocytometry, statistics for object localizations were exported into Excel (v.16.88; Microsoft) and analysed using GraphPad Prism software (GraphPad). Quantification of the number of cells was performed relative to the volume of the imaged section. Interacting cells were described as being less than <5 µm apart from each other.

    Antibodies for immunofluorescence microscopy

    The following antibodies were used for staining of mouse tissues: anti-CD3 (BioLegend, clone 17A2), anti-CD103 (R&D Systems, goat polyclonal), anti-FSCN1 (Santa Cruz Biotechnology, clone 55-k2), anti-Ly6C (BioLegend, clone HK1.4) and anti-MHCII I-A/I-E (BioLegend, clone M5/114.15.2). All antibodies were either validated by the manufacturer or were previously reported for IF microscopy. The populations were defined as follows: T cells (CD3+), monocytes (Ly6C+CD103MHCII+), cDC1s (FSCN1CD103+MHCII+), CCR7+ cDC1 (FSCN1+CD103+MHCII+) and CCR7+ cDC2 (FSCN1+CD103MHCII+). Nur77–GFP was directly assessed by transferring Nur77–GFP reporter OT-1 T cells.

    Meta-analysis of NSAID immunotherapy cohorts

    The meta-analysis was performed in accordance with the updated Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines82. The literature search was conducted using the PubMed (MEDLINE) database and last updated on 31 December 2023. The full search strategy is available in Supplementary Table 6. The literature review included studies of (1) adult patients with (2) melanoma or NSCLC (3) undergoing FDA-approved immunotherapy, including anti-PD1, anti-PD-L1 or anti-CTLA4, (4) co-medication with NSAIDs and (5) available sufficient patients’ outcome data to calculate odds ratios for overall response rates or hazard ratios for progression-free and overall survival. Patients were not excluded when receiving concomitant chemotherapy and/or radiotherapy. Included studies report time of overall survival, time of progressions-free survival and overall response rates (defined as complete responses and partial responses divided by patient population). All studies published since 1 January 2011 (FDA approval of first immunotherapy, for example, ipilimumab) were included. Survival data are reported as univariate or multivariate hazard ratios; if both were available, multivariate analysis was prioritized. Odds ratios and hazard ratios with 95% CIs for overall response rates, progression-free and overall survival from included studies were utilized to calculate the pooled odds and hazard ratios. The heterogeneity of the pooled results was evaluated using Q-tests to assess between-study heterogeneity and quantified by the Higgins I2 test. If P was <0.10 for the Q-test or I2 was >50%, significant heterogeneity was assumed, and the random-effects model was used to summarize the data. Statistical analysis was performed using R software (v.4.3.2) with meta (General Package for Meta-Analysis, v.7.0-0).

    Statistical analysis and reproducibility

    Statistical analyses were performed using GraphPad Prism (v.9.1.2 or newer) and Microsoft Excel (v.16.88). Normality of the data distribution was calculated using a D’Agostino and Pearson test or Shapiro–Wilk test. The number of samples (n) used per experiment and the statistical test used are indicated in the figure legends. All in vitro and in vivo experiments were repeated at least twice and always with multiple replicates, except for the following experiments that were performed only once: scRNA-seq involving pharmacological treatment of the YUMM1.7 RTT model, intratumorally injected T cells and the YUMM3.3 model. IF stainings for which representative images are shown were repeated at least twice, except for the NTT in Batf3–/– and Nur77 reporter experiment, which was performed once but with n = 3 tumours and was also confirmed with flow cytometry. Pharmacological combination treatments of the KPAR model were performed once. No statistical methods were used to determine sample size for in vivo experiments, and numbers were chosen on the basis of previous preliminary experiments. Scientists were not blinded to experimental groups, and experiments were repeated by different investigators. Mice were randomly assigned to treatment groups on the basis of tumour size at the day of treatment start or randomly allocated across separate cages when treatment had to be started at day 3. P values < 0.05 were considered significant.

    Reporting summary

    Further information on research design is available in the Nature Portfolio Reporting Summary linked to this article.

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  • New AI tool enhances medical imaging with deep learning and text analysis

    New AI tool enhances medical imaging with deep learning and text analysis

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    In a recent study published in Nature Medicine, researchers developed the medical concept retriever (MONET) foundation model, which connects medical pictures to text and evaluates images based on their idea existence, which aids in critical tasks in medical artificial intelligence (AI) development and implementation.

    Study: Prediction of tumor origin in cancers of unknown primary origin with cytology-based deep learning. Image Credit: LALAKA/Shutterstock.comStudy: Prediction of tumor origin in cancers of unknown primary origin with cytology-based deep learning. Image Credit: LALAKA/Shutterstock.com

    Background

    Building reliable picture-based medical artificial intelligence systems necessitates analyzing information and neural network models at each level of development, from the training phase to the post-deployment phase.

    Richly annotated medical datasets containing semantically relevant ideas could de-mystify the ‘black-box’ technologies.

    Understanding clinically significant notions like darker pigmentation, atypical pigment networks, and multiple colors is medically beneficial; however, getting labels takes effort, and most medical information sets provide just diagnostic annotations.

    About the study

    In the current study, researchers created MONET, an AI model that can annotate medical pictures with medically relevant ideas. They designed the model to identify various human-understandable ideas across two picture modalities in dermatology: dermoscopic and clinical images.

    The researchers gathered 105,550 dermatology image-text pairings from PubMed articles and medical textbooks, followed by training MONET using 105,550 dermatology-related photos and natural language data from a broad-scale medical literature database.

    MONET assigns ratings to photos for each idea, which indicate the extent to which the image portrays the notion.

    MONET, based on contrastive-type learning, is an artificial intelligence approach that allows for direct plain language description application to images.

    This method avoids manual labeling, allowing for massive image-text pair information on a considerably larger scale than possible with supervised-type learning. After MONET training, the researchers evaluated its effectiveness in annotation and other AI transparency-related use cases.

    The researchers tested MONET’s concept annotation capabilities by selecting the most conceptual photos from dermoscopic and clinical images.

    They compared MONET’s performance to supervised learning strategies involving training ResNet-50 models with ground-truth conceptual labels and OpenAI’s Contrastive language-image pretraining (CLIP) model.

    The researchers also used MONET to automate data evaluation and tested its efficacy in concept differential analysis.

    They utilized MONET to analyze the International Skin Imaging Collaboration (ISIC) data, the broadest dermoscopic image collection with over 70,000 publicly available images routinely used to train dermatological AI models.

    The researchers developed model auditing using MONET’ (MA-MONET) using MONET for the automatic detection of semantically relevant medical concepts and model mistakes.

    Researchers evaluated MONET-MA in real-world settings by training CNN models on data from several universities and assessing their automated concept annotation.

    They contrasted the ‘MONET + CBM’ automatic idea scoring method against the human labeling method, which exclusively applies to photos containing SkinCon labels.

    The researchers also investigated the effect of concept selection on MONET+CBM performance, specifically task-relevant ideas in bottleneck layers. Further, they evaluated the impact of incorporating the concept of red in the bottleneck on MONET+CBM performance in interinstitutional transfer scenarios.

    Results

    MONET is a flexible medical AI platform that can appropriately annotate ideas across dermatological images, as confirmed by board-certified dermatologists.

    Its concept annotation feature enables relevant trustworthiness evaluations across the medical artificial intelligence pipeline, as proven by model audits, data audits, and interpretable model developments.

    MONET successfully finds appropriate dermoscopic and clinical images for various dermatological keywords, beating the baseline CLIP model in both areas. MONET outperformed CLIP for dermoscopic and clinical pictures while remaining equivalent to supervised learning models for clinical pictures.

    MONET’s automated annotation functionality aids in the identification of differentiating traits between any two arbitrary groups of images in a human-readable language during idea differential analysis.

    The researchers found that MONET recognizes differentially expressed ideas in clinical and dermoscopic datasets and can help with large-scale dataset auditing.

    MA-MONET use revealed features linked with high mistake rates, such as a cluster of photos labeled blue-whitish veil, blue, black, gray, and flat-topped.

    The researchers identified the cluster with the highest error rate by erythema, regression structure, red, atrophy, and hyperpigmentation. Dermatologists chose ten target-related ideas for the MONET+CBM and CLIP+CBM bottleneck layers, allowing for flexible labeling options.

    MONET+CBM surpasses all baselines concerning the mean area under the receiver-operating characteristic curve (AUROC) for predicting malignancy and melanoma in clinical pictures. Supervised black-box models consistently outperformed in cancer and melanoma prediction tests.

    Conclusion

    The study found that image-text models can increase AI transparency and trustworthiness in the medical field. MONET, a platform for medical concept annotation, can improve dermatological AI transparency and trustworthiness by allowing for large-scale annotation of ideas.

    AI model developers may improve data collection, processing, and optimization procedures, resulting in more dependable medical AI models.

    MONET can influence clinical deployment and monitoring of medical image AI systems by allowing for full auditing and fairness analysis through annotating skin tone descriptors.

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  • Breakthrough study reveals melanoma’s resistance tactics to targeted therapy

    Breakthrough study reveals melanoma’s resistance tactics to targeted therapy

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    Melanoma is the deadliest form of skin cancer. With global incidence rates rising, new, more effective treatments are necessary to alleviate the health burden of the disease. Important advances in recent years include doctors using genetic tests to look for specific mutations they can target for more personalised, effective treatment.

    Around 1 in 2 melanoma patients will have mutations in the BRAF gene. This gene normally makes a protein which helps control cell growth, but mutations can cause the cells to grow and divide uncontrollably instead, happening in many different types of cancer including melanoma.

    The discovery of BRAF mutations has led to development of targeted therapies to inhibit its function. One of the standard treatment options for melanoma over the last ten years has been to simultaneously target both BRAF mutations and MEK. These two genes are part of the MAPK signalling pathway, which, in cancer, is rewired for uncontrolled growth. Targeting two different critical points in the same domino chain helps slow or stop cancer growth.

    Despite great initial responses to the combined use of the first-generation inhibitors, around 50% of melanoma patients with BRAF mutations will relapse within one year. The cancer acquires resistance to the drugs, finding other ways to reactive the MAPK pathway through mechanisms which remain poorly understood.

    Melanoma drug resistance is a huge clinical problem because it occurs in almost all BRAF-mutated patients under BRAF/MEK inhibitor therapy and there are few or no therapeutic alternatives. There is an urgent need to understand the many different underlying mechanisms and find new strategies to deal with this constantly evolving arms race.”


    Dr. Francisco Aya Moreno, medically-trained oncologist and recent PhD graduate at the Centre for Genomic Regulation (CRG) in Barcelona

    A study published today in the journal Cell Reports has disentangled the mechanisms behind one of the ways cancer cells develop resistance to targeted therapy. The study found that, in response to treatment, melanomas can ‘break’ parts of their BRAF gene, also known as genomic deletions. This helps the tumour create alternative versions of the protein (altBRAFs) which lack regions targeted by BRAF inhibitors, reactivating the MAPK pathway and making the drugs less effective. The finding was consistent across various lab models and patient tumour samples.

    The findings are important because altBRAFs were thought to be made through alternative splicing, which is when cells use the same gene to synthesise different proteins. The discovery that genomic deletions, and not splicing, are the cause means a shift away from previous proposals for using drugs that target splicing as a therapeutic strategy.

    “For years, we’ve known that some patients produce altBRAFs and these help the cancer resist treatment, but we misunderstood the mechanism behind their creation. Knowing that genomic deletions are the cause opens new avenues for developing therapies that could more effectively help patients with BRAF mutations,” explains ICREA Research Professor Juan Valcarcel, co-author of the study and researcher at the Centre for Genomic Regulation.

    Surprisingly, the researchers found evidence of the same genomic deletions in melanomas which hadn’t been treated yet. In other words, melanomas can naturally develop mechanisms that mimic drug resistance, even without exposure to drugs. Identifying and targeting these early resistance mechanisms through profound genetic testing in a clinical setting before treatment begins could improve the efficacy of first-line therapies.

    Even more surprisingly, further analyses revealed that genomic deletions might be a more widespread mechanism of oncogenesis and resistance than previously thought. Though uncommon, researchers found evidence of altBRAFs in melanomas with a normal-functioning BRAF gene, as well as in other types of cancer including non-small cell lung cancer, breast cancer, kidney cancer and prostate cancer. The findings could increase the patient population benefiting from targeted treatments which are currently under clinical development.

    “There is an emerging class of drugs known as second generation RAF inibitors. Unlike BRAF inhibitors, these drugs have a broad spectrum, and so could potentially inhibit the function of altBRAFs. Clinical trials which are assessing their effectiveness should also expand to include melanoma patients with a normal functioning BRAF gene as well, and possibly to other cancer types which express altBRAFs,” explains Dr. Aya Moreno.

    Dr. Aya Moreno is part of the second cohort of the PhD4MD programme, a joint effort by Centre for Genomic Regulation (CRG), the Institute for Research in Biomedicine (IRB Barcelona), the August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and the Vall d’Hebron Research Institute (VHIR) designed to leverage the medical insight of a doctor to drive research that benefits patients.

    “Having the opportunity to approach this research with both a clinician’s perspective and a scientist’s curiosity has been invaluable. It allowed us to uncover not just how melanomas resist treatment but also how this knowledge could lead to more effective therapies for patients. This fusion of clinical insight and scientific investigation is crucial for making real progress in our fight against cancer,” concludes Dr. Aya Moreno.

    The study was led by Dr. Aya Moreno and co-supervised by Professor Juan Valcarcel at the Centre for Genomic Regulation and Dr. Ana Arance at IDIBAPS. It was also carried out in collaboration with Nuria López Bigas’ research group at IRB Barcelona. Since completing his PhD at the CRG, Dr. Aya Moreno has returned to the Medical Oncology department in the Hospital Clinic in Barcelona.

    Source:

    Journal reference:

    Aya, F., et al. (2024). Genomic deletions explain the generation of alternative BRAF isoforms conferring resistance to MAPK inhibitors in melanoma. Cell Reports. doi.org/10.1016/j.celrep.2024.114048.

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  • New murine model sheds light on anti-MDA5 antibody-positive dermatomyositis

    New murine model sheds light on anti-MDA5 antibody-positive dermatomyositis

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    Some diseases involve autoimmune reactions, when the body begins to attack its own cells and proteins. The biological mechanisms underlying these diseases are often unknown, making treatment challenging. Now, a group at TMDU has created a murine model for a disease known as “anti-MDA5 antibody-positive dermatomyositis”. Use of this model has allowed them to identify components of the immune system that are vital in disease development, with implications for future treatments.

    Dermatomyositis is a member of a disease group known as idiopathic inflammatory myopathies, which cause typical rashes and muscle weakness, leading to disability and premature death. As part of the normal immune response, the body produces proteins known as antibodies, specific to individual “antigens”, or foreign substances. However, autoimmune reactions involve the abnormal production of antibodies to human proteins, called “autoantibodies”. Anti-MDA5 antibody-positive dermatomyositis involves the production of autoantibodies against the protein MDA5, causing rashes and lung inflammation and fibrosis, called interstitial lung disease (ILD). This often progresses very rapidly with a high mortality rate, and current anti-inflammatory treatments are ineffective.

    To develop a model of this disease in mice, we first triggered the production of anti-MDA5 autoantibodies. This resulted in the development of some lung inflammation but not full ILD.”


    Dr. Yuki Ichimura, lead author of the study

    Because MDA5 is involved in the body’s response to certain viruses, the team then mimicked a viral infection in the lungs. The mice producing anti-MDA5 antibodies developed significant lung inflammation and fibrosis, emulating the pathogenesis seen in human patients, successfully modeling the disease.

    The researchers then analyzed the specific immune responses occurring in the mice and investigated how these led to disease. Of the various cells involved in the immune response, they showed that cells called “CD4-positive T cells” are key for the development of ILD. Experimentally reducing the numbers of these cells lessened the lung damage observed. The involvement of these T cells is backed up by autopsy findings from the lungs of patients.

    The research team went on to identify elevated levels of a signaling molecule called interleukin-6 in the murine model. “Experimental reduction of interleukin-6 levels ameliorated the development of ILD,” explains senior author Dr. Naoko Okiyama, “indicating that medical intervention targeting interleukin-6 could be a potential treatment option for ILD.”

    The murine model developed in this study provides a key tool for investigating the mechanisms underlying anti-MDA5 antibody-positive dermatomyositis, the value of which is proved by the identification of key factors in the immune system involved in this highly progressive disease. Future work enabled by this study could aid in the development of more specific and effective therapies, improving treatment and quality of life.

    Source:

    Journal reference:

    Ichimura, Y., et al. (2024). Autoimmunity against melanoma differentiation–associated gene 5 induces interstitial lung disease mimicking dermatomyositis in mice. Proceedings of the National Academy of Sciences. doi.org/10.1073/pnas.2313070121.

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  • Childhood obesity not linked to adult skin cancer risk, study says

    Childhood obesity not linked to adult skin cancer risk, study says

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    A recent Scientific Reports study investigates whether genetically predicted childhood adiposity influences the risk of developing skin cancer in adulthood.

    Study: Genetic predisposition to childhood obesity does not influence the risk of developing skin cancer in adulthood. Image Credit: Gorodenkoff / Shutterstock.com

    Background

    Several studies have reported that childhood obesity increases the risk of several types of cancers in adulthood. Although a causal link between body mass index (BMI) and melanoma has been established, no studies have evaluated whether childhood obesity influences the risk of developing basal cell carcinoma (BCC) or cutaneous squamous cell carcinoma (cSCC) in adulthood.

    Several mechanisms have been proposed to contribute to the potential causal link between BMI and melanoma. For example, some studies have suggested that obesity increases the risk of melanoma due to greater body surface area (BSA) that subsequently increases the number of target cells at risk. This hypothesis has been supported by some observational studies indicating that BSA positively correlates with increased melanoma risk.

    Nevertheless, other studies have hypothesized that obese people receive less sunlight exposure than their non-obese counterparts due to limited outdoor recreational activity. This reduced sunlight exposure could indirectly reduce the risk of melanoma. 

    About the study

    The current study utilized a Mendelian randomization (MR) approach to determine the effect of genetically predicted childhood adiposity on the development of skin cancer in adulthood. MR uses genetic variation to investigate potential relationships that may exist between exposures and outcomes documented in observational studies.

    Generic variants and other relevant data associated with childhood obesity were obtained from a recently published genome-wide association study (GWAS) meta-analysis. The analysis included 61,111 children of European descent between two and ten years of age.

    Importantly, these data were pooled from 40 individual studies from the original meta-analysis. The final analyses comprised 10,557 SCC cases, 36,479 BCC cases, and controls.

    Study findings

    Of the twenty-five genome-wide significant variants for childhood obesity, five were not associated with cSCC, BCC, or melanoma GWAS datasets. Therefore, twenty variants were eligible for the analysis, which explained 2.3% of the variance of BMI in childhood.

    The calculated risk estimates did not identify any significant association between genetically predicted childhood BMI and the risk of skin cancer development. Sensitivity analyses were performed to determine any breaches of MR assumptions that resulted in null findings. However, this result was also consistent with the risk estimates obtained in the MR inverse-variance-weighted (IVW) method.

    No pleiotropic variants for melanoma or cSCC were detected through the MR pleiotropy residual sum and outlier (MR-PRESSO) method. Here, three outlier variants for BCC were detected. Taken together, genetically predicted childhood obesity exhibited no significant effect on the development of skin cancer, including melanoma, cSCC, or BCC later in life.

    The lack of an observed association between genetically predicted childhood obesity and the risk of skin cancer development in adulthood indicates that body size is not likely to increase the risk of different types of skin cancer. Thus, the current study failed to validate whether obesity reduced the risk of melanoma due to limited outdoor activities. However, future studies could further analyze this potential association using pigmentation genes as a proxy for sun exposure.

    Strengths and limitations

    Key strengths of the current study include the consideration of vital confounding factors and the utilization of a large dataset to determine potential causal effects. Since the childhood GWAS meta-analysis encompassed thousands of children of European descent, population stratification could be effectively performed.

    Nevertheless, the current study is associated with certain limitations, such as the inclusion of participants exclusively of European descent, which limits the generalizability of the findings to a broader ethnic population. The genetic predictors of childhood obesity could also differ based on geography and ethnicity.

    Conclusions

    Despite the limitations, the current study strongly indicated that genetically predicted childhood adiposity does not influence skin cancer risks.

    Even if genetically predicted adiposity has an effect on risk of skin cancer, the magnitude of the effect would be very low so would likely have limited public health implications or clinical relevance.”

    Future studies are needed to understand whether genetic differences may impact the risk of developing skin cancer. Although genetically predicted adiposity provides essential information, it is not a faultless proxy, as genetic predisposition interacts with lifestyle and environmental factors that might influence childhood BMI.

    Journal reference:

    • Keatley, J., Law, M. H., Seviiri, M., et al. (2024) Genetic predisposition to childhood obesity does not influence the risk of developing skin cancer in adulthood. Scientific Reports 14(1); 1-5. doi:10.1038/s41598-024-58418-8

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  • Research from NY highlights pollution as a key factor in rising cancer rates among youth

    Research from NY highlights pollution as a key factor in rising cancer rates among youth

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    In a recent study published in Scientific Reports, researchers investigated cancer incidence trends among adults in the New York State (NYS) and associations with common population-level exposures.

    Study: Cancer incidence trends in New York State and associations with common population-level exposures 2010–2018: an ecological study. Image Credit: nyker/Shutterstock.comStudy: Cancer incidence trends in New York State and associations with common population-level exposures 2010–2018: an ecological study. Image Credit: nyker/Shutterstock.com

    Background

    In the United States (US), cancer remains the leading cause of morbidity and mortality. Exogenous factors, like lifestyle factors and environmental exposures, account for 70% to 90% of cancer risk and can influence cancer trends. Cancer incidence in the US has increased over time.

    Identification of modifiable exogenous factors driving these increases could inform cancer prevention. Studies have demonstrated that higher-level environmental exposures can elevate cancer risks.

    Environmental carcinogens exist at low levels in water and air and can potentially contribute to cancer risk. Some studies have revealed associations between air pollutants and specific cancers, and fewer studies have evaluated water contaminants, yielding mixed findings.

    However, the impact of low-dose, persistent, chronic environmental exposure on the risk of cancer is understudied.

    About the study

    The present study examined cancer incidence trends in NYS and associations with common exposures. They used cancer incidence data from 2010 to 2018 and risk factor data between 2000-09, accounting for an induction time of 10 years. They focused on cancers with the highest incidence rates in NYS and selected ten cancers.

    Cancers included 1) colorectal, 2) thyroid, 3) kidney and renal pelvis, 4) non-Hodgkin lymphoma, 5) melanoma, 6) leukemia, and 7) lung and bronchus cancer for both sexes, 8) prostate cancer in males, and 9) breast and 10) corpus uteri cancer in females.

    Age-standardized incidence rates were calculated by sex and age group across 62 NYS counties. Statewide sex- and site-specific annual rates of cancer incidence for each year.

    Risk factor data were compiled from several sources. They included six types of measures – 1) environmental exposure, 2) socioeconomic status (SES) and race composition, 3) general health conditions, 4) community characteristics, 5) lifestyle factors, and 6) spatial differences.

    Temporal incidence trends were analyzed in the 25–49 age group to examine changes in early-onset cancers. Linear regression models were used to assess associations with exposures.

    Findings

    The NYS shared the nine most prevalent cancers with the US. Incidence rates for most cancers in the NYS were higher than in the US overall, ranging from 0.2% higher for lung and bronchus cancer to 36.6% higher for thyroid cancer.

    Incidence rates in the 25–49 age group were also higher by 24.1% for non-Hodgkin lymphoma, 25% for prostate cancer, and 39.7% for thyroid cancer.

    The incidence of six cancers (breast, prostate, corpus uteri, thyroid, colorectal, and kidney and renal pelvis) significantly increased between 2000 and 2018.

    The models explained ≥ 30% variation in incidence data for six, five, and four cancers in the 25–49, 50–69, and 70–84 age groups, respectively. Moreover, models revealed a positive association between various PM2.5-related variables and several cancers in males.

    Moreover, for breast cancer cases in the 25–49 age group, a positive association was observed with ambient PM2.5 levels.

    Among 15 environmental variables, positive associations were observed between ambient ozone levels and prostate cancer; mineral dust levels and acute toxic substance release rate were associated with melanoma in males. In females, the percentage of land used for agriculture was negatively associated with thyroid cancer.

    Among race and SES variables, counties with lower insurance coverage and higher poverty had reduced incidence rates of breast cancer and thyroid cancer.

    Counties with increased proportions of white residents had higher melanoma incidence rates in both sexes and across age groups; these counties also had higher incidence rates of uterine cancer across age groups.

    Among four lifestyle factors, smoking was positively associated with lung cancer in both sexes and across age groups. Besides, physical inactivity was positively associated with thyroid cancer in the 25–49 age group in both sexes.

    Two spatial patterns were identified; counties in northern NYS had higher incidence rates of lung cancer and lower incidence rates of thyroid cancer.

    Conclusions

    In sum, the study found positive associations between ambient air pollutants and melanoma, breast cancer and prostate cancer, physical inactivity and thyroid cancer, and smoking and lung cancer.

    In general, models could better explain the variation in incidence data in the 25–49 age group than in older age groups. This reflects higher relative risk contributions of exogenous factors during younger ages than for older ages when aging may have more influence on cancer risk.

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  • DNA origami vaccine DoriVac paves way for personalized cancer immunotherapy

    DNA origami vaccine DoriVac paves way for personalized cancer immunotherapy

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    Therapeutic cancer vaccines are a form of immunotherapy in the making that could not only destroy cancer cells in patients, but keep a cancer from coming back and spreading. Multiple therapeutic cancer vaccines are being studied in clinical trials, but despite their promise, they are not routinely used yet by clinical oncologists to treat their patients. 

    The central ingredient of therapeutic cancer vaccines is antigens, which are preferentially produced or newly produced (neoantigens) by tumor cells and enable a patient’s immune system to search and destroy the cancerous cells. In most cases, those antigens cannot act alone and need the help of adjuvant molecules that trigger a general alarm signal in immune cells known as antigen-presenting cells (APCs). APCs internalize both antigen and adjuvant molecules and present the antigens to different types of T cells. Those T cells then launch an immediate attack against the tumor, or preserve a longer-lasting memory of the tumor for future defense.

    A cancer vaccine’s effectiveness depends on the level and duration of the “alarm” its adjuvants can ring in APCs. Previously, researchers found that delivering adjuvant and antigen molecules to APCs simultaneously using nanostructures like DNA origami can increase APC activation. However, none of these approaches systematically investigated how the number and nanoscale arrangement of adjuvant molecules affect downstream tumor-directed immunity. 

    Now, a research team at the Wyss Institute at Harvard University, Dana-Farber Cancer Institute (DFCI), Harvard Medical School (HMS), and Korea Institute of Science and Technology (KIST) has created a DNA origami platform called DoriVac, whose core component is a self-assembling square block-shaped nanostructure. To one face of the square block, defined numbers of adjuvant molecules can be attached in highly tunable, nanoprecise patterns, while the opposite face can bind tumor antigens. The study found that molecules of an adjuvant known as CpG spaced exactly 3.5 nanometers apart from each other resulted in the most beneficial stimulation of APCs that induced a highly-desirable profile of T cells, including those that kill cancer cells (cytotoxic T cells), those that cause beneficial inflammation (Th-1 polarized T cells), and those that provide a long-term immune memory of the tumor (memory T cells). DoriVac vaccines enabled tumor-bearing mice to better control the growth of tumors and to survive significantly longer than control mice. Importantly, the effects of DoriVac also synergized with those of immune checkpoint inhibitors, which are a highly successful immunotherapy that is already widely used in the clinic. The findings are published in Nature Nanotechnology.

    “DoriVac’s DNA origami vaccine technology merges different nanotechnological capabilities that we have developed over the years with an ever-deepening knowledge about cancer-suppressing immune processes,” said Wyss Core Faculty member William Shih, Ph.D., who led the Wyss Institute team together with first-author Yang (Claire) Zeng, M.D., Ph.D. “We envision that in the future, antigens identified in patients with different types of tumors could be quickly loaded onto prefabricated, adjuvant-containing DNA origami to enable highly effective personalized cancer vaccines that can be paired with FDA-approved checkpoint inhibitors in combination therapies.”

    Shih is also a Professor at HMS and DFCI’s Department of Cancer Biology and, as some of the other authors, a member of the NIH-funded cross-institutional “Immuno-engineering to Improve Immunotherapy” (i3) Center based at the Wyss. 

    DNA origami rationale

    The CpG adjuvant is a synthetic strand of DNA made up of repeated CpG nucleotide motifs that mimic the genetic material from immune cell-invading bacterial and viral pathogens. Like its natural counterparts, CpG adjuvants bind to a “danger receptor” called TLR9 in immune cells, which in turn induces an inflammatory (innate) immune response that works in concert with the antigen-induced (adaptive) immune response. 

    “We knew from previous work that to trigger strong inflammatory responses, TLR9 receptors need to dimerize and aggregate into multimeric complexes binding to multiple CpG molecules. The nanoscale distances between the CpG-binding domains in effective TLR9 assemblies revealed by structural analysis fell right into the range of what we hypothesized we could mirror with DNA origami structures presenting precisely spaced CpG molecules,” explained Zeng, who was an Instructor in Medicine at the time of the study and now is a senior scientist at DFCI and Harvard Medical School (HMS). In addition to Shih, Zeng was also mentored on the project by senior authors Ju Hee Ryu, Ph.D., a Principal Researcher at KIST, and Wyss Founding Core Faculty member David Mooney, Ph.D., who also is Professor at Harvard John A. Paulson School of Engineering and Applied Sciences (SEAS), and one of the i3 Center’s Principal Investigators. 

    Zeng and the team fabricated DoriVac vaccines in which different numbers of CpG strands were spaced at 2.5, 3.5, 5, or 7 nanometers apart from each other on one face of the square block, and a model antigen was attached to the opposite face. They protected their structures from being degraded in the body using a chemical modification method that Shih’s group had developed earlier. When internalized by different types of APCs, including dendritic cells (DCs), which orchestrate tumor-directed T cell responses, the DoriVac vaccines improved the uptake of antigens compared to controls consisting of free antigen molecules. A CpG spacing of 3.5 nanometers produced the strongest and most beneficial responses in APCs, and significantly outperformed a control vaccine containing only free CpG molecules. “We were excited to find that the DoriVac vaccine preferentially induced an immune activation state that supports anti-tumor immunity, which is what researchers generally want to see in a good vaccine,” said Zeng. 

    Besides spacing, the numbers of CpG molecules in DoriVac vaccines also mattered. The team tested vaccines containing between 12 to 63 optimally spaced CpG molecules and found that 18 CpG molecules provided the best APC activation. This meant that their approach can also help limit the dosage of CpG molecules and thus minimize commonly observed toxic side effects observed with adjuvants.

    Gained in (tumor) translation

    Importantly, these in vitro trends translated to in vivo mouse tumor models. When prophylactically injected under the skin of mice, DoriVac vaccines accumulated in the closest lymph nodes where they stimulated DCs. A vaccine loaded with a melanoma antigen prevented the growth of subsequently injected aggressive melanoma cells. While all control animals had succumbed to the cancer by day 42 of the experiment, DoriVac-protected animals all were alive. DoriVac vaccines also inhibited tumor growth in mice in which the formation of melanoma tumors was already underway, with a 3.5 nanometer spacing of 18 CpG molecules again providing maximum effects on DC and T cells, and the strongest reduction in tumor growth.

    Next, the team asked whether DoriVac vaccines could also boost immune responses produced by small “neoantigens” emerging in melanoma tumors. Neoantigens are ideal targets because they are exclusively made by tumor cells. However, they often are not very immunogenic themselves, which make highly effective adjuvants an important component in neoantigen vaccines. A DoriVac vaccine customized with four neoantigens enabled the researchers to significantly suppress growth of the tumor in mice that produced the neoantigens.

    Finally, the researchers asked whether DoriVac could synergize with immune checkpoint therapy, which reactivates T cells that have been silenced in tumors. In mice, the two therapies combined resulted in the total regression of melanoma tumors, and prevented them from growing back when the animals were exposed to the same tumor cells again four months later. The animals had built up an immune memory of the tumor. The team obtained a similar vaccination efficiency in a mouse lymphoma model.

    We think that DoriVac’s value for determining a sweet spot in adjuvant delivery and enhancing the delivery and effects of coupled antigens can pave the way to more effective clinical cancer vaccines for use in patients with a variety of cancers.”


    Yang (Claire) Zeng, M.D., Ph.D., First Author

    The team is currently translating the DoriVac platform toward its clinical application, which is supported by the study’s assessment of vaccine distribution and vaccine-directed antibodies in mice, as well as cytokines produced by immune cells in response to the vaccines in vivo. 

    “The DoriVac platform is our first example of how our pursuit of what we call Molecular Robotics – synthetic bioinspired molecules that have programmable shape and function – can lead to entirely new and powerful therapeutics. This technology opens an entirely new path for development of designer vaccines with properties tailored to meet specific clinical challenges. We hope to see its rapid translation into the clinic,” said Wyss Institute Founding Director Donald Ingber, M.D., Ph.D., who is also the Judah Folkman Professor of Vascular Biology at HMS and Boston Children’s Hospital, and the Hansjörg Wyss Professor of Bioinspired Engineering at SEAS.

    Other authors on the study are Olivia Young, Christopher Wintersinger, Frances Anastassacos, James MacDonald, Giorgia Isinelli, Maxence Dellacherie, Miguel Sobral, Haiqing Bai, Amanda Graveline, Andyna Vernet, Melinda Sanchez, Kathleen Mulligan, Youngjin Choi, Thomas Ferrante, Derin Keskin, Geoffrey Fell, Donna Neuberg, Cathrine Wu, and Ick Chan Kwon. The study was funded by the Wyss Institute’s Validation Project and Institute Project programs, Claudia Adams Barr Program at DFCI, Korean Fund for Regenerative Medicine (award #21A0504L1), Intramural Research Program of KIST (award #2E30840), and National Institutes of Health (under the i3 Center supporting U54 grant (award #CA244726-01).

    Source:

    Journal reference:

    Zeng, Y. C., et al. (2024). Fine tuning of CpG spatial distribution with DNA origami for improved cancer vaccination. Nature Nanotechnologydoi.org/10.1038/s41565-024-01615-3.

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  • New analysis sheds light on cancer incidence and mortality trends in the UK

    New analysis sheds light on cancer incidence and mortality trends in the UK

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    In a recent study published in BMJ, researchers investigated trends in cancer incidence and deaths in the United Kingdom (UK) among individuals aged between 35 and 69 years.

    Study: 25 year trends in cancer incidence and mortality among adults aged 35-69 years in the UK, 1993-2018: retrospective secondary analysis. Image Credit: Image Point Fr/Shutterstock.comStudy: 25 year trends in cancer incidence and mortality among adults aged 35-69 years in the UK, 1993-2018: retrospective secondary analysis. Image Credit: Image Point Fr/Shutterstock.com

    Background

    Over the last 25 years, the UK has seen remarkable improvements in cancer risk factors, including a decline in smoking prevalence as a result of tariff rises, advertising restrictions, and smoke-free laws. Diet and exercise are leading to an increase in the number of overweight or obese individuals.

    Between 1993 and 2018, three screening programs for cervical, breast, and bowel cancer were implemented, with the ability to detect non-harmful cases. However, there is limited recent research on cancer incidences and deaths among those aged 35 to 69.

    About the study

    In the present study, researchers examined changes in cancer incidences and deaths in the United Kingdom between 1993 and 2018 for individuals aged 35 to 69 years.

    The researchers examined cancer registration, deaths, and nationwide population-level data from the Public Health Wales, Office for National Statistics (ONS), North Ireland Cancer Registry, Public Health Scotland, the General Register Office for North Ireland, and National Health Service (NHS) England.

    They investigated 23 cancer locations in the United Kingdom to determine cancer incidence and deaths among individuals aged 35 to 69 who received cancer diagnoses or died from cancers between 1993 and 2018.

    The team used the International Classification of Diseases, Tenth Revision (ICD-10) codes to diagnose cancers. The primary outcomes were changes in cancer incidences and deaths based on age across time.

    Sex-specific cancer groups were evaluated without breast and prostate cancers to examine general trends in the absence of the most prevalent cancer site for each gender.

    Mesothelioma was a new particular code released in ICD-10, and there were no credible mortality statistics available for this site before 2001; hence, the researchers did not include this kind of malignancy.

    They included non-malignant brain and spinal cord tumor codes, despite their benign character, because their presence in the cranial cavity can lead to death.

    The researchers omitted non-melanoma skin cancer from the incidence statistics due to incomplete documentation of these tumors, making the data unreliable. To account for yearly volatility in low-case sites, the researchers estimated three-year rolling average age-standardized rates per 100,000 population. They used generalized linear modeling for analysis.

    Results

    Cancer incidence among individuals aged 35 to 69 years increased by 57% (86,297 from 55,014) for males and 48% (88,970 from 60,187) for women, with an average yearly growth of 0.80% for both genders.

    Between 2003 and 2013, prostate and breast cancers grew in both sexes, with the male age-standardized incidence rate falling before 2000 and rising among women. Less frequent malignancies, such as melanoma, skin, liver, mouth, and kidney, have also shown alarming rises.

    For males aged 35 to 69 years, the highest mean yearly percentage elevations were for malignancies of hepatic tissues (4.70%), prostate (4.20%), and skin melanomas (4.20%). The highest yearly declines were for stomach (4.2%), bladder (4.10%), and lung (2.10%) cancers.

    For females, the highest average yearly percentage increases were for the liver (3.90%), skin melanomas (3.50%), and mouth (3.30%) cancers, whereas the highest annual declines were for bladder (3.60%) and stomach (3.10%).

    Over the past 25 years, cancer fatalities were reduced by 20% (26,322 from 32,878) in men and 17% (23,719 from 28,516) in women. Age-standardized mortality rates for all malignancies were decreased by 37% (2.0% each year) in men and 33% (1.6% per year) in women.

    The study discovered that after omitting prostate cancer from mortality trends, men’s death rates fell considerably, whereas women’s mortality decreased by 1.3% each year. The highest decline in mortality happened before 2000, with 14% in males and 11% in females.

    The most significant declines were shown in bladder, mesothelioma, and stomach malignancies in males, as well as stomach, cervical, and non-Hodgkin lymphoma in women.

    For males, the cancers with mean yearly percentage decreases in death rates of ≥1.0% per year were stomach (5.10%), mesothelioma (4.20%), bladder (3.20%), lung (3.10%), non-Hodgkin lymphoma (2.90%), testis (2.80%), Hodgkin lymphoma (2.60%), larynx (2.50%), bowel (2.50%), prostate (1.80%), myeloma (1.70%), and leukemia (1.60%).

    For females, the cancers with mean yearly reductions in death rates of ≥1.0% were of the stomach (4.20%), cervix (3.60%), non-Hodgkin lymphomas (3.20%), ovaries (2.80%), breast (2.80%), myeloma (2.30%), bowel (2.20%), mesothelioma (2.0%), laryngeal tissues (2.0%), leukemia (2.0%), bladder (1.60%), esophagus (1.20%), and kidneys (1.00%).

    In both sexes, liver (2.70%) and mouth (1.20%) malignancies had mean yearly mortality increases of ≥1.0%.

    Conclusion

    The study findings showed that cancer mortality in males and females aged 35 to 69 years decreased significantly over the last 25 years, primarily due to cancer prevention, early diagnosis, improved diagnostic testing, and successful treatment.

    However, an increase in nonsmoking risk factors may result in a rise in some malignancies. The research provides a baseline for the coming years, assessing the influence of coronavirus disease 2019 (COVID-19) on cancer incidences and outcomes.

    There are increased concerns regarding specific cancer sites, with the highest concern being the need to expedite the decline in female lung cancer.

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  • Increased stiffness in aging skin may contribute to higher rates of metastatic skin cancer

    Increased stiffness in aging skin may contribute to higher rates of metastatic skin cancer

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    Age-related changes that cause the skin to stiffen and become less elastic may also contribute to higher rates of metastatic skin cancer in older people, according to research by investigators from the Johns Hopkins Kimmel Cancer Center. 

    The study, published March 12 in Nature Aging, shows that increased stiffness in aging skin increases the release of a protein called ICAM1. Increased ICAM1 levels stimulate blood vessel growth in the tumor, helping it grow. It also makes the blood vessels “leaky,” enabling tumor cells to escape and spread throughout the body more easily. 

    As we age, the stiffness of our skin changes. That not only has physical implications, but it also has signaling implications and can lead to increases in new blood vessel growth or disruption of blood vessel function.” 


    Ashani Weeraratna, Ph.D., associate director for laboratory research at the Kimmel Cancer Center and professor of oncology at the Johns Hopkins University School of Medicine

    Melanoma is the deadliest form of skin cancer, according to the Melanoma Research Foundation. In 2024, over 200,000 Americans are expected to be diagnosed with melanoma. Older patients are more likely to get melanoma and die from it than younger patients. They experience more recurrences after treatment, and their tumors are more likely to spread, or metastasize, to other parts of the body. 

    Weeraratna’s laboratory focuses on how age-related changes help melanoma tumors spread and resist cancer therapies. Previous research by Weeraratna and her team has shown that a protein called HAPLN1 helps maintain the structure of the extracellular matrix, a network of molecules and minerals that provide structural support, to keep the skin supple. As people age, they release less HAPLN1, which causes the skin to stiffen. 

    The new study shows that reduced HAPLN1 indirectly increases ICAM1 levels by causing stiffening, which alters cellular signaling. The increase in ICAM1 contributes to angiogenesis, or the growth of new blood vessels that supply the tumors with nutrients and help them grow. The blood vessels are also leakier, making it easier for tumor cells to escape from the initial tumor site and spread to distant areas of the body. 

    Treating older mice with melanoma with drugs that block ICAM1, however, prevents these changes, shrinking their tumors and reducing metastasis, Weeraratna and her colleagues demonstrated. They are now studying ICAM1’s activities to develop more precise ways of targeting it with drugs, which might lead to new approaches to treating older people with melanoma. 

    The discoveries might also lead to new approaches to treating other age-related cancers. Previous therapies targeting growth factors that contribute to angiogenesis have failed in many tumor types, including melanoma. But ICAM1 provides a promising new target. 

    “We know that age-related angiogenesis is important in many different cancers and multiple aspects of health and disease,” says Weeraratna, who is also the E.V. McCollum Chair of Biochemistry and Molecular Biology at the Johns Hopkins Bloomberg School of Public Health and a Bloomberg Distinguished Professor. “Finding a new way to target that in different tumor types could have a big impact.” 

    Learning more about ICAM could also have important implications for understanding wound healing in older adults. Angiogenesis is essential in healing wounds not only in the skin, but also in the cardiovascular system and brain, Weeraratna says. As a result, the lab’s discoveries could have important implications for understanding age-related changes that may contribute to cardiovascular disease or strokes. 

    “Understanding angiogenesis in the context of aging is important,” she says. 

    Study co-authors were Gloria E. Marino-Bravante, Alexis E. Carey, Laura Hüser, Agrani Dixit, Vania Wang, Supeng Ding, Rahel Schnellmann, Luo Gu and Yash Chhabra of Johns Hopkins. Other authors were from the University of Pennsylvania and Duke University. 

    The study was supported in part by the National Institutes of Health (grants P01CA114046, U01CA227550 and R01CA232256 to Weeraratna). 

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  • UCLA and UAMS teams secure $3.2 million NIH grant for melanoma research

    UCLA and UAMS teams secure $3.2 million NIH grant for melanoma research

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    A team of investigators from the UCLA Health Jonsson Comprehensive Cancer and the University of Arkansas for Medical Sciences (UAMS) Winthrop P. Rockefeller Cancer Institute was awarded a $3.2 million grant from the National Institutes of Health to identify new ways to prevent and overcome treatment resistance to targeted therapy in patients with all sub-types of cutaneous melanoma, an aggressive form of skin cancer. 

    Virtually all cutaneous melanomas display genetic alterations that activate a cancer-driving pathway called MAPK. In about half of advanced cutaneous melanomas, specific mutations in a protein called BRAF provide targets for a currently approved MAPK-targeted therapy. While some patients with BRAF mutated melanomas respond to existing MAPK-targeted therapy, many develop resistance over time, leading to clinical relapses and more aggressive cancers. For the other half of patients with melanomas lacking the specific BRAF mutations, there is currently no FDA-approved options for treatment with MAPK-targeted drugs. In order to improve existing and develop new treatments, it is critical to understand how all melanomas evolve resistance in response to one or two drugs aimed at turning off the MAPK pathway.

    The new grant, led by Dr. Roger Lo, professor of medicine and molecular and medical pharmacology at the David Geffen School of Medicine at UCLA, and Alan Tackett, professor of biochemistry and molecular biology at UAMS, supports their work in creating the Melanoma Resistance Evolution Atlas (MREA). This atlas, which uses fragments of tumors from patient biopsies and implanted to grow in specialized mice, will allow the team to test different combination therapies. A technical core facility creating these specialized mice is directed by Gatien Moriceau, assistant adjunct professor of medicine at the David Geffen School of Medicine at UCLA.

    The team will then examine the unique characteristics and behaviors of each patient’s tumor, before and after it is treated with MAPK-targeted drugs as well as when it stops responding all together. They will use proteogenomic and single-cell analyses to identify new drug targets to design future experimental combination therapies. The MREA will comprise rich data matched to individual patients represented by the mouse models, serving as a unique resource for the broader cancer research field.

    It is really important for the field to use a comprehensive set of in vivo models that reflect the full-spectrum of patient-specific disease sub-types to generate rich multi-omic data on how melanomas respond to and then evolve resistance to evade this important type of therapy.”


    Alan Tackett, professor of biochemistry and molecular biology at UAMS

    “We will use current and newer MAPK-targeting agents as foundations to add other types of drugs,” said Lo. “Better MAPK inhibitor-based combination treatments will benefit not only patients with melanoma but also a large fraction of patients with other types of common and aggressive tumors such as lung and colorectal cancers.”

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