Oral Presentation 49th Annual Scientific Meeting of the Australian and New Zealand Society for Immunology 2021

Human Cancer-Associated Fibroblasts suppress T cells through a novel COX-2 mediated immune checkpoint (#74)

Alfie T Baker 1 , Sara B Cruz Migoni 2 , Krystal Lianos 1 , Sunny Z Wu 3 , Joshua J D'Rozario 1 , Lylarath Poly 1 , Mohammed H Abuwarwar 1 , Sacha Khong 1 , Baksho Kaul 2 , Karen Oliva 4 , Birunthi Niranjan 1 , Mitchell G Lawrence 1 , Renea A Taylor 1 , Gail P Risbridger 1 , Simon Wilkins 4 , Alexander Swarbrick 3 , Paul J McMurrick 4 , Konstantin Knoblich 1 , Anne L Fletcher 1
  1. Monash University, Clayton, VICTORIA, Australia
  2. Institute of Immunology and Immunotherapy , University of Birmingham, Birmingham, West Midlands, United Kingdom
  3. The Kinghorn Cancer Centre and Cancer Research Division, Garvan Institute of Medical Research, Darlinghurst, NSW , Australia
  4. Cabrini Monash University Department of Surgery, Cabrini Hospital, Malvern, Victoria, Australia

Response to immune checkpoint inhibitors in epithelial tumours is often limited to a minority of patients. Recent studies have implicated the tumour microenvironment in resistance to immunotherapies. Cancer-associated fibroblasts (CAFs) are a predominant non-malignant cell population in solid tumours, with a wide range of pro-tumourigenic properties. Of note, CAFs can restrict CD8 T cell infiltration into the tumour epithelium, promote Treg recruitment and differentiation, and delete antigen-specific T cells. Here, we identify a novel targetable mechanism of T cell restriction mediated by CAFs and conserved across four major tumour types: colorectal, breast, pancreatic and prostate carcinomas. CAFs restricted the proliferation of resting and pre-stimulated T cells in a dose-dependent fashion, through provision of soluble factors and independent of Tregs. Inhibition of cyclooxygenase-2 (COX-2) using available drugs (diclofenac, indomethacin, celecoxib) significantly relieved T cell suppression. COX-2 is highly expressed by CAFs, and COX-2+ CAFs co-localised with infiltrating T cells in vivo. COX2-inhibition significantly increased the effector T cell response to anti-PD1 therapy, including production of IL-2 and TNF. Viable colorectal tumour slice assays were used to monitor patient T cell responses within the complex tumour microenvironment, and showed that combination COX-2 inhibition and anti-PD-1 therapy significantly increased T cell proliferation, supporting in vitro results. These data describe a novel CAF-driven immune checkpoint. Targeting CAF-T cell interactions is likely required to unlock the full potential of current and emerging tumour immunotherapies.