Dissecting anti-tumor immunity in glioblastoma

Abstract

Abstract Glioblastoma multiforme (GBM) is the deadliest form of brain cancer, for which there is currently no effective treatment. Despite success of immunotherapies such as checkpoint inhibitors (CPI) in treating some cancers, less than 8% of GBM patients responded to anti-PD-1 therapy. Thus, we need to understand what mechanisms underlie tumor resistance to immunotherapies. In our GBM mouse model, we have found that anti-CTLA-4 treatment greatly improved survival and suppressed tumor growth, but surprisingly, its efficacy was lost in mice that were depleted of CD4+ but not CD8+ T cells, suggesting that CD4+ T cells are critical for protection against GBM. This matches clinical data showing decreased populations of CD4+ T cells in patients with adverse clinical outcomes such as high-grade GBM. Our preliminary results from flow cytometry and single-cell RNA sequencing (sc-RNAseq) also suggested enhanced cytokine production (IFNγ, TNFα, IL-2) in CD4+ T cells after anti-CTLA-4 treatment. Similarly, we found that microglia, the local sentinels of the central nervous system, also play a significant role in tumor control, as indicated by faster GBM growth and reduced number of tumor-infiltrating CD4+ T cells when mice are depleted of microglia by a CSF1R inhibitor (PLX3397). Additionally, microglia in GBM may serve as potential antigen-presenting cells, as shown by their high MHC class II (MHC-II) expression. Therefore, we postulate that microglia are necessary to sustain anti-tumor immunity by CD4+ T cells. Importantly, through a more detailed exploration of how CD4+ T cells and microglia interact to impact tumor control, our study will provide new insights for developing therapeutic strategies against “difficult-to-treat” cancers such as GBM.