Abstract

Encouraging clinical results using immune checkpoint therapies to target the PD-1 axis in a variety of cancer types have paved the way for new immune therapy trials in brain tumor patients. However, the molecular mechanisms that regulate expression of the PD-1 pathway ligands, PD-L1 and PD-L2, remain poorly understood. To address this, we explored the cell-intrinsic mechanisms of constitutive PD-L1 and PD-L2 expression in brain tumors. PD-L1 and PD-L2 expression was assessed by flow cytometry and qRT-PCR in brain tumor cell lines and patient tumor-derived brain tumor-initiating cells (BTICs). Immunologic effects of PD-L2 overexpression were evaluated by IFN-γ ELISPOT. CD274 and PDCD1LG2 cis-regulatory regions were cloned from genomic DNA and assessed in full or by mutating and/or deleting regulatory elements by luciferase assays. Correlations between clinical responses and PD-L1 and PD-L2 expression status were evaluated in TCGA datasets in LGG and GBM patients. We found that a subset of brain tumor cell lines and BTICs expressed high constitutive levels of PD-L1 and PD-L2 and that PD-L2 overexpression inhibited neoantigen specific T cell IFN-γ production. Characterization of novel cis-regulatory regions in CD274 and PDCD1LG2 lead us to identify that GATA2 is sufficient to drive PD-L1 and PD-L2 expression and is necessary for PD-L2 expression. Importantly, in TCGA datasets, PD-L2 correlated with worse clinical outcomes in glioma patients.. By perturbing GATA2 biology, targeted therapies may be useful to decrease inhibitory effects of PD-L2 in the microenvironment.

Highlights

  • Glioblastoma (GBM) remains a challenging malignancy to treat

  • We investigated the molecular basis of cell autonomous expression of immunoregulatory ligands PD-L1 and PD-L2

  • We demonstrated that a subset of cancer cell lines and patient-derived brain tumor-initiating cells (BTICs) expresses constitutive high levels of both proteins

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Summary

Introduction

Glioblastoma (GBM) remains a challenging malignancy to treat. Poor clinical outcomes likely reflect aggressive GBM biology[1], and growing evidence suggests that there is signficant immunosuppression in GBM. Several mechanisms can drive cell-intrinsic PD-L1 induction including PTEN loss[7], aberrant signaling[8], genomic amplification[9], and post-translational modifications[10]. It is unclear which of these mechanisms is most germane to brain tumors. We showed that increased PD-L2 expression correlated with worse clinical outcomes in low and high grade glioma These data show that PD-L2 is expressed in brain tumors and together with PD-L1 is regulated, at least in part, by GATA2 transcriptional activity

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