Abstract

BackgroundIt has been proposed that cancer establishment, maintenance, and recurrence may be attributed to a unique population of tumor cells termed cancer-initiating cells (CICs) that may include characteristics of putative cancer stem cell-like cells. Studies in lung cancer have shown that such cells can be enriched and propagated in vitro by culturing tumor cells in serum-free suspension as tumorspheres. CICs have been characterized for their phenotype, stem cell-like qualities, and their role in establishing tumor and maintaining tumor growth. Less is known about the interaction of CICs with the immune system.MethodsWe established CIC-enriched tumorspheres from murine TC-1 lung cancer cells, expressing human papillomavirus 16 (HPV-16) E6/E7 antigens, and evaluated their susceptibility to antitumor immune responses both in vitro and in vivo.ResultsTC-1 CICs demonstrated reduced expression of surface major histocompatibility complex (MHC)-I molecules compared to non-CICs. We similarly determined decreased MHC-I expression in five of six human lung cancer cell lines cultured under conditions enriching for CICs. In vivo, TC-1 cells enriched for CICs were resistant to human papillomavirus 16 E6/E7 peptide vaccine-mediated killing. We found that vaccinated mice challenged with CIC enriched tumorspheres demonstrated shorter survivals and showed significantly fewer CD8+ tumor infiltrating lymphocytes compared to CIC non-enriched challenged mice. Furthermore, cultured cytotoxic T lymphocytes (CTLs) from vaccinated mice demonstrated reduced capacity to lyse TC-1 cells enriched for CICs compared to non-enriched TC-1 cells. Following treatment with IFN-γ, both CIC enriched and non-enriched TC-1 cells expressed similar levels of MHC-I, and the increased MHC-I expression on CICs resulted in greater CTL-mediated tumor lysis and improved tumor-free survival in mice.ConclusionsThese results suggest that the attenuated expression of MHC-I molecules by CICs represents a potential strategy of CICs to escape immune recognition, and that the development of successful immunotherapy strategies targeting CICs may decrease their resistance to T cell-mediated immune detection by enhancing CIC MHC-I expression.

Highlights

  • It has been proposed that cancer establishment, maintenance, and recurrence may be attributed to a unique population of tumor cells termed cancer-initiating cells (CICs) that may include characteristics of putative cancer stem cell-like cells

  • Cancer-initiating cells are resistant to in vivo vaccinemediated antitumor effects We examined whether CICs were resistant to immunemediated killing following vaccination against an immunodominant antigen present on TC-1 tumor cells

  • Mice vaccinated with Human papillomavirus (HPV)-16 E749–57 (RAHYNIVTF) peptide [15] and challenged with TC-1 cancer cells not enriched for CICs had significantly improved tumor-free survival compared to the unvaccinated animals (P = 0. 007) (Fig. 1a)

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Summary

Introduction

It has been proposed that cancer establishment, maintenance, and recurrence may be attributed to a unique population of tumor cells termed cancer-initiating cells (CICs) that may include characteristics of putative cancer stem cell-like cells. CICs have been shown to have a number of characteristics that increase their resistance to radiation and chemotherapy, including increased expression of membrane drug transporters that mediate chemotherapy drug efflux, detoxification enzymes that metabolize cytotoxic drugs, upregulation of anti-apoptotic proteins, increased efficiency of DNA repair, and alterations in cell cycle kinetics [3] The combination of these factors allows CICs to be intrinsically resistant to traditional treatments potentially leading to enrichment of CICs. Consistent with this, the number of CICs have been shown to be increased in colorectal, glioma and breast cancer mouse xenografts following treatment with chemotherapy and radiation [3,4,5]. These treatments may initially debulk a tumor of the more “differentiated”, rapidly growing tumor cells, but leaves behind the innately resistant CICs

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