Abstract In recent years, immunotherapy has achieved significant success in the treatment of a variety of cancer types, including melanoma, non-small cell lung cancer, and colorectal cancer. However, in stark contrast, patients with glioblastoma (GBM) show remarkably poor responses to immunotherapy, failing to derive any therapeutic benefit. Thus, an understanding of the immunosuppressive microenvironment of GBM, which is considered an immunotherapy-cold tumor, is of paramount importance. One common and distinctive genetic mutation found in gliomas is that of EGFRvIII, which is linked with enhanced cell proliferation, invasion, migration, and angiogenesis in GBM. Intriguingly, we found that this mutation induced a significantly more severe immunosuppressive microenvironment compared with wild-type EGFR. To unravel the mechanisms underlying EGFRvIII mutation-induced immunosuppression in GBM, we posited that the mutant variant secretes an array of immunosuppression-related proteins into the glioma microenvironment. To investigate this, we conducted proteomic analysis of conditioned media from EGFRvIII mutant cell lines and discovered significant changes in the expression of insulin-like growth factor-binding protein-2 (IGFBP2), a well-documented oncogenic protein. Although IGFBP2 is known to be upregulated in various tumor types and is associated with malignant behaviors such as proliferation and invasion in gliomas, its role in glioma immunology remains largely unexplored. In line with our earlier bioinformatic analyses, our study revealed significant enrichment of IGFBP2 in pathways related to immunosuppression in GBM. Thus, in the present investigation, we analyzed the mechanisms by which IGFBP2 induces an immunosuppressive microenvironment. Using co-culture models, we found that IGFBP2-overexpressing glioma cells as well as glioma cells treated with exogenous IGFBP2 recruited immune cells through binding to integrin αvβ5. Furthermore, we demonstrated that IGFBP2 promoted the secretion of the classical macrophage polarization factor IL-10 by phosphorylation of STAT3. These findings indicate the significant influence of IGFBP2 in steering glioma-associated macrophages toward a pro-tumor M2-like phenotype. We also observed that IGFBP2 upregulated the expression of PD-L1 on tumor cell surfaces. These results were verified in animal experiments. Intriguingly, our preliminary data indicated that exogenous IGFBP2 translocated to the cell nucleus within hours, and immunoprecipitation assays confirmed its interaction with STAT3 in vitro. These findings collectively underscore the pivotal role of IGFBP2 in the creation of the immunosuppressive microenvironment induced by EGFRvIII mutation. Consequently, targeting IGFBP2 holds great promise for advancing immunotherapeutic approaches in EGFRvIII-mutant glioblastomas, offering an exciting avenue for potential treatments of GBM. Citation Format: Jikang Fan, Xisen Wang, Tao Li, Xuejun Yang, Wei Zhang. IGFBP2 assists EGFRvIII-positive glioblastoma to evade immune elimination [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2650.
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