Abstract Head and neck cancers (HNC) are associated with significant changes in the immune profile, with lower systemic absolute lymphocyte count and reduced tumor-infiltrating lymphocytes (TILs), which are inversely correlated with overall survival. Galectin-1(Gal-1), which is a carbohydrate binding protein, is secreted at high level by cancer cells, including HNC, and contributes to tumor-immune escape and disease progression. Our group has shown that both hypoxia and radiotherapy (RT) can individually stimulate tumor Gal-1 secretion, which is detrimental to therapeutic efficacy. Targeting Gal-1 in HNC therefore may synergize with radiotherapy and/or immunotherapy. Using the CRISPR/Cas9 deletion approach, we developed an orthotopic model of HNC with/without Gal-1 expression. We found that Gal-1 KO tumors showed a marked decrease in tumor growth and nodal metastases. Gal-1 WT tumors had very low infiltration of CD4+/CD8+ T cells (TILs) compared to Gal-1 null tumors. The decrease in TILs was due to both Gal-1-induced apoptosis of activated T cells and Gal-1 inhibition of trans-endothelial T-cell migration, which was confirmed by in vitro assays. Endothelial cells within Gal-1 WT tumors showed uniformed staining of PD-L1 expression by immunohistochemistry, that was not present in Gal-1 null tumors. Similarly, isolated tumor endothelial cells (TECs) from Gal-1 WT tumors showed significantly higher expression of PD-L1 (PD1 ligand) and Gal-9 (Tim-3 ligand) than TECs from Gal-1 null tumor. Concurrently, there were more PD1+ and Tim3+ intra-tumoral T cells within the Gal-1 WT than Gal-1 null tumors. Our study therefore suggest that in addition to T-cell apoptosis, tumor Gal-1 can impede transendothelial T cell migration, leading to less TIL, resulting in immune escape and possible resistance to immune check point therapy. Therefore, a combined approach of targeting Gal-1 with immune checkpoint inhibitors may lead to better therapeutic efficacy in HNC patients. (Acknowlegement: NIH Grant-R01CA161585-03) Citation Format: Dhanya K. Nambiar, Hongbin Cao, Quynh Thu Le. Targeting galectin-1 to improve therapeutic efficacy in head and neck cancers. [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology and Immunotherapy; 2016 Oct 20-23; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2017;5(3 Suppl):Abstract nr B51.