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Estrogens determine the efficacy of cancer immunotherapy in obese males with melanoma
Eloïse Dupuychaffray, Hélène Poinot, Aurélie Vuilleumier, Maxime Borgeaud, Montserrat Alvarez, Betül Taskoparan, Olivier Preynat-Seauve, Clarissa D. Voegel, Eliana Marinari, Denis Migliorini, Valérie Dutoit, Carole Bourquin, Aurélien Pommier
Eloïse Dupuychaffray, Hélène Poinot, Aurélie Vuilleumier, Maxime Borgeaud, Montserrat Alvarez, Betül Taskoparan, Olivier Preynat-Seauve, Clarissa D. Voegel, Eliana Marinari, Denis Migliorini, Valérie Dutoit, Carole Bourquin, Aurélien Pommier
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Research Article Immunology Oncology

Estrogens determine the efficacy of cancer immunotherapy in obese males with melanoma

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Abstract

Although obesity is a major risk factor for cancer, it may also improve the response to cancer therapy. Here we investigated the impact of obesity on the efficacy of immune checkpoint inhibitors (ICI). In male mice, obesity promoted tumor growth but enhanced the response to ICI. This was associated with higher expression of immune-related genes within the tumor and enhanced infiltration of tumor-specific CD8+ T cells. Further, obesity in mice was associated with higher estrogen levels and enrichment of estrogen response genes in the tumor, and anti–programmed cell death 1 (anti–PD-1) efficacy was reduced upon administration of the aromatase inhibitor letrozole, which blocks the production of estrogens. Mechanistically, adipocyte-derived estrogens increased antigen presentation by dendritic cells and tumor-specific CD8+ T cell cytotoxicity. Last, overweight and obese men with melanoma responded better to ICI, with high estrogen levels being associated with improved response and survival. Our results suggest that estrogens may serve as a predictive factor of response to ICI in men with melanoma.

Authors

Eloïse Dupuychaffray, Hélène Poinot, Aurélie Vuilleumier, Maxime Borgeaud, Montserrat Alvarez, Betül Taskoparan, Olivier Preynat-Seauve, Clarissa D. Voegel, Eliana Marinari, Denis Migliorini, Valérie Dutoit, Carole Bourquin, Aurélien Pommier

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Figure 3

Inhibition of 17β-estradiol synthesis in obese males reduces the efficacy of anti–PD-1.

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Inhibition of 17β-estradiol synthesis in obese males reduces the efficac...
Male C57BL/6 mice were fed with a Western diet to induce obesity. Daily treatment with the aromatase inhibitor letrozole was started 4 weeks before subcutaneous injection of B16-F10 tumor cells. Letrozole treatment was continued until the end of the experiment. After the development of palpable tumors, mice received either anti–PD-1 or isotype control. (A) Expression of the 9 most significant genes from the GSEA Hallmark “Estrogen_Response_Late,” measured by qPCR in isotype-treated mice (n = 9–10/group). Unpaired 2-tailed Student’s t test was used. *P < 0.05, **P < 0.01. Data are depicted as a heatmap and as box plots for 3 representative genes. Box plots show the interquartile range (IQR), median (line), and the most extreme values within 1.5 × IQR (whiskers). Points beyond the whiskers represent outliers. (B) Tumor growth of vehicle-treated (dotted line) or letrozole-treated (solid line) mice receiving anti–PD-1 (red) or isotype control (blue). Black arrows indicate anti–PD-1 or isotype treatment (n = 9–10/group). Two-way ANOVA with Tukey’s post hoc test was used. *P < 0.05, **P < 0.01, ****P < 0.0001. (C) Infiltration of CD3+ cells and gp100-specific CD8+ T cells in tumors, quantified by flow cytometry (n = 9–10/group). Unpaired 2-tailed Student’s t test was used. *P < 0.05. (B and C) Data are depicted as mean ± SEM. (D) Expression of selected immune genes, measured by qPCR (n = 9–10/group). Data are depicted as Tukey box plots and Mann-Whitney test was used. *P < 0.05.

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