Secreted PD-L1 variants mediate resistance to PD-L1 blockade therapy in non–small cell lung cancer

B Gong, K Kiyotani, S Sakata, S Nagano… - Journal of Experimental …, 2019 - rupress.org
B Gong, K Kiyotani, S Sakata, S Nagano, S Kumehara, S Baba, B Besse, N Yanagitani…
Journal of Experimental Medicine, 2019rupress.org
Immune checkpoint blockade against programmed cell death 1 (PD-1) and its ligand PD-L1
often induces durable tumor responses in various cancers, including non–small cell lung
cancer (NSCLC). However, therapeutic resistance is increasingly observed, and the
mechanisms underlying anti–PD-L1 (aPD-L1) antibody treatment have not been clarified
yet. Here, we identified two unique secreted PD-L1 splicing variants, which lacked the
transmembrane domain, from aPD-L1–resistant NSCLC patients. These secreted PD-L1 …
Immune checkpoint blockade against programmed cell death 1 (PD-1) and its ligand PD-L1 often induces durable tumor responses in various cancers, including non–small cell lung cancer (NSCLC). However, therapeutic resistance is increasingly observed, and the mechanisms underlying anti–PD-L1 (aPD-L1) antibody treatment have not been clarified yet. Here, we identified two unique secreted PD-L1 splicing variants, which lacked the transmembrane domain, from aPD-L1–resistant NSCLC patients. These secreted PD-L1 variants worked as “decoys” of aPD-L1 antibody in the HLA-matched coculture system of iPSC-derived CD8 T cells and cancer cells. Importantly, mixing only 1% MC38 cells with secreted PD-L1 variants and 99% of cells that expressed wild-type PD-L1 induced resistance to PD-L1 blockade in the MC38 syngeneic xenograft model. Moreover, anti–PD-1 (aPD-1) antibody treatment overcame the resistance mediated by the secreted PD-L1 variants. Collectively, our results elucidated a novel resistant mechanism of PD-L1 blockade antibody mediated by secreted PD-L1 variants.
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