Poster Presentation 31st Lorne Cancer Conference 2019

Disrupting copper homeostasis enhances anti-tumour immune response (#399)

Florida Voli 1 , Luigi Lerra 1 , Kathleen Kimpton 1 , Sylvie Shen 1 , Federica Saletta 2 , Maria Kavallaris 1 , Orazio Vittorio 1
  1. Children's Cancer Institute, Randwick, NEW SOUTH WALES, Australia
  2. Children's Cancer Research Unit, Kids Research Institute, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia

Immunotherapy has shown great potential for treating aggressive cancers and it is becoming the fourth pillar of cancer therapy. However, tumors express molecules, such as the Programmed Death Ligand 1 (PD-L1), to prevent immune cells activity (immune-evasion). The immune checkpoint protein Programmed Death receptor 1 (PD-1) expressed by lymphocytes instructs T-cells not to attack any tumor cell expressing PD-L1. Several therapies anti PD-1/PD-L1 have been approved by FDA, but concerns have been raised about their efficacy and safety. Therefore, there is a need for different approaches to target this pathway. Copper transporter 1 (CTR1) and Copper levels are elevated in tumors and the use of copper targeting agents is currently under intense investigation. It has been also reported that copper plays a major role in the immune-system, but its activity is unclear. In this study we demonstrated that copper plays a key role in the expression of PD-L1 in cancer cells. Tissue microarrays from neuroblastoma (NB) and glioblastoma (GBM) patients showed a significant correlation between CTR1 and PD-L1 expression (p=0.00014 and p=0.012 respectively). In vitro experiments showed that downregulation of CTR1 caused a decrease of intracellular copper which in turn led to a downregulation of PD-L1 expression in cancer cells. On the other hand, addition of copper into the media clearly induced PD-L1 upregulation. Consistently, Dextran-Catechin (DC) and TEPA, drugs reducing copper, were able to downregulate PD-L1 expression in tumours. In vivo studies showed that copper lowering drugs prolonged mice survival, and ex vivo immunohistochemistry staining confirmed the downregulation of CTR1 and PD-L1 expression. In addition, 24h and 48h of DC treatments showed an increase of tumor-infiltrating CD4+ and CD8+ lymphocytes and activated NK cells in NB immune-competent mouse model. In conclusion, our results have shown that copper targeting drugs DC and TEPA are able to downregulate PD-L1 in vitro and in vivo by reducing intracellular copper levels, and this promoted a significant increase of tumor infiltrating lymphocytes.