Phenotypic plasticity and reduced tissue retention of exhausted tumor-infiltrating T cells following neoadjuvant immunotherapy in head and neck cancer

Cancer Cell. 2023 May 8;41(5):887-902.e5. doi: 10.1016/j.ccell.2023.03.014. Epub 2023 Apr 13.

Abstract

Neoadjuvant immunotherapies (NITs) have led to clinical benefits in several cancers. Characterization of the molecular mechanisms underlying responses to NIT may lead to improved treatment strategies. Here we show that exhausted, tumor-infiltrating CD8+ T (Tex) cells display local and systemic responses to concurrent neoadjuvant TGF-β and PD-L1 blockade. NIT induces a significant and selective increase in circulating Tex cells associated with reduced intratumoral expression of the tissue-retention marker CD103. TGF-β-driven CD103 expression on CD8+ T cells is reversed following TGF-β neutralization in vitro, implicating TGF-β in T cell tissue retention and impaired systemic immunity. Transcriptional changes implicate T cell receptor signaling and glutamine metabolism as important determinants of enhanced or reduced Tex treatment response, respectively. Our analysis illustrates physiological and metabolic changes underlying T cell responses to NIT, highlighting the interplay between immunosuppression, tissue retention, and systemic anti-tumor immunity and suggest antagonism of T cell tissue retention as a promising neoadjuvant treatment strategy.

Keywords: TGF-β; glutamine metabolism; neoadjuvant immunotherapy; neoepitope-specific T cells; single-cell transcriptomics; tissue-resident T cells.

Publication types

  • Research Support, N.I.H., Intramural
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Physiological
  • CD8-Positive T-Lymphocytes*
  • Head and Neck Neoplasms* / metabolism
  • Head and Neck Neoplasms* / therapy
  • Humans
  • Immunotherapy
  • Lymphocytes, Tumor-Infiltrating
  • Neoadjuvant Therapy
  • Transforming Growth Factor beta / metabolism

Substances

  • Transforming Growth Factor beta