Obesity and CD8 T cell metabolism: Implications for anti-tumor immunity and cancer immunotherapy outcomes

Immunol Rev. 2020 May;295(1):203-219. doi: 10.1111/imr.12849. Epub 2020 Mar 10.

Abstract

Obesity is an established risk factor for many cancers and has recently been found to alter the efficacy of T cell-based immunotherapies. Currently, however, the effects of obesity on immunometabolism remain unclear. Understanding these associations is critical, given the fact that T cell metabolism is tightly linked to effector function. Thus, any obesity-associated changes in T cell bioenergetics are likely to drive functional changes at the cellular level, alter the metabolome and cytokine/chemokine milieu, and impact cancer immunotherapy outcomes. Here, we provide a brief overview of T cell metabolism in the presence and absence of solid tumor growth and summarize current literature regarding obesity-associated changes in T cell function and bioenergetics. We also discuss recent findings related to the impact of host obesity on cancer immunotherapy outcomes and present potential mechanisms by which T cell metabolism may influence therapeutic efficacy. Finally, we describe promising pharmaceutical therapies that are being investigated for their ability to improve CD8 T cell metabolism and enhance cancer immunotherapy outcomes in patients, regardless of their obesity status.

Keywords: T cell metabolism; immunotherapy; obesity; tumor immunology.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • CD8-Positive T-Lymphocytes / immunology
  • CD8-Positive T-Lymphocytes / metabolism*
  • Disease Management
  • Disease Progression
  • Energy Metabolism* / drug effects
  • Glycolysis
  • Humans
  • Immunity, Cellular
  • Immunotherapy / adverse effects
  • Immunotherapy / methods
  • Lymphocytes, Tumor-Infiltrating / immunology
  • Lymphocytes, Tumor-Infiltrating / metabolism
  • Lymphocytes, Tumor-Infiltrating / pathology
  • Neoplasms / complications
  • Neoplasms / immunology
  • Neoplasms / metabolism
  • Neoplasms / therapy
  • Obesity / complications
  • Obesity / immunology*
  • Obesity / metabolism*
  • Prognosis
  • T-Lymphocyte Subsets / immunology
  • T-Lymphocyte Subsets / metabolism
  • Treatment Outcome
  • Tumor Microenvironment / genetics
  • Tumor Microenvironment / immunology