TY - JOUR T1 - TIGIT/CD155 axis mediates resistance to immunotherapy in patients with melanoma with the inflamed tumor microenvironment JF - Journal for ImmunoTherapy of Cancer JO - J Immunother Cancer DO - 10.1136/jitc-2021-003134 VL - 9 IS - 11 SP - e003134 AU - Shusuke Kawashima AU - Takashi Inozume AU - Masahito Kawazu AU - Toshihide Ueno AU - Joji Nagasaki AU - Etsuko Tanji AU - Akiko Honobe AU - Takehiro Ohnuma AU - Tatsuyoshi Kawamura AU - Yoshiyasu Umeda AU - Yasuhiro Nakamura AU - Tomonori Kawasaki AU - Yukiko Kiniwa AU - Osamu Yamasaki AU - Satoshi Fukushima AU - Yuzuru Ikehara AU - Hiroyuki Mano AU - Yutaka Suzuki AU - Hiroyoshi Nishikawa AU - Hiroyuki Matsue AU - Yosuke Togashi Y1 - 2022/05/01 UR - http://jitc.bmj.com/content/9/11/e003134.abstract N2 - Background Patients with cancer benefit from treatment with immune checkpoint inhibitors (ICIs), and those with an inflamed tumor microenvironment (TME) and/or high tumor mutation burden (TMB), particularly, tend to respond to ICIs; however, some patients fail, whereas others acquire resistance after initial response despite the inflamed TME and/or high TMB. We assessed the detailed biological mechanisms of resistance to ICIs such as programmed death 1 and/or cytotoxic T-lymphocyte-associated protein 4 blockade therapies using clinical samples.Methods We established four pairs of autologous tumor cell lines and tumor-infiltrating lymphocytes (TILs) from patients with melanoma treated with ICIs. These tumor cell lines and TILs were subjected to comprehensive analyses and in vitro functional assays. We assessed tumor volume and TILs in vivo mouse models to validate identified mechanism. Furthermore, we analyzed additional clinical samples from another large melanoma cohort.Results Two patients were super-responders, and the others acquired resistance: the first patient had a non-inflamed TME and acquired resistance due to the loss of the beta-2 microglobulin gene, and the other acquired resistance despite having inflamed TME and extremely high TMB which are reportedly predictive biomarkers. Tumor cell line and paired TIL analyses showed high CD155, TIGIT ligand, and TIGIT expression in the tumor cell line and tumor-infiltrating T cells, respectively. TIGIT blockade or CD155-deletion activated T cells in a functional assay using an autologous cell line and paired TILs from this patient. CD155 expression increased in surviving tumor cells after coculturing with TILs from a responder, which suppressed TIGIT+ T-cell activation. Consistently, TIGIT blockade or CD155-deletion could aid in overcoming resistance to ICIs in vivo mouse models. In clinical samples, CD155 was related to resistance to ICIs in patients with melanoma with an inflamed TME, including both primary and acquired resistance.Conclusions The TIGIT/CD155 axis mediates resistance to ICIs in patients with melanoma with an inflamed TME, promoting the development of TIGIT blockade therapies in such patients with cancer.Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author, YT, upon reasonable request. Whole exome sequencing data and RNA-seq data are deposited in JGAS000285. ER -