Modulation of Nr2f2 Reprograms Tumor Blood Vessels to Enhance Anti-Tumor Immunity and Immunotherapy.

Abstract A critical limitation to cancer immunotherapy is posed by the paucity of anti-tumor T cells in tumor tissues, even after therapeutic intervention. Development of effective strategies to enhance T cell recruitment remains challenging. As a critical regulator of immune cell trafficking, the tumor vasculature is a promising target that can be utilized to enhance anti-tumor immunity. Functional vasculature requires specialization of endothelial cells (ECs): capillary ECs transport oxygen and nutrients to promote tumor growth, while venular ECs regulate the recruitment and extravasation of immune cells. The majority of the current vessel-targeting therapies are designed to deplete endothelial cells indiscriminately with the goal of starving tumor cells. Loss of venules as a consequence could further block sustained recruitment of anti-tumor T cells. An alternative strategy that instead promotes capillary-to-venule “reprogramming” could simultaneously inhibit the tumor-promoting activities of capillaries and preserve the T cell-recruiting functions of tumor vessels, and thus better augment anti-tumor immunity and benefit immunotherapies. Through single cell transcriptomic profiling of tumor ECs, we found the nuclear receptor Nr2f2 to be specifically expressed in tumor-associated venules but not in capillaries. Upon ectopic expression of Nr2f2 in tumor ECs, capillary vessels undergo fate switch and adopt the venular phenotype and functions, as confirmed by immune profiling and single cell transcriptomic analyses. Nr2f2-driven capillary-to-venule reprogramming enhanced the recruitment of cytotoxic T cells into the tumor tissue, and led to a significant reduction of tumor burden in mouse breast and pancreatic tumor models. Interestingly, Nr2f2-driven EC fate switch enhanced the anti-tumor efficacy of immunotherapies, including immune checkpoint blockade and adoptive cell therapy by transferring T cells specific for a surrogate tumor cell antigen. Collectively, these data suggest that strategies that reprogram tumor vessels from capillaries into venules can be exploited to enhance anti-tumor immune responses and sensitize tumors to immunotherapy, especially in immunologically cold tumors. Citation Format: Yu Zhu, Nicole Lazarus, Kevin Brulois, Nicole Salazar, Theresa Dinh, Junliang Pan, Eugene Butcher. Modulation of Nr2f2 reprograms tumor blood vessels to enhance anti-tumor immunity and immunotherapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1804.