Eµ-Myc grows similarly in the left and right cervical and inguinal lymph nodes.

Relapsed and refractory diffuse large B-cell lymphoma (rrDLBCL) presents a significant challenge in hematology-oncology, with approximately 30% to 40% of patients with DLBCL experiencing relapse or resistance to treatment. This underscores the urgent need to better understand the molecular mechanisms governing therapeutic resistance. Signal transducer and activator of transcription 6 (STAT6) has been previously identified as a gene with recurrent D419 gain-of-function mutations in rrDLBCL. We demonstrated previously that when STAT6D419 mutations are present in DLBCL tumor cells, transcription of the chemokine CCL17 (aka TARC) is increased, and tumors have increased infiltration of CD4+ T cells. However, the implication of increased T-cell infiltration has not been reported previously. In the present study, we developed a mouse model of STAT6D419N mutant DLBCL that recapitulates the critical features of human STAT6D419-mutant DLBCL, including increased expression of phospho-STAT6, increased CD4+ T-cell invasion, and resistance to doxorubicin treatment. We report CD4+ T cells in STAT6D419N tumors exhibit higher expression of the receptor for CCL17, CCR4. Using ex vivo functional assays, we demonstrated that STAT6D419N tumor cells are directly chemoattractive to CCR4+ CD4+ T cells, and CCR4 inhibition using a small-molecule antagonist reduced CD4+ T-cell infiltration into STAT6D419N tumors and made STAT6D419N tumors regain therapeutic sensitivity to doxorubicin. Using PhenoCycler imaging of human rrDLBCL samples, we found that STAT6D419 tumors have increased expression of phospho-STAT6 and increased cellular interactions between phospho-STAT6+ tumor cells and CD4+/CCR4+ CD4+ T cells. Thus, our data identify CCR4 as a therapeutic target in STAT6D419-mutant rrDLBCL.

Diffuse large B-cell lymphoma (DLBCL) relapses in approximately 40% of patients following frontline therapy. We reported that STAT6 D419 mutations are enriched in relapsed/refractory DLBCL (rrDLBCL) samples, suggesting that JAK/STAT signaling plays a role in therapeutic resistance. We hypothesized that STAT6 D419 mutations can improve DLBCL cell survival by reprogramming the microenvironment to sustain STAT6 activation. Thus, we investigated the role of STAT6 D419 mutations on DLBCL cell growth and its microenvironment. We found that phospho-STAT6 D419N was retained in the nucleus longer than phospho-STAT6 WT following IL-4 stimulation, and STAT6 D419N recognized a more restricted DNA-consensus sequence than STAT6 WT. Upon IL-4 induction, STAT6 D419N expression led to a higher magnitude of gene expression changes, but in a more selective list of gene targets compared with STAT WT . The most significantly expressed genes induced by STAT6 D419N were those implicated in survival, proliferation, migration, and chemotaxis, in particular CCL17. This chemokine, also known as TARC, attracts helper T-cells to the tumor microenvironment, especially in Hodgkin’s lymphoma. To this end, in DLBCL, phospho-STAT6 + rrDLBCL cells had a greater proportion of infiltrating CD4 + T-cells than phospho-STAT6 − tumors. Our findings suggest that STAT6 D419 mutations in DLBCL lead to cell autonomous changes, enhanced signaling, and altered composition of the tumor microenvironment.

Diffuse large B cell lymphoma (DLBCL) is successfully treated with combination immuno-chemotherapy, but relapse with resistant disease occurs in ~ 40% of patients. However, little is known regarding relapsed/refractory DLBCL (rrDLBCL) genetics and alternative therapies. Based on findings from other tumors, we hypothesized that RAS-MEK-ERK signaling would be upregulated in resistant tumors, potentially correlating with mutations in RAS, RAF, or associated proteins. We analyzed mutations and phospho-ERK levels in tumor samples from rrDLBCL patients. Unlike other tumor types, rrDLBCL is not mutated in any Ras or Raf family members, despite having increased expression of p-ERK. In paired biopsies comparing diagnostic and relapsed specimens, 33% of tumors gained p-ERK expression, suggesting a role in promoting survival. We did find mutations in several Ras-associating proteins, including GEFs, GAPs, and downstream effectors that could account for increased ERK activation. We further investigated mutations in one such protein, RASGRP4. In silico modeling indicated an increased interaction between H-Ras and mutant RASGRP4. In cell lines, mutant RASGRP4 increased basal p-ERK expression and lead to a growth advantage in colony forming assays when challenged with doxorubicin. Relapsed/refractory DLBCL is often associated with increased survival signals downstream of ERK, potentially corresponding with mutations in protein controlling RAS/MEK/ERK signaling.

Melanomas commonly undergo a phenotype switch, from a proliferative to an invasive state. Such tumor cell plasticity contributes to immunotherapy resistance; however, the mechanisms are not completely understood and thus are therapeutically unexploited. Using melanoma mouse models, we demonstrated that blocking the MNK1/2-eIF4E axis inhibited melanoma phenotype switching and sensitized melanoma to anti-PD-1 immunotherapy. We showed that phospho-eIF4E-deficient murine melanomas expressed high levels of melanocytic antigens, with similar results verified in patient melanomas. Mechanistically, we identified phospho-eIF4E-mediated translational control of NGFR, a critical effector of phenotype switching. Genetic ablation of phospho-eIF4E reprogrammed the immunosuppressive microenvironment, exemplified by lowered production of inflammatory factors, decreased PD-L1 expression on dendritic cells and myeloid-derived suppressor cells, and increased CD8+ T cell infiltrates. Finally, dual blockade of the MNK1/2-eIF4E axis and the PD-1/PD-L1 immune checkpoint demonstrated efficacy in multiple melanoma models regardless of their genomic classification. An increase in the presence of intratumoral stem-like TCF1+PD-1+CD8+ T cells, a characteristic essential for durable antitumor immunity, was detected in mice given a MNK1/2 inhibitor and anti-PD-1 therapy. Using MNK1/2 inhibitors to repress phospho-eIF4E thus offers a strategy to inhibit melanoma plasticity and improve response to anti-PD-1 immunotherapy.

Melanomas commonly undergo a phenotype switch, from a proliferative to an invasive state. Melanoma plasticity exhibited as phenotype switching contributes to immunotherapy resistance, however the mechanisms are not completely understood and thus therapeutically unexploited. Here, using a transgenic melanoma mouse model, we demonstrated a critical role of the MNK1/2-eIF4E axis in melanoma plasticity and resistance to immunotherapy. We showed that phospho-eIF4E deficient murine melanomas express high levels of melanocytic antigens, with similar results verified in patient melanomas. Mechanistically, we identified that phospho-eIF4E controls the translation of NGFR , a critical effector of phenotype switching. In patients with melanoma, the expression of MKNK1 , the kinase for eIF4E, positively correlated with markers of immune exhaustion. Genetic ablation of phospho-eIF4E reprogrammed the immunosuppressive microenvironment, exemplified by lowered production of inflammatory factors and increased CD8 + T cell infiltrates. Blocking phospho-eIF4E, using MNK1/2 inhibitors, offers a new strategy to inhibit melanoma plasticity and improve the survival response to anti-PD-1 immunotherapy.

Abstract Introduction: Melanoma is the deadliest form of skin cancer. Melanoma phenotype switching is characterized by reduced expression of melanocyte lineage transcription factor MITF and its downstream targets, leading to increased invasiveness of melanoma cells and resistance to both targeted therapy and immunotherapy, and worse prognosis. In melanoma, MAPK and PI3K pathways ultimately converge upon eukaryotic translation initiation factor 4E (eIF4E) to induce its phosphorylation (p-eIF4E), which is critical for the oncogenicity of eIF4E. Here, we investigate the role of p-eIF4E in melanoma progression and tumor immunity. Methods: We crossed p-eIF4E deficient (eIF4EKI) mice with an inducible melanoma mouse model. We monitored the primary tumor outgrowth, metastasis, and survival of the eIF4EKI mice versus eIF4EWT mice. Melanoma samples were isolated for further investigation. Results: Compared to the eIF4EWT mice, eIF4EKI mice exhibit significantly delayed tumor growth, reduced metastasis, and increased survival. Increased expression of MITF and downstream melanoma antigens were observed in eIF4EKI tumors, suggesting a p-eIF4E-mediated phenotype switching. Cytokine array analysis revealed a novel proinvasive cytokine signature in eIF4EWT melanoma primary culture, further supporting a role of phospho-eIF4E in phenotype switching. The cytokine profiling also revealed a pro-myeloid-derived suppressor cell (MDSC) cytokine signature in the eIF4EWT tumor, indicating a p-eIF4E-linked immunosuppression. In support of the immune suppressive cytokine signature associated with phospho-eIF4E expressing melanomas, immune phenotyping of eIF4EWT melanomas showed a significant increase in MDSCs and less cytotoxic T cells, compared to eIF4EKI melanomas. Finally, pharmacologic inhibition of p-eIF4E in combination with anti-PD-1 immunotherapy results in a synergistic delay in primary tumor outgrowth and reduced metastasis. Conclusions: Here we showed that phosphorylation of eIF4E promotes melanoma phenotype switching, leading to increased invasiveness and reduced expression of tumor-associated antigens. Further, by increasing the secretion of pro-MDSC cytokines, p-eIF4E permits an immunosuppressive microenvironment. Pharmacologic inhibition of p-eIF4E sensitizes melanoma to anti-PD-1 immunotherapy, potentially by increasing melanoma antigen expression and compromising MDSC-mediated immunosuppression. This study provides a novel therapeutic approach for the treatment of melanoma. Citation Format: Fan Huang, Christophe Gonçalves, Qianyu Guo, Joelle Rémy-Sarrazin, Audrey Emond, William Yang, Dany Plourde, Margarita Bartish, Jie Su, Yao Zhan, Marina G. Gimeno, Elie Khoury, Alexandre Benoit, David Dankort, Wilson H. Miller, Sonia V. del Rincón. Phosphorylation of eIF4E promotes phenotype switching and MDSC-mediated immunosuppression in melanoma [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology and Immunotherapy; 2019 Nov 17-20; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2020;8(3 Suppl):Abstract nr A53.