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BRD4 inhibition impairs DNA mismatch repair, induces mismatch repair mutation signatures and creates therapeutic vulnerability to immune checkpoint blockade in MMR-proficient tumors

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单位: [1]Department of Gynecological Oncology,Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan,Hubei,People's Republic of China [2]National Clinical Research Center for Gynecology and Obstetrics,Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan,Hubei,People's Republic of China [3]Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China [4]Department of Obstetrics and Gynecology, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, People's Republic of China [5]Department of Stomatology,Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan,Hubei,People's Republic of China [6]Department of Cell, Development and Cancer Biology, Oregon Health & Science University Knight Cancer Institute, Portland, Oregon, USA
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Mismatch repair deficiency (dMMR) is a well-recognized biomarker for response to immune checkpoint blockade (ICB). Strategies to convert MMR-proficient (pMMR) to dMMR phenotype with the goal of sensitizing tumors to ICB are highly sought. The combination of bromodomain containing 4 (BRD4) inhibition and ICB provides a promising antitumor effect. However, the mechanisms underlying remain unknown. Here, we identify that BRD4 inhibition induces a persistent dMMR phenotype in cancers.We confirmed the correlation between BRD4 and mismatch repair (MMR) by the bioinformatic analysis on The Cancer Genome Atlas and Clinical Proteomic Tumor Analysis Consortium data, and the statistical analysis on immunohistochemistry (IHC) scores of ovarian cancer specimens. The MMR genes (MLH1,MSH2,MSH6,PMS2) were measured by quantitative reverse transcription PCR, western blot, and IHC. The MMR status was confirmed by whole exome sequencing, RNA sequencing, MMR assay and hypoxanthine-guanine phosphoribosyl transferase gene mutation assay. The BRD4i AZD5153 resistant models were induced both in vitro and in vivo. The transcriptional effects of BRD4 on MMR genes were investigated by chromatin immunoprecipitation among cell lines and data from the Cistrome Data Browser. The therapeutic response to ICB was testified in vivo. The tumor immune microenvironment markers, such as CD4, CD8, TIM-3, FOXP3, were measured by flow cytometry.We identified the positive correlation between BRD4 and MMR genes in transcriptional and translational aspects. Also, the inhibition of BRD4 transcriptionally reduced MMR genes expression, resulting in dMMR status and elevated mutation loads. Furthermore, prolonged exposure to AZD5153 promoted a persistent dMMR signature both in vitro and in vivo, enhancing tumor immunogenicity, and increased sensitivity to α-programmed death ligand-1 therapy despite the acquired drug resistance.We demonstrated that BRD4 inhibition suppressed expression of genes critical to MMR, dampened MMR, and increased dMMR mutation signatures both in vitro and in vivo, sensitizing pMMR tumors to ICB. Importantly, even in BRD4 inhibitors (BRD4i)-resistant tumor models, the effects of BRD4i on MMR function were maintained rendering tumors sensitive to ICB. Together, these data identified a strategy to induce dMMR in pMMR tumors and further, indicated that BRD4i sensitive and resistant tumors could benefit from immunotherapy.© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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出版当年[2022]版:
大类 | 2 区 医学
小类 | 2 区 肿瘤学 2 区 免疫学
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 免疫学 2 区 肿瘤学
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出版当年[2021]版:
Q1 IMMUNOLOGY Q1 ONCOLOGY
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Q1 IMMUNOLOGY Q1 ONCOLOGY

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第一作者单位: [1]Department of Gynecological Oncology,Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan,Hubei,People's Republic of China [2]National Clinical Research Center for Gynecology and Obstetrics,Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan,Hubei,People's Republic of China
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通讯机构: [2]National Clinical Research Center for Gynecology and Obstetrics,Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan,Hubei,People's Republic of China
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