Breaking barriers for T cells by targeting the EPHA2/TGF-β/COX-2 axis in pancreatic cancer

J Clin Invest. 2019 Jul 29;129(9):3521-3523. doi: 10.1172/JCI130316.

Abstract

Pancreatic ductal adenocarcinoma is projected to become the second leading cause of cancer-related death and is largely resistant to immunotherapies. The tumor microenvironment, largely composed of heterogeneous myeloid cells, creates a physical, metabolic, and immunosuppressive barrier that prevents T cells from infiltrating cancer beds. In this issue of the JCI, Markosyan and colleagues have reported a tumor-intrinsic mechanism that excludes T cells from the vicinity of tumor cells. They showed that a receptor tyrosine kinase, ephrin-A receptor 2 (EPHA2), regulates prostaglandin endoperoxide synthase 2 (PTGS2) (encodes COX-2) expression in a TGF-β signaling-dependent manner. Genetic ablation of Epha2 or Ptgs2 in preclinical models or pharmacological inhibition of COX-2 elicited the transformation of this immunosuppressive microenvironment into a T cell-permissive milieu. Consequent T cell relocation rendered this immunoresistant malignancy responsive to combinations of checkpoint blockers and CD40 agonists. Because the association between T cell infiltration and the EPHA2/TGF-β/COX-2 axis is supported by independent clinical data, these results provide a rationale for ensuing clinical trials aimed at incorporating pancreatic cancer into the range of immunotherapy-responsive tumors.

Publication types

  • Research Support, N.I.H., Extramural
  • Comment

MeSH terms

  • Carcinoma, Pancreatic Ductal*
  • Cyclooxygenase 2
  • Humans
  • Pancreatic Neoplasms*
  • T-Lymphocytes
  • Tumor Microenvironment

Substances

  • Cyclooxygenase 2
  • PTGS2 protein, human