Targeting cancer glycosylation repolarizes tumor-associated macrophages allowing effective immune checkpoint blockade

Sci Transl Med. 2022 Nov 2;14(669):eabj1270. doi: 10.1126/scitranslmed.abj1270. Epub 2022 Nov 2.


Immune checkpoint blockade (ICB) has substantially improved the prognosis of patients with cancer, but the majority experiences limited benefit, supporting the need for new therapeutic approaches. Up-regulation of sialic acid-containing glycans, termed hypersialylation, is a common feature of cancer-associated glycosylation, driving disease progression and immune escape through the engagement of Siglec receptors on tumor-infiltrating immune cells. Here, we show that tumor sialylation correlates with distinct immune states and reduced survival in human cancers. The targeted removal of Siglec ligands in the tumor microenvironment, using an antibody-sialidase conjugate, enhanced antitumor immunity and halted tumor progression in several murine models. Using single-cell RNA sequencing, we revealed that desialylation repolarized tumor-associated macrophages (TAMs). We also identified Siglec-E as the main receptor for hypersialylation on TAMs. Last, we found that genetic and therapeutic desialylation, as well as loss of Siglec-E, enhanced the efficacy of ICB. Thus, therapeutic desialylation represents an immunotherapeutic approach to reshape macrophage phenotypes and augment the adaptive antitumor immune response.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Glycosylation
  • Humans
  • Immune Checkpoint Inhibitors*
  • Mice
  • Neoplasms*
  • Sialic Acid Binding Immunoglobulin-like Lectins / genetics
  • Sialic Acid Binding Immunoglobulin-like Lectins / metabolism
  • Tumor Microenvironment
  • Tumor-Associated Macrophages


  • Immune Checkpoint Inhibitors
  • Sialic Acid Binding Immunoglobulin-like Lectins