The integrated stress response promotes immune evasion through lipocalin 2

Nature. 2026 Apr;652(8112):1329-1338. doi: 10.1038/s41586-026-10143-0. Epub 2026 Feb 18.

Abstract

Cancer cells activate the integrated stress response (ISR) to adapt to stress and resist therapy1. ISR signals converge on activating transcription factor 4 (ATF4), which controls cell-intrinsic transcriptional programs that are involved in metabolic adaptation, survival and growth2,3. However, whether the ISR-ATF4 axis influences anti-tumour immune responses remains mostly unknown. Here we show that loss of ATF4 decreases tumour progression considerably in immunocompetent mice, but not in immunocompromised ones, by enhancing T cell-dependent anti-cancer immune responses. An unbiased genetic screen of ATF4-regulated genes identifies lipocalin 2 (LCN2) as the principal ATF4-dependent effector that impairs anti-tumour immunity by favouring infiltration with immunosuppressive interstitial macrophages. Furthermore, we find that LCN2 promotes T cell exclusion and immune evasion in preclinical mouse models, and correlates with decreased T cell infiltration in patients with lung and pancreatic adenocarcinomas. Anti-LCN2 antibodies promote robust anti-tumour T cell responses in mouse models of aggressive solid tumours. Our study shows that the ATF4-LCN2 axis has a cell-extrinsic role in suppressing anti-cancer immunity, and could pave the way for an immunotherapy approach that targets LCN2.

MeSH terms

  • Activating Transcription Factor 4 / deficiency
  • Activating Transcription Factor 4 / genetics
  • Activating Transcription Factor 4 / metabolism
  • Adenocarcinoma / genetics
  • Adenocarcinoma / immunology
  • Adenocarcinoma / pathology
  • Animals
  • Cell Line, Tumor
  • Disease Models, Animal
  • Disease Progression
  • Female
  • Humans
  • Immune Evasion*
  • Lipocalin-2* / immunology
  • Lipocalin-2* / metabolism
  • Lung Neoplasms / genetics
  • Lung Neoplasms / immunology
  • Lung Neoplasms / pathology
  • Macrophages / immunology
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Pancreatic Neoplasms / genetics
  • Pancreatic Neoplasms / immunology
  • Pancreatic Neoplasms / pathology
  • Stress, Physiological* / genetics
  • Stress, Physiological* / immunology
  • T-Lymphocytes / immunology
  • Tumor Escape* / immunology

Substances

  • Lipocalin-2
  • Activating Transcription Factor 4
  • Lcn2 protein, mouse
  • LCN2 protein, human
  • Atf4 protein, mouse
  • ATF4 protein, human