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EML4-ALK enhances programmed cell death-ligand 1 expression in pulmonary adenocarcinoma via hypoxia-inducible factor (HIF)-1 alpha and STAT3

Cited 59 time in Web of Science Cited 64 time in Scopus
Authors
Koh, Jaemoon; Jang, Ji-Young; Keam, Bhumsuk; Kim, Sehui; Kim, Moon-Young; Go, Heounjeong; Kim, Tae Min; Kim, Dong-Wan; Kim, Chul Woo; Jeon, Yoon Kyung; Chung, Doo Hyun
Issue Date
2016-03
Citation
OncoImmunology, Vol.5 No.3, p. e1108514
Keywords
Adenocarcinomaanaplastic lymphoma kinasecancer immunotherapyhypoxia-inducible factor-1immune checkpointprogrammed cell death-1programmed cell death-ligand 1
Abstract
Programmed cell death (PD)-1/PD-1 ligand-1 (PD-L1)-targeted therapy has emerged as a promising therapeutic strategy for lung cancer. However, whether EML4-ALK regulates PD-L1 expression in lung cancer remains unknown. A total of 532 pulmonary adenocarcinomas (pADCs), including 58 ALK-translocated tumors, were immunohistochemically evaluated for PD-L1 and PD-1. H23 (EGFR(Wild-type)EML4-ALK(-)PD-L1(Low)) and H2228 (EGFR(Wild-type)EML4-ALK(+)PD-L1(High)) cells were transfected with EML4-ALK or ALK short interfering RNAs and used to investigate the alterations in PD-L1 expression. PD-L1 expression was detected in 81% of ALK-translocated pADCs; this value was significantly higher than those of pADCs with EGFR mutation, KRAS mutation or lacking ALK, EGFR or KRAS mutation (p<0.005 for all). Moreover, ALK-translocated pADC with PD-L1 expression showed significantly higher numbers of tumor-infiltrating PD-1(+) cells. ALK knockdown or inhibition (crizotinib treatment) in H2228 cells downregulated PD-L1 expression. Transfection of H23 cells with EML4-ALK enhanced PD-L1 expression, which was compromised by crizotinib treatment. This ALK-dependent upregulation of PD-L1 expression was mediated by STAT3 and hypoxia-inducible factor (HIF)-1 alpha under normoxia and hypoxia. Furthermore, EML4-ALK enhanced HIF-1 alpha expression through increasing transcription and decreasing ubiquitination of HIF-1 alpha. In ALK-translocated pADC tissues, significant positive correlations between PD-L1 and nuclear HIF-1 alpha (p < 0.05) or pSTAT3 expression levels (p<0.005) were observed. Among patients with ALK-translocated pADC, strong PD-L1 expression was significantly associated with shorter progression-free (p = 0.001) and overall survival (p = 0.002) after crizotinib treatment. Collectively, our findings demonstrate that ALK-derived pADCs increase PD-L1 expression via HIF-1 alpha and/or STAT3, thus providing a rationale for PD-1/PD-L1 pathway-targeted therapy in ALK-translocated lung cancer.
ISSN
2162-4011
URI
http://hdl.handle.net/10371/165300
DOI
https://doi.org/10.1080/2162402X.2015.1108514
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College of Medicine/School of Medicine (의과대학/대학원)Cancer Research Institute (암연구소)Journal Papers (저널논문_암연구소)
College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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