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How popular steroids could mess up some cancer treatments

Images of mouse tumors with colorized cancer cells
Two looks at mouse tumors. Left: staining by the 黑料吃瓜资源 Animal & Tissue Imaging Shared Resource. Right: segmenting by Dominik Loiero in the lab of University of Zurich Assistant Professor Viktor Koelzer. The red segments on the right are cancer cells.

Immunotherapy is among the newest and most potent weapons against cancer. It prompts the immune system to recognize tumors as intruders in the body and attack. But not all patients respond well to immunotherapy. Why? Scientists aren鈥檛 always sure.

Sometimes, immunotherapy patients experience side effects that steroids called glucocorticoids (GCs) can treat. GCs are often used to regulate the immune response in conditions such as asthma, Crohn鈥檚 disease, and even COVID-19. Yet just how they work is also a mystery.

Now, 黑料吃瓜资源 (CSHL) researchers may be closer to answering both questions. Their new research indicates GCs may indirectly lead to some immunotherapy treatment failures by driving the production of a protein called Cystatin C (CyC). Higher levels of CyC are linked to poorer outcomes of this type of therapy.

CSHL Assistant Professor Tobias Janowitz says, 鈥淕Cs are very powerful suppressors of immunity and are consequently used to treat autoimmunity,鈥 which is when the immune system attacks healthy cells. 鈥淲e鈥檝e previously shown that GCs can also break cancer immunotherapy. Now, here鈥檚 perhaps a clue into how they鈥檙e doing it.鈥

Janowitz鈥檚 lab studies the whole-body response to cancer. For this study, he and a Ph.D. student in his lab, physician-turned-researcher Sam Kleeman, teamed with a third CSHL scientist, Assistant Professor Hannah Meyer, an expert in quantitative biology. Together, they analyzed a massive genetic dataset from the UK Biobank. How massive? Almost 500,000 volunteers, including patients with cancer. Kleeman also reached out to researchers overseas to gather even more patient data.

The scientists found that patients who were more likely to produce CyC in response to GCs had a worse overall survival rate. These patients were also less likely to benefit from treatment. This suggests CyC production within a tumor may contribute to the failure of cancer immunotherapy.

To confirm CyC鈥檚 connection with cancer, the researchers turned to good old-fashioned lab work. In mice, they deleted a CyC-producing gene so it was no longer present in cancer cells. They found that tumors without CyC grew slower.

鈥淚t鈥檚 really powerful to come at this from multiple angles and support the findings through many approaches,鈥 Meyer says. 鈥淐lever genetic models gave us some indication of which experiments to design to help us answer the question of what this molecule does.鈥

Janowitz says he plans to continue studying CyC. He hopes this could greatly help future patients.

鈥淭he research has given me an impetus to find out more about the function of this molecule, specifically in the context of cancer immunotherapy,鈥 he says. 鈥淧erhaps its function can be targeted to enhance the success of cancer immunotherapy.鈥

Written by: Margaret Osborne, Science Writer | [email protected] | 516-367-8455


Funding

Simons Foundation, Mark Foundation, Nancy Gay Foundation, Simons Center for Quantitative Biology, Starr Foundation, La Caixa Foundation, Wellcome Trust, Medical Research Council, Royal Ministry of Education and Research, National Institutes of Health

Citation

Kleeman, S., et al., 鈥淐ystatin C is glucocorticoid-responsive, directs recruitment of Trem2+ macrophages and predicts failure of cancer immunotherapy鈥, Cell Genomics, June 23, 2023. DOI:

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Principal Investigator

Tobias Janowitz

Tobias Janowitz

Associate Professor
Cancer Center Program Co-Leader
M.D., Ph.D., University of Cambridge, UK, 2007

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