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Shi DD, Anand S, Abdullah KG, McBrayer SK. DNA damage in IDH-mutant gliomas: mechanisms and clinical implications. J Neurooncol 2023; 162:515-523. [PMID: 36352183 PMCID: PMC10956168 DOI: 10.1007/s11060-022-04172-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/14/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE Since the discovery of IDH mutations in glioma over a decade ago, significant progress has been made in determining how these mutations affect epigenetic, transcriptomic, and metabolic programs in brain tumor cells. In this article, we summarize current understanding of how IDH mutations influence DNA damage in glioma and discuss clinical implications of these findings. METHODS We performed a thorough review of peer-reviewed publications and provide an overview of key mechanisms by which IDH mutations impact response to DNA damage in gliomas, with an emphasis on clinical implications. RESULTS The effects of mutant IDH on DNA damage largely fall into four overarching categories: Gene Expression, Sensitivity to Alkylating Agents, Homologous Recombination, and Oxidative Stress. From a mechanistic standpoint, we discuss how mutant IDH and the oncometabolite (R)-2HG affect each of these categories of DNA damage. We also contextualize these mechanisms with respect to ongoing clinical trials. Studies are underway that incorporate current standard-of-care therapies, including radiation and alkylating agents, in addition to novel therapeutic agents that exert genotoxic stress specifically in IDH-mutant gliomas. Lastly, we discuss key unanswered questions and emerging data in this field that have important implications for our understanding of glioma biology and for the development of new brain tumor therapies. CONCLUSION Mounting preclinical and clinical data suggest that IDH mutations alter DNA damage sensing and repair pathways through distinct mechanisms. Future studies are needed to deepen our understanding of these processes and provide additional mechanistic insights that can be leveraged for therapeutic benefit.
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Affiliation(s)
- Diana D Shi
- Harvard Radiation Oncology Program, MA 02215, Boston, USA
- Children's Medical Center Research Institute, University of Texas Southwestern Medical Center, TX 75390, Dallas, USA
| | - Soummitra Anand
- Children's Medical Center Research Institute, University of Texas Southwestern Medical Center, TX 75390, Dallas, USA
- University of Texas Southwestern Medical School, TX 75390, Dallas, USA
| | - Kalil G Abdullah
- Department of Neurosurgery, University of Pittsburgh School of Medicine, 15213, Pittsburgh, PA, USA.
- Hillman Comprehensive Cancer Center, University of Pittsburgh Medical Center, 15232, Pittsburgh, PA, USA.
| | - Samuel K McBrayer
- Children's Medical Center Research Institute, University of Texas Southwestern Medical Center, TX 75390, Dallas, USA.
- Department of Pediatrics, University of Texas Southwestern Medical Center, TX 75390, Dallas, USA.
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, TX 75235, Dallas, USA.
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Notarangelo G, Spinelli JB, Perez EM, Baker GJ, Kurmi K, Elia I, Stopka SA, Baquer G, Lin JR, Golby AJ, Joshi S, Baron HF, Drijvers JM, Georgiev P, Ringel AE, Zaganjor E, McBrayer SK, Sorger PK, Sharpe AH, Wucherpfennig KW, Santagata S, Agar NYR, Suvà ML, Haigis MC. Oncometabolite d-2HG alters T cell metabolism to impair CD8 + T cell function. Science 2022; 377:1519-1529. [PMID: 36173860 PMCID: PMC9629749 DOI: 10.1126/science.abj5104] [Citation(s) in RCA: 91] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Gain-of-function mutations in isocitrate dehydrogenase (IDH) in human cancers result in the production of d-2-hydroxyglutarate (d-2HG), an oncometabolite that promotes tumorigenesis through epigenetic alterations. The cancer cell-intrinsic effects of d-2HG are well understood, but its tumor cell-nonautonomous roles remain poorly explored. We compared the oncometabolite d-2HG with its enantiomer, l-2HG, and found that tumor-derived d-2HG was taken up by CD8+ T cells and altered their metabolism and antitumor functions in an acute and reversible fashion. We identified the glycolytic enzyme lactate dehydrogenase (LDH) as a molecular target of d-2HG. d-2HG and inhibition of LDH drive a metabolic program and immune CD8+ T cell signature marked by decreased cytotoxicity and impaired interferon-γ signaling that was recapitulated in clinical samples from human patients with IDH1 mutant gliomas.
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Affiliation(s)
- Giulia Notarangelo
- Department of Cell Biology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Jessica B. Spinelli
- Department of Cell Biology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Elizabeth M. Perez
- Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Department of Pathology and Center for Cancer Research, Massachusetts General Hospital, Boston, MA, USA.,Department of Systems Biology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Gregory J. Baker
- Laboratory of Systems Pharmacology, Harvard Medical School, Boston, MA, USA.,Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA
| | - Kiran Kurmi
- Department of Cell Biology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Ilaria Elia
- Department of Cell Biology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Sylwia A. Stopka
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Gerard Baquer
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.,Department of Electronic Engineering, Rovira i Virgili University, Tarragona, Spain
| | - Jia-Ren Lin
- Laboratory of Systems Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Alexandra J. Golby
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Shakchhi Joshi
- Department of Cell Biology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Heide F. Baron
- Chemical Neurobiology Laboratory, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Departments of Psychiatry and Neurology, Harvard Medical School, Boston, MA, USA
| | - Jefte M. Drijvers
- Department of Cell Biology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.,Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Peter Georgiev
- Department of Cell Biology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.,Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Alison E. Ringel
- Department of Cell Biology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Elma Zaganjor
- Department of Cell Biology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Samuel K. McBrayer
- Children’s Medical Center Research Institute and Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Peter K. Sorger
- Laboratory of Systems Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Arlene H. Sharpe
- Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Kai W. Wucherpfennig
- Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.,Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Sandro Santagata
- Laboratory of Systems Pharmacology, Harvard Medical School, Boston, MA, USA.,Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA.,Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Nathalie Y. R. Agar
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.,Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Mario L. Suvà
- Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Department of Pathology and Center for Cancer Research, Massachusetts General Hospital, Boston, MA, USA
| | - Marcia C. Haigis
- Department of Cell Biology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.,Corresponding author.
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Chuntova P, Yamamichi A, Chen T, Narayanaswamy R, Ronseaux S, Hudson C, Tron AE, Hyer ML, Montoya M, Mende AL, Nejo T, Downey KM, Diebold D, Lu M, Nicolay B, Okada H. Inhibition of D-2HG leads to upregulation of a proinflammatory gene signature in a novel HLA-A2/HLA-DR1 transgenic mouse model of IDH1R132H-expressing glioma. J Immunother Cancer 2022; 10:e004644. [PMID: 35606087 PMCID: PMC9174833 DOI: 10.1136/jitc-2022-004644] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Long-term prognosis of WHO grade II, isocitrate dehydrogenase (IDH)-mutated low-grade glioma (LGG) is poor due to high risks of recurrence and malignant transformation into high-grade glioma. Immunotherapy strategies are attractive given the relatively intact immune system of patients with LGG and the slow tumor growth rate. However, accumulation of the oncometabolite D-2-hydroxyglutarate (D-2HG) in IDH-mutated gliomas leads to suppression of inflammatory pathways in the tumor microenvironment, thereby contributing to the 'cold' tumor phenotype. Inhibiting D-2HG production presents an opportunity to generate a robust antitumor response following tumor antigen vaccination and immune checkpoint blockade. METHODS An IDH1R132H glioma model was created in syngeneic HLA-A2/HLA-DR1-transgenic mice, allowing us to evaluate the vaccination with the human leukocyte antigens (HLA)-DR1-restricted, IDH1R132H mutation-derived neoepitope. The effects of an orally available inhibitor of mutant IDH1 and IDH2, AG-881, were evaluated as monotherapy and in combination with the IDH1R132H peptide vaccination or anti-PD-1 immune checkpoint blockade. RESULTS The HLA-A2/HLA-DR1-syngeneic IDH1R132H cell line expressed the IDH1 mutant protein and formed D-2HG producing orthotopic gliomas in vivo. Treatment of tumor-bearing mice with AG-881 resulted in a reduction of D-2HG levels in IDH1R132H glioma cells (10 fold) and tumor-associated myeloid cells, which demonstrated high levels of intracellular D-2HG in the IDH1R132H gliomas. AG-881 monotherapy suppressed the progression of IDH1R132H gliomas in a CD4+ and CD8+ cell-dependent manner, enhanced proinflammatory IFNγ-related gene expression, and increased the number of CD4+ tumor-infiltrating T-cells. Prophylactic vaccination with the HLA-DR1-restricted IDH1R132H peptide or tumor-associated HLA-A2-restricted peptides did not enhance survival of tumor-bearing animals; however, vaccination with both HLA-A2-IDH1R132H and DR1-IDH1R132H peptides in combination with the IDH inhibitor significantly prolonged survival. Finally, tumor-bearing mice treated with both AG-881 and a PD-1 blocking antibody demonstrated improved survival when compared with either treatment alone. CONCLUSION The development of effective IDH1R132H-targeting vaccine may be enhanced by integration with HLA class I-restricted cytotoxic T cell epitopes and AG-881. Our HLA-A2/HLA-DR1-syngeneic IDH1R132H glioma model should allow us to evaluate key translational questions related to the development of novel strategies for patients with IDH-mutant glioma.
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Affiliation(s)
- Pavlina Chuntova
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Akane Yamamichi
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Tiffany Chen
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Rohini Narayanaswamy
- Agios Pharmaceuticals Inc, Cambridge, Massachusetts, USA
- Servier BioInnovation, Boston, Massachusetts, USA
| | - Sebastien Ronseaux
- Agios Pharmaceuticals Inc, Cambridge, Massachusetts, USA
- Cedilla Therapeutics, Cambridge, Massachusetts, USA
| | - Christine Hudson
- Agios Pharmaceuticals Inc, Cambridge, Massachusetts, USA
- Deciphera Pharmaceuticals Inc, Waltham, Massachusetts, USA
| | | | - Marc L Hyer
- Servier BioInnovation, Boston, Massachusetts, USA
| | - Megan Montoya
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Abigail L Mende
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Takahide Nejo
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Kira M Downey
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - David Diebold
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Min Lu
- Agios Pharmaceuticals Inc, Cambridge, Massachusetts, USA
- Servier BioInnovation, Boston, Massachusetts, USA
| | - Brandon Nicolay
- Agios Pharmaceuticals Inc, Cambridge, Massachusetts, USA
- Cedilla Therapeutics, Cambridge, Massachusetts, USA
| | - Hideho Okada
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
- The Parker Institute for Cancer Immunotherapy, San Francisco, CA, USA
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