Abstract 2188: Tirzepatide treatment restores antitumor immunity in a model of obesity-driven cancer

Abstract Obesity is a widely and increasingly prevalent disease and a risk factor for several cancers. Recent work has shown that weight loss following bariatric surgery is potently protective against obesity-associated cancers. However, little is known about the potential anticancer effects of weight loss achieved through incretin-based therapies. We therefore interrogated the effects of the dual glucagon-like peptide 1 and glucose-dependent insulinotropic polypeptide receptor agonist tirzepatide (TZP) on body weight and tumor progression in a mouse model of obesity and transplanted colon cancer cells. Moreover, we tested whether TZP-mediated weight loss can reverse obesity-associated suppression of CD8+ T cell immunity. Male C57BL/6J mice were fed either 60 kcal% fat diet (D12492) or a sucrose-matched 10 kcal% fat diet (D12450J) for ≥15 weeks to generate diet induced obese (DIO) or control mice, respectively. Once DIO mice reached a body weight of 47 g they were randomized to begin TZP treatment or receive a vehicle control every other day for 3 weeks (when stable body weights were reached for TZP mice). All mice then received subcutaneous injections with 2.5 × 105 MC38 cells and continued to receive TZP or vehicle. To determine the role of CD8+ T cell mediated tumor control in driving the effects of TZP treatment, mice received either CD8-depleting antibodies or an isotype control at days -2, 0, 2 relative to tumor cell injection and subsequently every 4 days. Tumor mass was determined by digital scale. Fasting blood glucose, body weight loss, and body composition were monitored to determine the metabolic effects of TZP. Immune cell populations were measured by full spectrum flow cytometry. We found TZP reduced body weight, fasting blood glucose, and adiposity relative to DIO mice, as was expected. These metabolic improvements were accompanied by reduction of tumor mass in TZP mice relative to DIO mice. DIO mice had increased levels of exhausted T cells which were normalized by TZP treatment. Depletion of CD8+ cells did not alter the tumor mass of DIO mice, indicating negligible CD8+ T cell-mediated tumor control. In contrast, CD8+ cell depletion in control and TZP mice increased in tumor masses to the levels comparable to those of DIO mice. These results demonstrate that TZP can mitigate obesity-associated acceleration of tumor growth and restore markers of effective antitumor T cell immunity. Critically, we find that restoration of CD8+ T cell function is essential for TZP’s ability to limit tumor growth in DIO mice. Taken together, these results demonstrate that the metabolic improvements achieved by TZP treatment are accompanied by mitigation of obesity-driven immunosuppression. These findings shed important light on the potential for TZP and other incretin-based therapies to limit obesity-associated cancer progression, and are especially timely given the growing population of patients utilizing incretin-based therapies. Citation Format: Michael F. Coleman, Elaine M. Glenny, Tori L. McFarlane, Hannah M. Malian, Claire E. Gates, Fangxin Chen, Alyssa N. Ho, Violet A. Kiesel, Stephen D. Hursting. Tirzepatide treatment restores antitumor immunity in a model of obesity-driven cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2188.