Abstract 6596: BRMS1 downregulation alters the tumor microenvironment and induces immunotherapy resistance in lung adenocarcinoma

Abstract Background: Lung cancer is the leading cause of cancer-related deaths globally. During cancer progression, tumor cells interact with tumor-infiltrating immune cells (TIICs) creating an immunosuppressive microenvironment. Therefore, it is essential to delineate the communication dynamics between cancer cells and TIICs to identify novel pathways for therapeutic targeting. BRMS1 is a metastasis suppressor gene that is frequently downregulated in lung adenocarcinoma (LUAD). We, and others, have shown that loss of BRMS1 results in increased distant metastatic disease. Given the strong correlation between immune suppression, metastasis, and immunotherapy resistance we sought to elucidate if BRMS1 contributes to these processes. Specifically, we hypothesized that loss of BRMS1 in LUAD cells influences the immune cell composition, shaping an immunosuppressive microenvironment and decreasing tumor response to immunotherapy. Methods: To experimentally address our hypothesis, we generated KrasG12D P53fl/fl Brms1−/− mice inducing spontaneous tumors with Ad-Cre intratracheal inoculation. RNA-seq scRNA-seq on Brms1+/+ and Brms1−/− tumors, coupled with cell type annotations using mMCP-counter and DCATS were used to identify diverse TIIC subsets. To validate our observation, we performed immunofluorescence and flow cytometry to assess the number of TIICs. To explore the impact of Brms1 loss on the efficacy of anti-PD1 immunotherapy, a syngeneic CMT167 mouse model with BRMS1KD cells implanted in the flank was treated with an anti-PD1 antibody. Results: Differential gene expression analysis of RNA-seq data revealed a reduction in CCL9, CCL24, CLEC1B, PYCARD and other proinflammatory molecules in Brms1−/− tumors. Gene ontology and GSEA highlighted a diminished immune response signature in Brms1−/- tumors. In contrast, hallmark gene sets like IFNγ response, IL6 signaling, and inflammation are highly enriched in Brms1+/+ tumors. mMCP-counter suggested a decrease in CD8+ T cells in Brms1−/- tumors. Likewise, scRNA-seq data confirmed a significant decrease in cytotoxic CD8+ T cells in the Brms1−/− mice. Immunofluorescence and flow cytometric analysis showed a reduction in cytotoxic CD8+ T cells with low proliferative potential (Ki67+) in the Brms1−/− mice. Postmortem on our syngeneic mouse tumors after a 30-day anti-PD1 antibody treatment revealed a significantly larger mean tumor size in the BRMS1KD group compared to the WT group (942.4 mm³ vs. 184 mm³; p<0.023). Immunophenotyping on these tumors using flow cytometry also demonstrated reduced cytotoxic CD8+ T cells in the KD group post-treatment. Conclusion: Our data suggest that reduced BRMS1 expression in LUAD alters CD8+ T cell composition and primary tumor response to immunotherapy. Implications of our findings underscore the potential of BRMS1 as a therapeutic target in the context of immunotherapy-resistant LUAD. Citation Format: Manendra B. Lankadasari, Yuan Liu, Brooke Mastrogiacomo, Yingjie Zhu, Elizabeth G. Dunne, Cameron N. Fick, Choudhary Harsha, Jorge S. Reis-Filho, David R. Jones. BRMS1 downregulation alters the tumor microenvironment and induces immunotherapy resistance in lung adenocarcinoma [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 6596.