1. A PoleP286R mouse model of endometrial cancer recapitulates high mutational burden and immunotherapy response
- Author
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Changzheng Lu, Esra A. Akbay, Xiaojing Wang, Prasad Koduru, Peter Ly, Diego H. Castrillon, Junqiu Zhang, Yang Xin Fu, Mitzi Aguilar, Ileana Cuevas, Hao Dong Li, Subhransu S. Sahoo, Guo Min Li, Bo Li, Qing Hu, Shanrong Zhang, He Zhang, and Elizabeth G. Maurais
- Subjects
0301 basic medicine ,Carcinogenesis ,DNA repair ,medicine.medical_treatment ,Biology ,medicine.disease_cause ,DNA Mismatch Repair ,Endometrium ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Chromosomal Instability ,Chromosome instability ,medicine ,Animals ,Poly-ADP-Ribose Binding Proteins ,Cancer ,DNA Polymerase II ,General Medicine ,Immunotherapy ,medicine.disease ,Immune checkpoint ,Endometrial Neoplasms ,Disease Models, Animal ,Phenotype ,030104 developmental biology ,MSH2 ,030220 oncology & carcinogenesis ,Mutation ,Cancer research ,Female ,DNA mismatch repair ,Research Article - Abstract
Cancer is instigated by mutator phenotypes, including deficient mismatch repair and p53-associated chromosomal instability. More recently, a distinct class of cancers was identified with unusually high mutational loads due to heterozygous amino acid substitutions (most commonly P286R) in the proofreading domain of DNA polymerase ε, the leading strand replicase encoded by POLE. Immunotherapy has revolutionized cancer treatment, but new model systems are needed to recapitulate high mutational burdens characterizing human cancers and permit study of mechanisms underlying clinical responses. Here, we show that activation of a conditional LSL-Pole(P286R) allele in endometrium is sufficient to elicit in all animals endometrial cancers closely resembling their human counterparts, including very high mutational burden. Diverse investigations uncovered potentially novel aspects of Pole-driven tumorigenesis, including secondary p53 mutations associated with tetraploidy, and cooperation with defective mismatch repair through inactivation of Msh2. Most significantly, there were robust antitumor immune responses with increased T cell infiltrates, accelerated tumor growth following T cell depletion, and unfailing clinical regression following immune checkpoint therapy. This model predicts that human POLE-driven cancers will prove consistently responsive to immune checkpoint blockade. Furthermore, this is a robust and efficient approach to recapitulate in mice the high mutational burdens and immune responses characterizing human cancers.
- Published
- 2020
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