Jong Seok Lee, Jin Won Kim, Keun Wook Lee, Song Hee Han, Seock-Ah Im, Mi Hyun Kang, Se Hyun Kim, Koung Jin Suh, Ahrum Min, Jeong Ok Lee, Soo Mee Bang, Yu Jung Kim, Ji Hea Sung, Ji Eun Kim, Jee Hyun Kim, Hye Seung Lee, and Ji Won Kim
// Koung Jin Suh 1, 3, * , Ji Hea Sung 1, * , Jin Won Kim 1 , Song-Hee Han 2 , Hye Seung Lee 2 , Ahrum Min 4 , Mi Hyun Kang 1 , Ji Eun Kim 1 , Ji-Won Kim 1 , Se Hyun Kim 1 , Jeong-Ok Lee 1 , Yu Jung Kim 1 , Keun-Wook Lee 1 , Jee Hyun Kim 1 , Soo-Mee Bang 1 , Seock-Ah Im 3, 4 and Jong Seok Lee 1 1 Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang-gu, Seongnam, Korea 2 Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang-gu, Seongnam, Korea 3 Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Jongno-gu, Seoul, Korea 4 Cancer Research Institute, Seoul National University, Jongno-gu, Seoul, Korea * These authors have contributed equally to this work Correspondance to: Jin Won Kim, email: jwkim@snubh.org Keywords: PD-L1, cytokine, EGFR, HER2, PI3K Received: January 04, 2017 Accepted: June 11, 2017 Published: July 12, 2017 ABSTRACT Background: Characteristics of tumor microenvironment have been suggested as predictive markers of anti-EGFR or anti-HER2 treatment response. However, the effect of EGFR/HER2 signal blockade on the tumor immune microenvironment is unclear. Methods: EGFR/HER2 pathway signaling and PD-L1 expression in gastric cancer cell lines were screened by western blot analysis. PD-L1 and HER2 expressions in 251 resected gastric tumors were determined by immunohistochemistry, and changes in EFGR, HER2, and PD-L1 expression in paired specimens between pre- and post-chemotherapy were evaluated. PD-L1 expression in HER2-amplified cell lines was evaluated by western blotting, fluorescence-activated cell sorting, reverse transcription, and real-time quantitative PCR analyses before and after afatinib, lapatinib, pictilisib and trametinib treatment. Changes in cytokines were evaluated by reverse transcription, real-time quantitative PCR, and enzyme-linked immunosorbent assay after EGFR/HER2 inhibition. Results: Cell lines with pEGFR or pHER2 overexpression showed higher PD-L1 expression. In resected gastric tumors, HER2 expression was significantly associated with PD-L1 expression ( p =0.030). PD-L1 overexpression accompanied by increased HER2 expression was identified in a post-chemotherapy specimen from a patient with an initial HER2/PD-L1-negative tumor. In HER2-overexpressing cell lines, PD-L1 expression was decreased in a dose- and time-dependent manner after afatinib and lapatinib treatment. PI3K pathway inhibition by pictilisib, but not MEK pathway inhibition by trametinib, resulted in PD-L1 suppression. After lapatinib treatment, the release of CCL2, CCL21, VEGF and CXCL1 decreased in a dose-dependent manner. Conclusions: Inhibition of the EGFR/HER2 signaling pathway, particularly of downstream PI3K activity, suppressed PD-L1 and release of cytokines, suggesting that EGFR/HER2 inhibition may create a more favorable milieu for tumor immunotherapy.