Targeting immunosuppressive macrophages overcomes PARP inhibitor resistance in BRCA1-associated triple-negative breast cancer

Nat Cancer. 2021 Jan;2(1):66-82. doi: 10.1038/s43018-020-00148-7. Epub 2020 Dec 14.

Abstract

Despite objective responses to PARP inhibition and improvements in progression-free survival compared to standard chemotherapy in patients with BRCA-associated triple-negative breast cancer (TNBC), benefits are transitory. Using high dimensional single-cell profiling of human TNBC, here we demonstrate that macrophages are the predominant infiltrating immune cell type in BRCA-associated TNBC. Through multi-omics profiling we show that PARP inhibitors enhance both anti- and pro-tumor features of macrophages through glucose and lipid metabolic reprogramming driven by the sterol regulatory element-binding protein 1 (SREBP-1) pathway. Combined PARP inhibitor therapy with CSF-1R blocking antibodies significantly enhanced innate and adaptive anti-tumor immunity and extends survival in BRCA-deficient tumors in vivo and is mediated by CD8+ T-cells. Collectively, our results uncover macrophage-mediated immune suppression as a liability of PARP inhibitor treatment and demonstrate combined PARP inhibition and macrophage targeting therapy induces a durable reprogramming of the tumor microenvironment, thus constituting a promising therapeutic strategy for TNBC.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • BRCA1 Protein / genetics
  • CD8-Positive T-Lymphocytes
  • Cell Line, Tumor
  • Humans
  • Macrophages
  • Poly(ADP-ribose) Polymerase Inhibitors* / pharmacology
  • Triple Negative Breast Neoplasms* / drug therapy
  • Tumor Microenvironment

Substances

  • BRCA1 Protein
  • BRCA1 protein, human
  • Poly(ADP-ribose) Polymerase Inhibitors