Immune selection drives
tumor cells to acquire refractory phenotypes. We previously demonstrated that cytotoxic T lymphocyte (CTL)-mediated immune pressure enriches NANOG+
tumor cells with stem-like and immune-refractory properties that make them resistant to CTLs. Here, we report that the emergence of refractory phenotypes is highly associated with an aberrant macroautophagic/autophagic state of the NANOG+
tumor cells and that the autophagic phenotype arises through transcriptional induction of MAP1LC3B/LC3B by NANOG. Furthermore, we found that upregulation of LC3B expression contributes to an increase in
EGF secretion. The subsequent hyperactivation of EGFR-AKT signaling rendered NANOG+
tumor cells resistant to CTL killing. The NANOG-LC3B-p-EGFR axis was preserved across various types of human
cancer and correlated negatively with the overall survival of
cervical cancer patients. Inhibition of LC3B in immune-refractory
tumor models rendered
tumors susceptible to adoptive T-cell transfer, as well as PDCD1/PD-1 blockade, and led to successful, long-term control of the disease. Thus, our findings demonstrate a novel link among immune-resistance, stem-like phenotypes, and LC3B-mediated autophagic secretion in immune-refractory
tumor cells, and implicate the LC3B-p-EGFR axis as a central molecular target for controlling NANOG+ immune-refractory
cancer.Abbreviations: ACTB: actin beta; ATG7: autophagy related 7; BafA1:
bafilomycin A1;
CASP3:
caspase 3;
CFSE:
carboxyfluorescein succinimidyl
ester; ChIP:
chromatin immunoprecipitation; CI: confidence interval; CIN:
cervical intraepithelial neoplasia; CSC: cancer stem cell; CTL: cytotoxic T lymphocyte;
EGF:
epidermal growth factor; EGFR:
epidermal growth factor receptor; FIGO: International Federation of Gynecology and Obstetrics; GFP:
green fluorescent protein; GZMB:
granzyme B; HG-CIN: high-grade CIN; IHC: immunohistochemistry; LG-CIN: low-grade CIN; LN: lymph node; MAP1LC3B/LC3B:
microtubule associated protein 1 light chain 3 beta; MCL1:
myeloid cell leukemia sequence 1; MLANA/MART-1:
melanoma antigen recognized by T cells 1; MUT: mutant; NANOG: Nanog homeobox; PDCD1/PD-1: programmed cell death 1; PMEL/gp100: premelanosome
protein; RTK:
receptor tyrosine kinase; TMA: tissue microarray; WT: wild type.