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Reversion of T cell exhaustion enables cancer vaccine efficacy in BRCA1-deficient ovarian cancer

ABSTRACT: Background: BRCA mutations in ovarian cancer (OC) are associated with increased tumor-infiltrating lymphocytes and inflammatory features, yet immunotherapy for OC has failed to meet expectations. This study hypothesizes that BRCA1 or BRCA2 deficiency differently influences the response to cancer vaccine. Methods: We used the syngeneic orthotopic ID8 mouse ovarian tumor models deficient for Trp53, Trp53 and Brca1, or Trp53 and Brca2. Tumor-implanted mice were vaccinated with a dendritic cell-based whole tumor lysate vaccine (termed OCDC) alone or in combination with anti-VEGF therapy, PARP inhibitor, and/or anti-PD-1 immune checkpoint inhibitor. Tumor burden, mice survival and monitoring of T cell responses were evaluated by bioluminescence imaging, flow cytometry and interferon gamma (IFNg)-ELISpot assay. Transcriptomic profiling of tumor cell and immune cell-compartments was performed using NanoString GeoMx digital spatial profiling. Results: Brca1 deficiency—but not Brca2— impairs effectiveness of OCDC vaccine. OCDC vaccine reduced tumor growth rates and improved survival of mice implanted with Trp53-/- and Trp53-/-Brca2-/-ID8 tumors, but was ineffective in mice implanted Trp53-/-Brca1-/- tumor model. Transcriptomic analysis revealed that tumors responsive to OCDC (Brca wild-type or Brca2-/-) underwent metabolic and immunologic reprogramming post-vaccination, unlike Brca1-/- tumors. Inefficacy of the cancer vaccine was driven by a tumor microenvironment that was already inflamed, characterized by a high level of activated yet exhausted T cells, which hinder additional immune activation by vaccination. Combining OCDC with anti-VEGF and PARP inhibitors partially overcame vaccine resistance in Brca1-/- tumors, while adding anti-PD-1 further improved vaccine effectiveness by boosting T cell activity and promoting long-term survival. Conclusion: These findings highlight BRCA1’s role in cancer vaccine sensitivity and support using rational combinations to overcome vaccine inefficacy in BRCA1-mutated OC.

ORGANISM(S): Mus musculus

PROVIDER: GSE309310 | GEO | 2026/06/09

REPOSITORIES: GEO

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Project description:Pathogenic germline mutations in BRCA1 or BRCA2 are detected in less than one third of families with a strong history of breast cancer. It is therefore expected that mutations still remain undetected by currently used screening methods. In addition, a growing number of BRCA1/2 sequence variants of unclear pathogen significance are found in the families, constituting an increasing clinical challenge. New methods are therefore needed to improve the detection rate and aid the interpretation of the clinically uncertain variants. In this study we analyzed a series of 33 BRCA1, 22 BRCA2, and 128 sporadic tumors by RNA profiling to investigate the classification potential of RNA profiles to predict BRCA1/2 mutation status. We found that breast tumors from BRCA1 and BRCA2 mutation carriers display characteristic RNA expression patterns, allowing them to be distinguished from sporadic tumors. The majority of BRCA1 tumors were basal-like while BRCA2 tumors were mainly luminal B. Using RNA profiles, we were able to distinguish BRCA1 tumors from sporadic tumors among basal-like tumors with 83% accuracy and BRCA2 from sporadic tumors among luminal B tumors with 89% accuracy. Furthermore, subtype-specific BRCA1/2 gene signatures were successfully validated in two independent data sets with high accuracies. Although additional validation studies are required, indication of BRCA1/2 involvement (“BRCAness”) by RNA profiling could potentially be valuable as a tool for distinguishing pathogenic mutations from benign variants, for identification of undetected mutation carriers, and for selecting patients sensitive to new therapeutics such as PARP inhibitors. Gene expression profiling of 183 breast tumor samples. Breast tumors from hereditary breast cancer patients carrying a pathogenic BRCA1 (n=33) or BRCA2 (n=22) germ-line mutation were included in the study. Serving as a representative control group, primary breast tumor samples (n=128) were randomly selected. The study was conducted using Agilent-029949 Custom SurePrint G3 Human GE 8x60K Microarray platform. For cross-platform validation, a subset of the tumor samples (92 of the 183 samples) were analyzed by our in-house spotted microarray platform.

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Reversion of T cell exhaustion enables cancer vaccine efficacy in BRCA1-deficient ovarian cancer

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