Systematic Discovery and Characterization of Novel Cancer Anti-Phagocytic Mechanisms - Project Summary/Abstract
Recent strategies to stimulate anti-cancer immune responses have transformed treatment options for many
cancer patients, but are critically hindered by the low abundance and/or suppression of lymphocytes in the
tumor microenvironment of many cancers. This work aims to address this significant problem in the context
of small cell lung cancer (SCLC), which has among the worst prognoses among all cancers and for which
adaptive immune checkpoint inhibitors have shown limited success in improving patient outcomes. Strategies
to stimulate macrophage activity are increasingly being investigated, as macrophages constitute a high
percentage of total tumor cell mass in SCLC and many other cancers. Therapeutic monoclonal antibodies
(mAbs) can induce macrophages to both kill cancer cells via phagocytosis and to prime adaptive immune
responses. However, anti-phagocytic factors expressed by cancer cells, only some of which have been
identified, enable resistance to phagocytosis. My long-term goal is to advance our fundamental knowledge
of the mechanisms by which cancer cells evade antibody-dependent phagocytosis, which might create new
therapeutic avenues to enhance mAb efficacy. I will build on an innovative CRISPR/Cas9-screening
approach I have developed to identify factors that modulate cancer sensitivity to phagocytosis. This approach
revealed a suite of known and novel anti-phagocytic pathways. The objective of this proposal is to investigate
one of the most potent novel mechanisms I identified, and to test the central hypothesis that cancer cells
metabolize inflammatory lipids to avoid activating macrophages. In Aim 1, I will undertake a series of in vitro
experiments to understand the mechanistic basis of macrophage regulation by cancer-derived
immunostimulatory lipids. In Aim 2, I will determine how cancer lipid regulation affects innate and adaptive
anti-cancer immune responses using an immunocompetent mouse model for SCLC. Finally, in Aim 3, I will
systematically characterize synergies between diverse anti-phagocytic pathways in SCLC to reveal how lipid
regulators and other factors cooperate to block macrophage attack, which may suggest possible new
combination therapeutic strategies. The expected outcome of these related but independent aims is an
understanding of the molecular mechanisms of a novel immunosuppressive lipid metabolism pathway used
by diverse cancers, including SCLC, to evade mAb therapies. These aims will be pursued within the stellar
scientific environment of Stanford University, with research training and mentorship by an experienced team
of experts in functional genomics, cancer immunology, lipid signaling, and bioinformatics. The career
development plan involves research training in lipid analysis methods, mouse tumor models, and
computational analysis of genetic screens, as well as professional training in communication, mentoring, and
laboratory management, and will establish a strong foundation for my career as an independent investigator.