Development of Mouse and Humanized Models to Study Sex Disparities in Tumor Progression and Treatment of NSCLC - Project Summary
According to the American Cancer Society, lung cancer is the second most commonly diagnosed cancer in men
and women. Outside of the sex-specific cancers, lung cancer and melanoma have the greatest sex disparity,
though the exact mechanisms behind these differences are not well understood. In the United States, men have
a higher lifetime risk of developing lung cancer and are more likely to develop severe disease than women.
Additionally, there are sex disparities in responses to treatment, such as men having better responses to
immunotherapies over women. There are multiple factors contributing to this sex disparity including lifestyle
choices, sex hormones, and differences in immune response. Our preliminary data shows that two mouse tumors
models of lung cancer, CMT-167 and Lewis Lung Carcinoma (LLC), two models of non-small cell lung cancer
(NSCLC), grow slower in female than in male mice. This sex difference is dependent on the ovary as tumors in
ovariectomized female mice grow equivalent to those in male mice. Innate immune cells (macrophages and NK
cells) and more specifically NKG2D receptor activity are required for reduced tumor growth in females. Multi-
parameter flow cytometry analysis shows significant sex differences in NSCLC tumor resident innate immune
cells. We show that these sex-disparities extend to several chemotherapy and anti-PDL1 immunotherapy
treatments. In preliminary in vivo data we show that the sex-disparity in NSCLC tumor growth and the response
to chemotherapy requires NK cells. Ex vivo NK cell killing assays show that preincubation of NSCLC cells with
female serum, but not male serum or serum from ovariectomized females, stimulates enhanced NK cell activity
utilizing the secreted pro-apoptotic factor TRAIL. This ex vivo NK cell assay provides a means to identify bioactive
molecules. Based upon this preliminary data, we propose two Aims for our future studies. Aim 1 we will
fractionate serum from female mice to identify a biological molecule from female serum required for LLC and
CMT-167 sensitization to NK cell killing via TRAIL. The sensitization of LLC and CMT-167 tumor cells in female
mice to the effects of TRAIL are proposed to contribute to the observed sex–differences in tumor growth and
sensitivity to therapies (both chemotherapy and immunotherapy). For Aim 2, we will determine if the response
to standard of care chemotherapies or anti-PD1 immunotherapy using orthotopic CMT-167 and LLC tumor
models is dependent on sex. If a sex difference in response is observed, we will characterize the immune
responses of male and female mice to lung tumors in the context of these drugs. In summary, this project aims
to gain an understanding of the biological mechanisms behind the sex disparities in NSCLC progression and
response to treatment, with the hopes of gaining knowledge to inform clinic decisions and treatment of the human
disease.