Statin drugs enhance responses to immune checkpoint blockade in head and neck cancer models

• DOI: 10.1136/jitc-2022-005940
• Publication Date: 2023-01-18T09:27:30Z
• Authors: Vikash Kansal; Andre J Burnham; Brendan L C Kinney; Nabil F Saba; Chrystal Paulos; Gregory B Lesinski; Zachary S Buchwald; Nicole C Schmitt
• Keywords: Clinical/Translational Cancer Immunotherapy; 0301 basic medicine; Simvastatin; Squamous Cell Carcinoma of Head and Neck; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; 3. Good health; Mice; 03 medical and health sciences; Head and Neck Neoplasms; Animals; Lovastatin; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Immune Checkpoint Inhibitors; RC254-282

BackgroundAnti-PD-1 immune checkpoint blockade is approved for first-line treatment of recurrent/metastatic head and neck squamous cell carcinoma (HNSCC), but few patients respond. Statin drugs (HMG-CoA reductase inhibitors) are associated with superior survival in several cancer types, including HNSCC. Emerging data suggest that manipulation of cholesterol may enhance some aspects of antitumor immunity.MethodsWe used syngeneic murine models (mouse oral cancer, MOC1 and TC-1) to investigate our hypothesis that a subset of statin drugs would enhance antitumor immunity and delay tumor growth.ResultsUsing an ex vivo coculture assay of murine cancer cells and tumor infiltrating lymphocytes, we discovered that all seven statin drugs inhibited tumor cell proliferation. Simvastatin and lovastatin also enhanced T-cell killing of tumor cells. In mice, daily oral simvastatin or lovastatin enhanced tumor control and extended survival when combined with PD-1 blockade, with rejection of MOC1 tumors in 30% of mice treated with lovastatin plus anti-PD-1. Results from flow cytometry of tumors and tumor-draining lymph nodes suggested T cell activation and shifts from M2 to M1 macrophage predominance as potential mechanisms of combination therapy.ConclusionsThese results suggest that statins deserve further study as well-tolerated, inexpensive drugs that may enhance responses to PD-1 checkpoint blockade and other immunotherapies for HNSCC.