Beach, Callum and MacLean, David and Majorova, Dominika and Melemenidis, Stavros and Nambiar, Dhanya K. and Kim, Ryan K. and Valbuena, Gabriel N. and Guglietta, Silvia and Krieg, Carsten and Darvish, Damavandi Mahnaz and Suwa, Tatsuya and Easton, Alistair and Hillson, Lily V.S. and McCulloch, Ashley K. and McMahon, Ross K. and Pennel, Kathryn and Edwards, Joanne and O'Cathail, Sean M. and Roxburgh, Campbell S. and Domingo, Enric and Moon, Eui Jung and Jiang, Dadi and Jiang, Yanyan and Zhang, Q. and Koong, Albert C. and Woodruff, Trent M. and Graves, Edward E. and Maughan, Tim and Buczacki, Simon J.A. and Stucki, Manuel and Le, Quynh-Thu and Leedham, Simon J. and Giaccia, Amato J. and Olcina, Monica M. (2023) Improving radiotherapy in immunosuppressive microenvironments by targeting complement receptor C5aR1. Journal of Clinical Investigation, 133 (23): e168277. ISSN 0021-9738

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Abstract

An immunosuppressive microenvironment causes poor tumor T cell infiltration and is associated with reduced patient overall survival in colorectal cancer. How to improve treatment responses in these tumors is still a challenge. Using an integrated screening approach to identify cancer-specific vulnerabilities, we identified complement receptor C5aR1 as a druggable target, which when inhibited improved radiotherapy, even in tumors displaying immunosuppressive features and poor CD8+ T cell infiltration. While C5aR1 is well-known for its role in the immune compartment, we found that C5aR1 is also robustly expressed on malignant epithelial cells, highlighting potential tumor cell–specific functions. C5aR1 targeting resulted in increased NF-κB–dependent apoptosis specifically in tumors and not normal tissues, indicating that, in malignant cells, C5aR1 primarily regulated cell fate. Collectively, these data revealed that increased complement gene expression is part of the stress response mounted by irradiated tumors and that targeting C5aR1 could improve radiotherapy, even in tumors displaying immunosuppressive features.

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