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Endothelial cell cycle inhibition enables blood vessel maturation to normalize the tumor vasculature
Shelby R. Cain, Gael Genet, Nafiisha Genet, Jordon W. Aragon, Madeline G. Jackson, Victoria M. Milosek, Mark R. Schwartz, Umadevi Paila, Aleksandra Cwiek, Zaneta Markowska, Nicholas W. Chavkin, Richard J. Price, Andrew C. Dudley, Karen K. Hirschi
Shelby R. Cain, Gael Genet, Nafiisha Genet, Jordon W. Aragon, Madeline G. Jackson, Victoria M. Milosek, Mark R. Schwartz, Umadevi Paila, Aleksandra Cwiek, Zaneta Markowska, Nicholas W. Chavkin, Richard J. Price, Andrew C. Dudley, Karen K. Hirschi
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Research Article Oncology Vascular biology

Endothelial cell cycle inhibition enables blood vessel maturation to normalize the tumor vasculature

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Abstract

Dysfunctional tumor vessels promote disease progression, whereas improved function enhances therapeutic delivery. However, current approaches to normalize tumor vasculature have limited efficacy. In vascular malformations, vessels are similarly dysfunctional, with endothelial cell (EC) hyperproliferation impairing arterial-venous specification. These defects are corrected with palbociclib, a cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) that has beneficial effects on tumor and immune cells, but the effects on tumor vasculature are not well characterized. In our studies, murine mammary tumor ECs (TECs) exhibited disrupted cell cycle and specification, and CDK4/6i promoted TEC cycle control, enabling improved tumor vascular function. To investigate transcriptomic changes, we performed single-cell RNA sequencing (scRNA-seq) of treated and untreated tumors, and healthy tissues. CDK4/6i-mediated TEC cycle arrest promoted arterial-venous specification, cellular junctions, and pericyte association, and suppressed glycolytic and immunosuppressive gene expression. These effects were associated with increased vessel perfusion, decreased tumor hypoxia, and a more favorable immune landscape with immunotherapy. In scRNA-seq datasets from patients treated long-term with CDK4/6i, TECs exhibited similar transcriptomic changes associated with arterial-venous specification, pericyte recruitment, and immune signaling. Thus, in contrast to current strategies, CDK4/6i-mediated vascular changes may be maintained with continued treatment, highlighting the relevance of modulating TEC cycle to improve vessel maturation/function.

Authors

Shelby R. Cain, Gael Genet, Nafiisha Genet, Jordon W. Aragon, Madeline G. Jackson, Victoria M. Milosek, Mark R. Schwartz, Umadevi Paila, Aleksandra Cwiek, Zaneta Markowska, Nicholas W. Chavkin, Richard J. Price, Andrew C. Dudley, Karen K. Hirschi

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Figure 7

CDK4/6i alters tumor EC immune signaling and cooperates with immunotherapy.

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CDK4/6i alters tumor EC immune signaling and cooperates with immunothera...
(A) Experimental timeline for EO771 model with CDK4/6i treatment. (B) Representative confocal images of tumors with and without CDK4/6i immunostained for CD31 (green) and BST2 (red) with colocalization (blue). (C) Average percentage vessel (CD31+) area colocalized with BST2 (4–7 ROI/tumor, n = 5–6 tumors/group). (D) Significantly decreased (P < 0.01) ligand-receptor communication probability between TECs and immune cells following CDK4/6i. (E) Experimental design for EO771 model with groups receiving CDK4/6i (150 mg/kg/day), anti–PD-1 (15 mg/kg), combination therapy, or vehicle and IgG2a isotype control. (F) Representative confocal images of tumor sections immunostained for CD8 (red) and with Hoechst (blue) following vehicle (top) or combination (bottom) treatment. Images span the tumor edge to center. (G) CD8+ density greater than 500 mm from tumor edge (n = 5–6 mice/group). (H) Ratio of CD8+ to CD4+FOXP3+ T cells in tumors quantified by flow cytometry (n = 5 mice/group). P values calculated with unpaired Mann-Whitney test (C) and 2-way ANOVA with Šídák’s multiple-comparison test (G and H). Scale bars: 20 mm (B) and 500 mm (F). *P < 0.05; **P < 0.01.

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