Androgen deprivation therapy drives a distinct immune phenotype in localized prostate cancer Journal Article


Authors: Dallos, M. C.; Obradovic, A. Z.; McCann, P.; Chowdhury, N.; Pratapa, A.; Aggen, D. H.; Gaffney, C.; Autio, K. A.; Virk, R. K.; De Marzo, A. M.; Antonarakis, E. S.; Scher, H. I.; Drake, C. G.; Rathkopf, D. E.
Article Title: Androgen deprivation therapy drives a distinct immune phenotype in localized prostate cancer
Abstract: PURPOSE: Androgen deprivation therapy (ADT) remains the backbone of prostate cancer treatment. Beyond the suppression of testosterone and tumor cell growth, emerging evidence suggests that ADT also modulates the immune tumor microenvironment. However, a more precise understanding of the timing and intricacies of these immunologic shifts is needed. EXPERIMENTAL DESIGN: In this study, we analyzed 49 primary prostate cancers, comparing those surgically removed either without treatment or following treatment with degarelix at 4, 7, and 14 days before surgery. Utilizing next-generation DNA and RNA sequencing and multiplexed immunofluorescence, we examined alterations in immune phenotypes in the presence or absence of ADT. RESULTS: Our findings reveal that ADT rapidly transforms the typically bland prostate tumor microenvironment into an inflamed environment within days. Notably, we observed an increase in activated CD8 T cells along with an increase in suppressive regulatory T cells (Treg). We also found an expansion of the myeloid compartment, particularly proinflammatory M1-like tumor-associated macrophages. Intriguingly, discernable changes which have not previously been described also occurred in tumor cells, including upregulation of antigen presentation by MHC classes I and II and, unexpectedly, a decrease in the "do not eat me" signal CD47. CONCLUSIONS: These observations underscore the critical role of timing and disease context in order to optimize the therapeutic efficacy of immune modulators combined with androgen ablation, for which the presurgical neoadjuvant setting may be ideal. Our findings warrant future prospective validation, which is currently underway. ©2024 American Association for Cancer Research.
Keywords: aged; middle aged; genetics; cd8+ t lymphocyte; tumor associated leukocyte; cd8-positive t-lymphocytes; lymphocytes, tumor-infiltrating; phenotype; metabolism; drug effect; pathology; prostatic neoplasms; regulatory t lymphocyte; immunology; t-lymphocytes, regulatory; prostate tumor; androgen antagonists; antiandrogen; drug therapy; tumor microenvironment; tumor-associated macrophage; tumor-associated macrophages; humans; human; male
Journal Title: Clinical Cancer Research
Volume: 30
Issue: 22
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2024-11-15
Start Page: 5218
End Page: 5230
Language: English
DOI: 10.1158/1078-0432.Ccr-24-0060
PUBMED: 39269310
PROVIDER: scopus
PMCID: PMC11905119
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Matthew C. Dallos -- Source: Scopus
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MSK Authors
  1. Karen Anne Autio
    118 Autio
  2. Patrick Mccann
    13 Mccann
  3. Dana Elizabeth Rathkopf
    271 Rathkopf
  4. Howard Scher
    1129 Scher
  5. David Henry Aggen
    56 Aggen
  6. Matthew Dallos
    4 Dallos