- Tavazoie, Masoud F;
- Pollack, Ilana;
- Tanqueco, Raissa;
- Ostendorf, Benjamin N;
- Reis, Bernardo S;
- Gonsalves, Foster C;
- Kurth, Isabel;
- Andreu-Agullo, Celia;
- Derbyshire, Mark L;
- Posada, Jessica;
- Takeda, Shugaku;
- Tafreshian, Kimia N;
- Rowinsky, Eric;
- Szarek, Michael;
- Waltzman, Roger J;
- Mcmillan, Elizabeth A;
- Zhao, Connie;
- Mita, Monica;
- Mita, Alain;
- Chmielowski, Bartosz;
- Postow, Michael A;
- Ribas, Antoni;
- Mucida, Daniel;
- Tavazoie, Sohail F
Therapeutic harnessing of adaptive immunity via checkpoint inhibition has transformed the treatment of many cancers. Despite unprecedented long-term responses, most patients do not respond to these therapies. Immunotherapy non-responders often harbor high levels of circulating myeloid-derived suppressor cells (MDSCs)-an immunosuppressive innate cell population. Through genetic and pharmacological approaches, we uncovered a pathway governing MDSC abundance in multiple cancer types. Therapeutic liver-X nuclear receptor (LXR) agonism reduced MDSC abundance in murine models and in patients treated in a first-in-human dose escalation phase 1 trial. MDSC depletion was associated with activation of cytotoxic T lymphocyte (CTL) responses in mice and patients. The LXR transcriptional target ApoE mediated these effects in mice, where LXR/ApoE activation therapy elicited robust anti-tumor responses and also enhanced T cell activation during various immune-based therapies. We implicate the LXR/ApoE axis in the regulation of innate immune suppression and as a target for enhancing the efficacy of cancer immunotherapy in patients.