Immunotherapies targeting the oncogenic fusion gene CLDN18-ARHGAP in gastric cancer

EMBO Mol Med. 2024 Sep;16(9):2170-2187. doi: 10.1038/s44321-024-00120-3. Epub 2024 Aug 20.

Abstract

The CLDN18-ARHGAP fusion gene is an oncogenic driver newly discovered in gastric cancer. It was detected in 9% (8/87) of gastric cancer patients in our center. An immunogenic peptide specifically targeting CLDN18-ARHGAP fusion gene was generated to induce neoantigen-reactive T cells, which was proved to have specific and robust anti-tumor capacity both in in vitro coculture models and in vivo xenograft gastric cancer models. Apart from the immunogenic potential, CLDN18-ARHGAP fusion gene was also found to contribute to immune suppression by inducing a regulatory T (Treg) cell-enriched microenvironment. Mechanistically, gastric cancer cells with CLDN18-ARHGAP fusion activate PI3K/AKT-mTOR-FAS signaling, which enhances free fatty acid production of gastric cancer cells to favor the survival of Treg cells. Furthermore, PI3K inhibition could effectively reverse Treg cells upregulation to enhance anti-tumor cytotoxicity of neoantigen-reactive T cells in vitro and reduce tumor growth in the xenograft gastric cancer model. Our study identified the CLDN18-ARHGAP fusion gene as a critical source of immunogenic neoepitopes, a key regulator of the tumor immune microenvironment, and immunotherapeutic applications specific to this oncogenic fusion.

Keywords: CLDN18-ARHGAP; Fusion Gene; Gastric Cancer; Immunotherapy; Neoantigen.

MeSH terms

  • Animals
  • Cell Line, Tumor
  • Claudins* / genetics
  • Claudins* / metabolism
  • GTPase-Activating Proteins / genetics
  • GTPase-Activating Proteins / metabolism
  • Humans
  • Immunotherapy* / methods
  • Mice
  • Oncogene Proteins, Fusion / genetics
  • Oncogene Proteins, Fusion / immunology
  • Oncogene Proteins, Fusion / metabolism
  • Stomach Neoplasms* / genetics
  • Stomach Neoplasms* / immunology
  • Stomach Neoplasms* / pathology
  • T-Lymphocytes, Regulatory / immunology
  • Tumor Microenvironment / immunology

Substances

  • CLDN18 protein, human
  • Claudins
  • GTPase-Activating Proteins
  • Oncogene Proteins, Fusion