IMMU-45. MYELOID-ASSOCIATED WILD-TYPE IDH1 PROMOTES IMMUNOSUPPRESSION IN GLIOBLASTOMA

Abstract Tumor-associated myeloid cells (TAMCs) promote immunosuppression in the GBM tumor microenvironment (TME) and resistance to immune checkpoint therapy (ICT). However, the metabolic and epigenetic mechanisms underlying TAMC activation and the therapeutic potential of fine-tuning TAMC activation remain largely unexplored. Our analyses of GBM patient single-cell RNA sequencing (scRNA-Seq) datasets demonstrated that in addition to tumor cells, wild-type isocitrate dehydrogenase (wt-IDH1) is also highly expressed in TAMCs. Using a murine model with myeloid cell-specific deletion of wt-IDH1 (LysM-cre-ERT2; wt-IDH1L/L), we demonstrated that the loss of wt-IDH1 promoted inflammatory myeloid phenotypes, increased CD8+ T cells in the TME, improved survival of GBM tumor-bearing mice, and enhanced anti-tumor effects of PD1 checkpoint blockade. Further, the pharmacological inhibition of wt-IDH1 using systemic administration of a first-in-class wt-IDH1-specific, brain-penetrant small molecule inhibitor or intrathecal delivery of siRNA targeted to wt-IDH1 mirrored the functional phenotype of wt-IDH1-deleted myeloid cells, overcame ICT resistance, and promoted long-term survival and anti-tumor immune memory. Mechanistically, in myeloid cells, the genetic or pharmacological inactivation of wt-IDH1 inhibited oxidative phosphorylation, reduced myeloid cell proliferation, increased their tumoricidal activity, and altered chromatin accessibility of key transcription factors implicated in the regulation of myeloid cell states, including AP-1, IRFs, STAT1/2, NFATs, and CEPBPs. These studies define wt-IDH1 as a metabolic checkpoint of myeloid cell activation and credential the inhibition of wt-IDH1 as a novel immunotherapeutic strategy to increase ICT efficacy for patients with GBM.