Abstract B027: Molecular characterization and therapeutic approaches for VISTA+ triple-negative breast cancers
Authors: Gruber Joshua , Zhao Yan , Charles Fatima , Reddy Priyanka , Paul Kristina , Ezenwa Virginia , Juntilla Marisa , Sagiv-Barfi Idit , Peng Yan , Zhang Song , Kurian Allison , Snyder Michael 
Published: February 2024

Abstract
Introduction: VISTA (V-domain Ig suppressor of T cell activation) is a single-pass transmembrane immune checkpoint receptor that is an emerging clinical target for cancer immunotherapy. Although VISTA confers quiescence to naïve T cells, molecular mechanisms responsible for this effect remain unclear. Also, the effects of VISTA expression on tumor cells remains poorly defined. Methods: Multi-omic profiling was performed in human breast cancer cells lines to determine immune regulatory genes. Human triple-negative breast cancers (N=248) were examined by immunohistochemistry for expression of VISTA, PDL1, PD1 and FoxP3. VISTA expression was engineered into human and mouse triple-negative breast cancer cell lines and growth was characterized in vitro and in mouse models. Membrane receptor trafficking and localization of EGFR and clathrin adapters was performed in cells expressing VISTA, VISTA mutants and VISTA knockouts. Proximity biotinylation identified protein partners that interacted with VISTA’s intracellular domain. Deletion mutagenesis was performed to identify functional VISTA cytoplasmic motifs. Cytokine response and tumor growth kinetics were measured in TNBC mouse models expressing VISTA or VISTA mutants. Results: A class of human triple-negative breast cancers were identified with high VISTA expression, low tumor infiltrating lymphocytes and low proliferative index (8-20% of all TNBCs). Tumor models demonstrated that enforced expression of VISTA in tumor cells caused growth suppression, even in the absence of an immune system. This effect was mapped to the cytoplasmic domain of VISTA, which lacks defined signaling domains. Through biochemical approaches, the clathrin-adaptor molecules NUMB and GULP1 were found in complex with a VISTA intracellular NPGF motif. This motif sequestered NUMB at early endosomes, resulting in diminished NUMB recycling for EGFR endocytosis, thereby causing growth suppression. VISTA impaired NUMB recycling by blocking Rab11 effector complex formation. VISTA NPGF mutations did not disrupt cytokine secretion in mixed lymphocyte assays. VISTA-targeted antibodies did not disrupt NUMB sequestration. VISTA+ tumors were selectively sensitive to VISTA-blocking antibodies. Conclusions: VISTA+ TNBC have distinct features including slower proliferative index and increased sensitivity to VISTA-blocking antibodies. This work identifies mechanisms by which VISTA enforces a quiescent cellular state by sequestering clathrin adapter proteins away from sites of endocytosis in cancer cells. This is the first description of intracellular molecular mechanisms controlled by VISTA’s intracellular tail. It may inform features of the VISTA-dependent immune checkpoint that could be exploited to improve anti-tumor immunity. Integration of these findings with ongoing VISTA clinical trials will be discussed.
Citation Format: Joshua Gruber, Yan Zhao, Fatima Charles, Priyanka Reddy, Kristina Paul, Virginia Ezenwa, Marisa Juntilla, Idit Sagiv-Barfi, Yan Peng, Song Zhang, Allison Kurian, Michael Snyder. Molecular characterization and therapeutic approaches for VISTA+ triple-negative breast cancers [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Breast Cancer Research; 2023 Oct 19-22; San Diego, California. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_1):Abstract nr B027.