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Glucocorticoids unleash immune-dependent melanoma control through inhibition of the GARP/TGF β axis

Earnshaw, C. H.
Dunn, P.
Chiang, S. C.
Moeini, A.
Koufaki, M. A.
Bonavita, E.
Russo, M.
Nebot-Bral, L.
Hockenhull, K.
Richardson, E.
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Abstract
Half of patients with advanced melanoma fail to benefit from immune checkpoint blockade, and novel treatments are urgently required. Testing topical medications for anticancer activity in an immunotherapy-resistant murine melanoma model, we found that, counterintuitively, glucocorticoids (GCs) elicit rapid cytotoxic T lymphocyte (CTL)-dependent tumor control. Genetic ablation of the GC receptor in different cellular compartments revealed that GCs acted not on immune cells but directly on tumor cells to downregulate the expression of glycoprotein A repetitions predominant (GARP). This inhibited TGF β signaling and unleashed CTL killing. In agreement, GCs stimulated tumor control in multiple cancer models but only if the tumors also responded to pharmacologic inhibition of TGF β signaling. Furthermore, patients with melanoma with high GC receptor expression or signaling showed improved prognosis and lower TGF β signaling in tumor-infiltrating CTLs. Additionally, elevated GARP expression correlated with reduced survival, including in immunotherapy-treated patients. Thus, the GARP/TGF β axis emerges as a GC-sensitive cancer cell-intrinsic immune-evasive mechanism. SIGNIFICANCE: This study uncovers a surprising role for GCs in triggering CD8+ T cell-dependent tumor control through downregulation of GARP and thus TGF β signaling. Analysis of samples from patients with melanoma suggested that GARP expression may serve as both a biomarker of poor antitumor immunity and a therapeutic target to improve the response to immunotherapy.
Affiliation
Cancer Inflammation and Immunity Group, Cancer Research UK Manchester Institute, The University of Manchester, Manchester, United Kingdom. Dermatology Centre, Northern Care Alliance NHS Foundation Trust & Division of Musculoskeletal and Dermatological Sciences, Manchester NIHR Biomedical Research Centre, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom. Visualisation, Irradiation and Analysis, Cancer Research UK Manchester Institute, The University of Manchester, Manchester, United Kingdom. Computational Biology Support, Cancer Research UK Manchester Institute, The University of Manchester, Manchester, United Kingdom. Cancer Research UK National Biomarker Centre, The University of Manchester, Manchester, United Kingdom. Cancer Research UK Lung Cancer Centre of Excellence, Manchester, United Kingdom. Biostatistics Research Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom. Small Cell Lung Cancer Biology Group, Cancer Research UK Manchester Institute, The University of Manchester, Manchester, United Kingdom. Institute of Medical Research at St. James's, University of Leeds, Leeds, United Kingdom. NIHR Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Trust, Newcastle, United Kingdom. Department of Dermatology, King's College Hospital, King's College London, London, United Kingdom. Lydia Becker Institute of Immunology and Inflammation, The University of Manchester, Manchester, United Kingdom.
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2025
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Article
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Earnshaw CH, Dunn P, Chiang SC, Moeini A, Koufaki MA, Bonavita E, et al. Glucocorticoids Unleash Immune-dependent Melanoma Control through Inhibition of the GARP/TGF β Axis. Cancer discovery. 2025 Oct 14:OF1-OF22. PubMed PMID: 41086837. Pubmed Central PMCID: PMC7618275. Epub 2025/10/15. eng.
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