Stromal Reprogramming through Dual PDGFRα/β Blockade Boosts the Efficacy of Anti-PD-1 Immunotherapy in Fibrotic Tumors

Takahiko Akiyama, Tadahito Yasuda, Tomoyuki Uchihara, Noriko Yasuda-Yoshihara, Benjy J.Y. Tan, Atsuko Yonemura, Takashi Semba, Juntaro Yamasaki, Yoshihiro Komohara, Koji Ohnishi, Feng Wei, Lingfeng Fu, Jun Zhang, Fumimasa Kitamura, Kohei Yamashita, Kojiro Eto, Shiro Iwagami, Hirotake Tsukamoto, Terumasa Umemoto, Mari MasudaOsamu Nagano, Yorifumi Satou, Hideyuki Saya, Patrick Tan, Hideo Baba, Takatsugu Ishimoto

Research output: Contribution to journalArticlepeer-review


Excess stroma and cancer-associated fibroblasts (CAF) enhance cancer progression and facilitate immune evasion. Insights into the mechanisms by which the stroma manipulates the immune microenvironment could help improve cancer treatment. Here, we aimed to elucidate potential approaches for stromal reprogramming and improved cancer immunotherapy. Platelet-derived growth factor C (PDGFC) and D expression were significantly associated with a poor prognosis in patients with gastric cancer, and PDGF receptor beta (PDGFRβ) was predominantly expressed in diffuse-type gastric cancer stroma. CAFs stimulated with PDGFs exhibited markedly increased expression of CXCL1, CXCL3, CXCL5, and CXCL8, which are involved in polymorphonuclear myeloid-derived suppressor cell (PMN-MDSC) recruitment. Fibrotic gastric cancer xenograft tumors exhibited increased PMN-MDSC accumulation and decreased lymphocyte infiltration, as well as resistance to anti-PD-1. Single-cell RNA sequencing and spatial transcriptomics revealed that PDGFRα/β blockade reversed the immunosuppressive microenvironment through stromal modification. Finally, combining PDGFRα/β blockade and anti-PD-1 treatment synergistically suppressed the growth of fibrotic tumors. These findings highlight the impact of stromal reprogramming on immune reactivation and the potential for combined immunotherapy for patients with fibrotic cancer. SIGNIFICANCE: Stromal targeting with PDGFRα/β dual blockade reverses the immunosuppressive microenvironment and enhances the efficacy of immune checkpoint inhibitors in fibrotic cancer. See related commentary by Tauriello, p. 655.

Original languageEnglish
Pages (from-to)753-770
Number of pages18
JournalCancer Research
Issue number5
Publication statusPublished - 2023 Mar 2

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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