Deciphering the Immunomodulatory Role of Cyclin-Dependent Kinase 4/6 Inhibitors in the Tumor Microenvironment

Cancer is characterized by persistent cell proliferation driven by aberrant cell cycle regulation and stimulation of cyclin-dependent kinases (CDKs). A very intriguing and potential approach for the development of antitumor medicines is the suppression of CDKs that lead to induction of apoptosis and cell cycle arrest. The shift of the cell cycle from the G0/G1 phase to the S phase, which is characterized by active transcription and synthesis, depends on the development of the cyclin D-CDK4/6 complex. A precise balance between anticancer activity and general toxicity is demonstrated by CDK inhibitors, which can specifically block CDK4/6 and control the cell cycle by reducing the G1 to S phase transition. CDK4/6 inhibitors have recently been reported to exhibit significant cell growth inhibition via modulating the tumour microenvironment in cancerous cells. One significant new understanding is that these inhibitors serve important functions in the interaction among tumour cells and the host immune system in addition to being cytostatic. Herein, we discuss the biological significance of CDK4/6 inhibitors in cancer therapeutics, as well as their biological impact on T cells and other important immune cells. Furthermore, we explore the integration of preclinical findings of these pharmaceuticals’ ability to enhance antitumor immunity.

[1]  U. Surana,et al.  DNA damage checkpoint execution and the rules of its disengagement , 2022, Frontiers in Cell and Developmental Biology.

[2]  Muhammad Bilal Ahmed,et al.  The Complex Roles of DNA Repair Pathways, Inhibitors, Hyperthermia, and Contact Inhibition in Cell Cycle Halts. , 2022, Mini reviews in medicinal chemistry.

[3]  S. Baker,et al.  CDK4: a master regulator of the cell cycle and its role in cancer , 2022, Genes & cancer.

[4]  K. Griffith,et al.  Phase I trial of ribociclib with platinum chemotherapy in ovarian cancer , 2022, JCI insight.

[5]  F. Relaix,et al.  From cyclins to CDKIs: Cell cycle regulation of skeletal muscle stem cell quiescence and activation. , 2022, Experimental cell research.

[6]  D. Bashash,et al.  Cyclins and cyclin-dependent kinases: from biology to tumorigenesis and therapeutic opportunities , 2022, Journal of Cancer Research and Clinical Oncology.

[7]  Daeui Park,et al.  Additive Effect of CD73 Inhibitor in Colorectal Cancer Treatment With CDK4/6 Inhibitor Through Regulation of PD-L1 , 2022, Cellular and molecular gastroenterology and hepatology.

[8]  A. Welm,et al.  CDK/cyclin dependencies define extreme cancer cell-cycle heterogeneity and collateral vulnerabilities , 2022, Cell reports.

[9]  C. Welter,et al.  Origin of Cancer: Cell work is the Key to Understanding Cancer Initiation and Progression , 2022, Frontiers in Cell and Developmental Biology.

[10]  A. Bardia,et al.  Mechanisms of Resistance to CDK4/6 Blockade in Advanced Hormone Receptor-Positive, HER2-Negative Breast Cancer and Emerging Therapeutic Opportunities. , 2021, Clinical cancer research : an official journal of the American Association for Cancer Research.

[11]  Pravir Kumar,et al.  Regulatory mechanism of cyclins and cyclin-dependent kinases in post-mitotic neuronal cell division. , 2021, Life sciences.

[12]  Helen K. Matthews,et al.  Cell cycle control in cancer , 2021, Nature Reviews Molecular Cell Biology.

[13]  Zhi-Yuan Zhang,et al.  Targeting cyclin-dependent kinase 4/6 as a therapeutic approach for mucosal melanoma , 2021, Melanoma research.

[14]  P. Jänne,et al.  Abemaciclib in Combination With Pembrolizumab for Stage IV KRAS-Mutant or Squamous NSCLC: A Phase 1b Study , 2021, JTO clinical and research reports.

[15]  A. Giordano,et al.  CDK4, CDK6/cyclin-D1 Complex Inhibition and Radiotherapy for Cancer Control: A Role for Autophagy , 2021, International journal of molecular sciences.

[16]  C. Presant,et al.  Phase I/II trial of palbociclib, pembrolizumab and letrozole in patients with hormone receptor-positive metastatic breast cancer. , 2021, European journal of cancer.

[17]  Hao Hu,et al.  The Influence of Cell Cycle Regulation on Chemotherapy , 2021, International journal of molecular sciences.

[18]  P. Fasching,et al.  Ribociclib plus fulvestrant for postmenopausal women with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer in the phase 3 randomized MONALEESA-3 trial: updated overall survival. , 2021, Annals of oncology : official journal of the European Society for Medical Oncology.

[19]  J. Sandow,et al.  CDK4/6 inhibition promotes anti-tumor immunity through the induction of T cell memory. , 2021, Cancer discovery.

[20]  G. McArthur,et al.  Immunomodulatory Effects of BRAF, MEK, and CDK4/6 Inhibitors: Implications for Combining Targeted Therapy and Immune Checkpoint Blockade for the Treatment of Melanoma , 2021, Frontiers in Immunology.

[21]  Q. Zheng,et al.  CDK inhibitors in cancer therapy, an overview of recent development. , 2021, American journal of cancer research.

[22]  R. Poon Cell Cycle Control: A System of Interlinking Oscillators. , 2021, Methods in molecular biology.

[23]  S. Burgos,et al.  Differential Regulation of Cancer Progression by CDK4/6 Plays a Central Role in DNA Replication and Repair Pathways , 2020, Cancer Research.

[24]  Y. Bang,et al.  Safety and Clinical Activity of a New Anti-PD-L1 Antibody as Monotherapy or Combined with Targeted Therapy in Advanced Solid Tumors: The PACT Phase Ia/Ib Trial , 2020, Clinical Cancer Research.

[25]  Venkatraman Manickam,et al.  Transcriptional cyclin-dependent kinases as the mediators of inflammation-a review. , 2020, Gene.

[26]  W. Tan,et al.  Novel Therapeutic Strategies for CDK4/6 Inhibitors in Metastatic Castrate-Resistant Prostate Cancer , 2020, OncoTargets and therapy.

[27]  T. Owonikoko,et al.  CDK4/6 inhibition enhances antitumor efficacy of chemotherapy and immune checkpoint inhibitor combinations in preclinical models and enhances T-cell activation in patients with SCLC receiving chemotherapy , 2020, Journal for ImmunoTherapy of Cancer.

[28]  Hong Yang,et al.  CDK4/6 inhibition promotes immune infiltration in ovarian cancer and synergizes with PD-1 blockade in a B cell-dependent manner , 2020, Theranostics.

[29]  U. Matulonis,et al.  Combined CDK4/6 and PD-1 Inhibition in Refractory SMARCA4-Deficient Small-Cell Carcinoma of the Ovary, Hypercalcemic Type. , 2020, JCO precision oncology.

[30]  V. Sexl,et al.  The role of CDK6 in cancer , 2020, International journal of cancer.

[31]  E. Winer,et al.  The genomic landscape of intrinsic and acquired resistance to cyclin-dependent kinase 4/6 inhibitors in patients with hormone receptor positive metastatic breast cancer. , 2020, Cancer discovery.

[32]  M. Malumbres,et al.  Mechanisms of Sensitivity and Resistance to CDK4/6 Inhibition. , 2020, Cancer cell.

[33]  M. Sablin,et al.  CDK4/6 inhibitors in P16/HPV16-negative squamous cell carcinoma of the head and neck , 2020, European Archives of Oto-Rhino-Laryngology.

[34]  Ç. Biray Avcı,et al.  Alterations of cell cycle genes in cancer: unmasking the role of cancer stem cells , 2020, Molecular Biology Reports.

[35]  Xueliang Gao,et al.  Cyclin D-CDK4/6 functions in cancer. , 2020, Advances in cancer research.

[36]  D. Barford Structural interconversions of the anaphase-promoting complex/cyclosome (APC/C) regulate cell cycle transitions. , 2019, Current opinion in structural biology.

[37]  Zhou Zhu,et al.  Biomarker Analyses of Response to Cyclin-Dependent Kinase 4/6 Inhibition and Endocrine Therapy in Women with Treatment-Naïve Metastatic Breast Cancer , 2019, Clinical Cancer Research.

[38]  D. Gerlich,et al.  Mitotic Chromosome Mechanics: How Cells Segregate Their Genome. , 2019, Trends in cell biology.

[39]  K. Flaherty,et al.  Genetic Aberrations in the CDK4 Pathway Are Associated with Innate Resistance to PD-1 Blockade in Chinese Patients with Non-Cutaneous Melanoma , 2019, Clinical Cancer Research.

[40]  R. Bonecchi,et al.  Chemokines and Chemokine Receptors: New Targets for Cancer Immunotherapy , 2019, Front. Immunol..

[41]  R. Roskoski Cyclin-dependent protein serine/threonine kinase inhibitors as anticancer drugs. , 2019, Pharmacological research.

[42]  S. Goel,et al.  CDK4/6 Inhibition in Cancer: Beyond Cell Cycle Arrest. , 2018, Trends in cell biology.

[43]  A. Aplin,et al.  Arrested Developments: CDK4/6 Inhibitor Resistance and Alterations in the Tumor Immune Microenvironment , 2018, Clinical Cancer Research.

[44]  Juanita Lopez,et al.  To Cycle or Fight—CDK4/6 Inhibitors at the Crossroads of Anticancer Immunity , 2018, Clinical Cancer Research.

[45]  Maryam Abbastabar,et al.  Multiple functions of p27 in cell cycle, apoptosis, epigenetic modification and transcriptional regulation for the control of cell growth: A double-edged sword protein. , 2018, DNA repair.

[46]  T. Helikar,et al.  Simulation of Stimulation: Cytokine Dosage and Cell Cycle Crosstalk Driving Timing-Dependent T Cell Differentiation , 2018, Front. Physiol..

[47]  J. Sage,et al.  Beyond the Cell Cycle: Enhancing the Immune Surveillance of Tumors Via CDK4/6 Inhibition , 2018, Molecular Cancer Research.

[48]  Hae-Chul Park,et al.  Targeting Cyclin D-CDK4/6 Sensitizes Immune-Refractory Cancer by Blocking the SCP3-NANOG Axis. , 2018, Cancer research.

[49]  E. Rasmussen,et al.  The CDK4/6 Inhibitor Abemaciclib Induces a T Cell Inflamed Tumor Microenvironment and Enhances the Efficacy of PD-L1 Checkpoint Blockade. , 2018, Cell reports.

[50]  S. Goff,et al.  Cyclin-dependent kinase activity is required for type I interferon production , 2017, Proceedings of the National Academy of Sciences.

[51]  G. Freeman,et al.  Cyclin D-CDK4 kinase destabilizes PD-L1 via Cul3SPOP to control cancer immune surveillance , 2017, Nature.

[52]  C. Paweletz,et al.  CDK4/6 Inhibition Augments Antitumor Immunity by Enhancing T-cell Activation. , 2017, Cancer discovery.

[53]  Amareshwar T. K. Singh,et al.  Cell-cycle Checkpoints and Aneuploidy on the Path to Cancer. , 2018, In vivo.

[54]  Volker Brinkmann,et al.  Cell-Cycle Proteins Control Production of Neutrophil Extracellular Traps. , 2017, Developmental cell.

[55]  S. Loi,et al.  Combined CDK4/6 and PI3Kα Inhibition Is Synergistic and Immunogenic in Triple-Negative Breast Cancer. , 2017, Cancer research.

[56]  M. Ellis,et al.  CDK4/6 inhibition triggers anti-tumor immunity , 2017, Nature.

[57]  A. Bardia,et al.  Clinical Management of Potential Toxicities and Drug Interactions Related to Cyclin‐Dependent Kinase 4/6 Inhibitors in Breast Cancer: Practical Considerations and Recommendations , 2017, The oncologist.

[58]  P. Neven,et al.  MONARCH 2: Abemaciclib in Combination With Fulvestrant in Women With HR+/HER2- Advanced Breast Cancer Who Had Progressed While Receiving Endocrine Therapy. , 2017, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[59]  Jacob T. Sanders,et al.  Genome organization during the cell cycle: unity in division , 2017, Wiley interdisciplinary reviews. Systems biology and medicine.

[60]  P. Workman,et al.  Inhibitors of cyclin‐dependent kinases as cancer therapeutics , 2017, Pharmacology & therapeutics.

[61]  Kwok-Kin Wong,et al.  MUC1-C INTEGRATES PD-L1 INDUCTION WITH REPRESSION OF IMMUNE EFFECTORS IN NON-SMALL CELL LUNG CANCER , 2017, Oncogene.

[62]  J. Diehl,et al.  Cyclin D1, cancer progression, and opportunities in cancer treatment , 2016, Journal of Molecular Medicine.

[63]  R. Finn,et al.  Treating cancer with selective CDK4/6 inhibitors , 2016, Nature Reviews Clinical Oncology.

[64]  S. Levy,et al.  Connecting the Dots: Therapy-Induced Senescence and a Tumor-Suppressive Immune Microenvironment. , 2016, Journal of the National Cancer Institute.

[65]  C. Barnett,et al.  Cyclin‐Dependent Kinase Inhibitors for the Treatment of Breast Cancer: Past, Present, and Future , 2016, Pharmacotherapy.

[66]  Tuan S. Nguyen,et al.  Efficacy and Safety of Abemaciclib, an Inhibitor of CDK4 and CDK6, for Patients with Breast Cancer, Non-Small Cell Lung Cancer, and Other Solid Tumors. , 2016, Cancer discovery.

[67]  M. Schmitz,et al.  Cyclin-Dependent Kinases as Coregulators of Inflammatory Gene Expression. , 2016, Trends in pharmacological sciences.

[68]  E. Buchbinder,et al.  CTLA-4 and PD-1 Pathways , 2016, American journal of clinical oncology.

[69]  C. O'Sullivan Overcoming Endocrine Resistance in Hormone-Receptor Positive Advanced Breast Cancer-The Emerging Role of CDK4/6 Inhibitors , 2015, International journal of cancer and clinical research.

[70]  Agnieszka K. Witkiewicz,et al.  The history and future of targeting cyclin-dependent kinases in cancer therapy , 2015, Nature Reviews Drug Discovery.

[71]  P. Kaldis,et al.  Cdks, cyclins and CKIs: roles beyond cell cycle regulation , 2013, Development.

[72]  A. Giordano,et al.  Emerging roles of RB family: New defense mechanisms against tumor progression , 2013, Journal of cellular physiology.

[73]  G. Bishop,et al.  CDK-Mediated Regulation of Cell Functions via c-Jun Phosphorylation and AP-1 Activation , 2011, PloS one.

[74]  D. Hanahan,et al.  Hallmarks of Cancer: The Next Generation , 2011, Cell.

[75]  M. Barbacid,et al.  Cell cycle, CDKs and cancer: a changing paradigm , 2009, Nature Reviews Cancer.

[76]  G. Hu,et al.  A requirement for cyclin-dependent kinase 6 in thymocyte development and tumorigenesis. , 2009, Cancer research.

[77]  D. Koller,et al.  The Immunological Genome Project: networks of gene expression in immune cells , 2008, Nature Immunology.

[78]  J. Sage,et al.  Cellular mechanisms of tumour suppression by the retinoblastoma gene , 2008, Nature Reviews Cancer.

[79]  Carlos Cordon-Cardo,et al.  Senescence and tumour clearance is triggered by p53 restoration in murine liver carcinomas , 2007, Nature.

[80]  G. Shapiro,et al.  Cyclin-dependent kinase pathways as targets for cancer treatment. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[81]  Pierre Dubus,et al.  Mammalian Cells Cycle without the D-Type Cyclin-Dependent Kinases Cdk4 and Cdk6 , 2004, Cell.

[82]  J. Biggs,et al.  Inhibitors of cyclin-dependent kinase and cancer , 1995, Journal of Molecular Medicine.

[83]  P. Nurse,et al.  NOBEL LECTURE: Cyclin Dependent Kinases and Cell Cycle Control , 2002 .

[84]  F. Kaye,et al.  RB and cyclin dependent kinase pathways: defining a distinction between RB and p16 loss in lung cancer , 2002, Oncogene.

[85]  L. Hartwell NOBEL LECTURE: Yeast and Cancer , 2002, Bioscience reports.

[86]  S. Lowe,et al.  Oncogenic ras and p53 Cooperate To Induce Cellular Senescence , 2002, Molecular and Cellular Biology.

[87]  M. Barbacid,et al.  Cyclin D-dependent kinases, INK4 inhibitors and cancer. , 2002, Biochimica et biophysica acta.

[88]  J. Diehl Cycling to Cancer with Cyclin D1 , 2002, Cancer biology & therapy.

[89]  P. Nurse,et al.  Cyclin Dependent Kinases and Cell Cycle Control , 2002 .

[90]  C. Martínez-A,et al.  Cell-cycle regulation in immunity, tolerance and autoimmunity. , 2000, Immunology today.

[91]  Chyung-Ru Wang,et al.  Helper T cell differentiation is controlled by the cell cycle. , 1998, Immunity.