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Published on: May 2, 2025
JAK inhibition in PD-1 immunotherapy and tumor microenvironment
Ziyuan Liu1, Jiaqi Liu2, Hongyu Chu3
1Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China.
Abstract:
Targeting the programmed cell death 1 (PD-1)/PD-L1 axis has revolutionized cancer therapy; however, the durability of clinical responses is frequently compromised by chronic inflammation and an immunosuppressive tumor microenvironment (TME). The Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway serves as a central intracellular node integrating cytokine signals that drive these resistance mechanisms. While physiological JAK/STAT signaling is essential for antitumor immunity, its persistent aberrant activation promotes malignant progression, upregulates PD-L1 expression, and orchestrates an immunosuppressive landscape by recruiting myeloid-derived suppressor cells (MDSCs) and polarizing tumor-associated macrophages (TAMs) toward an M2 phenotype, ultimately leading to T cell exhaustion. This review comprehensively elucidates the multifaceted role of JAK/STAT signaling in shaping the immune architecture of both hematologic and solid tumors. We examine the molecular crosstalk between JAK/STAT activation and key immune subsets within the TME and discuss the rationale for repurposing JAK inhibitors-established agents for autoimmune disorders-as adjuvants to immunotherapy. Emerging preclinical and clinical evidence suggests that combining selective JAK inhibition with PD-1 blockade can disrupt inflammatory feedback loops, reprogram the TME, and overcome resistance to immune checkpoint inhibitors. This synergistic strategy represents a promising therapeutic frontier for improving outcomes in refractory malignancies.
Insights
Combining Janus kinase (JAK) inhibitors with PD-1 blockade may overcome cancer therapy resistance. This approach targets chronic inflammation and immunosuppressive tumor microenvironments (TME) to improve patient outcomes.
Area of Science:
- Oncology
- Immunology
- Molecular Biology
Background:
- Immune checkpoint inhibitors targeting the PD-1/PD-L1 axis have transformed cancer treatment.
- Therapeutic response durability is often limited by chronic inflammation and immunosuppressive tumor microenvironments (TME).
- The Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway integrates cytokine signals that drive resistance to cancer therapies.
Purpose of the Study:
- To elucidate the role of JAK/STAT signaling in shaping the tumor immune microenvironment (TME) in hematologic and solid tumors.
- To explore the rationale for repurposing JAK inhibitors as adjuvants to cancer immunotherapy.
- To review evidence supporting the combination of JAK inhibition and PD-1 blockade for overcoming resistance to immune checkpoint inhibitors.
Main Methods:
- Comprehensive review of preclinical and clinical evidence.
- Analysis of molecular crosstalk between JAK/STAT signaling and immune cells within the TME.
- Examination of the impact of JAK/STAT aberrant activation on malignant progression and immune evasion.
Main Results:
- Aberrant JAK/STAT activation promotes cancer progression, upregulates PD-L1, and creates an immunosuppressive TME by recruiting myeloid-derived suppressor cells (MDSCs) and polarizing macrophages.
- JAK/STAT signaling plays a multifaceted role in the immune architecture of tumors.
- Combining JAK inhibitors with PD-1 blockade shows promise in preclinical and clinical studies.
Conclusions:
- JAK/STAT signaling is a critical regulator of the tumor immune microenvironment and a key driver of resistance to immunotherapy.
- Repurposing JAK inhibitors alongside PD-1 blockade offers a promising strategy to disrupt inflammatory feedback loops and reprogram the TME.
- This synergistic approach holds potential for improving outcomes in patients with refractory malignancies.
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