HDAC6 Inhibition Activates Proteasomes to Modulate the MHC Class I Immunopeptidome and Promote Antimyeloma Immunity

The evasion of host immunity is a hallmark of cancer. Tumor cells develop strategies to evade host immunity and to resist currently available immunotherapies, while others present a low tumor mutation burden limiting the presence of tumor antigenicity. Proteasomes are exquisitely complex, intricately regulated protein-degrading machines that are responsible for the overwhelming majority of intracellular proteolysis in eukaryotic cells. Proteasomes are also essential for the efficient processing of intracellular proteins to generate antigenic epitopes that complex with MHC-class I molecules and are displayed on antigen-presenting cells (APCs) to activate CD8 ⁺ cytotoxic T-lymphocytes (CTLs). We hypothesized that pharmacologic activation of proteasomes would modulate the tumor immunopeptidome to increase MHC class I antigen presentation and promote CTL activity. Here, we developed a cell-based, high-throughput screen (HTS) to identify FDA-approved pharmacologics and bioactive molecules that increased proteasomal activity to promote the presentation of MHC class I antigens. The HTS revealed that the histone deacetylase 6 (HDAC6)-selective inhibitors tubastatin-A, ACY-738 and ACY-1215 increased proteasome activity in a panel of multiple myeloma (MM) cell lines. The HDAC6 inhibitors also significantly enhanced MHC-class I antigen presentation pan-MHC class-I expression in a diverse panel of cancer cell lines. Pretreatment of MM patient CD138 ⁺ tumor cells with HDAC6 inhibitors promoted the cytotoxic activity of autologous patient-derived T-cells. Mechanistic studies revealed that pharmacologic blockade or genetic ablation of HDAC6 or the HDAC6 ubiquitin-binding (BUZ) domain disrupted the association of HDAC6 with the ubiquitin-like protein HR23B, a substrate-shuttle factor that delivers ubiquitinylated cargo to proteasomes. Taken together, the results validate the HDAC6-BUZ domain as an attractive drug discovery target and demonstrate the immediate translational impact of proteasome activators to modulate the immunopeptidome and enhance antitumor immunity. Proteasome activators also represent a paradigm-shifting approach to overcome mechanisms of immune escape. FDA-approved drugs that increase proteasome activity and boost antigen presentation can now be repositioned as cancer immunotherapeutics to overcome the existing bottlenecks in drug development.