Immune surveillance of brain metastatic cancer cells is mediated by IFITM1

Abstract Brain metastasis, most commonly originating from lung cancer, increases cancer morbidity and mortality. Although metastatic colonization is the rate‐limiting and most complex step of the metastatic cascade, the underlying mechanisms are poorly understood. Here, in vivo genome‐wide CRISPR‐Cas9 screening revealed that loss of interferon‐induced transmembrane protein 1 (IFITM1) promotes brain colonization of human lung cancer cells. Incipient brain metastatic cancer cells with high expression of IFITM1 secrete microglia‐activating complement component 3 and enhance the cytolytic activity of CD8 + T cells by increasing the expression and membrane localization of major histocompatibility complex class I. After activation, microglia (of the innate immune system) and cytotoxic CD8 + T lymphocytes (of the adaptive immune system) were found to jointly eliminate cancer cells by releasing interferon‐gamma and inducing phagocytosis and T‐cell‐mediated killing. In human cancer clinical trials, immune checkpoint blockade therapy response was significantly correlated with IFITM1 expression, and IFITM1 enhanced the brain metastasis suppression efficacy of PD‐1 blockade in mice. Our results exemplify a novel mechanism through which metastatic cancer cells overcome the innate and adaptive immune responses to colonize the brain, and suggest that a combination therapy increasing IFITM1 expression in metastatic cells with PD‐1 blockade may be a promising strategy to reduce metastasis.