Alternative splicing: A key regulator in T cell response and cancer immunotherapy
C.-C. Yong, Yexin Liang, Minmin Wang, Weiwei Jin, Xuefei Fan, Zhengwen Wang, Kui Cao, Tong Wu, Qian Li, Cunjie Chang
Abstract
Alternative splicing (AS), a key post-transcriptional regulatory mechanism, is frequently dysregulated in cancer, driving both tumor progression and immune modulation. Aberrant AS influences antigen presentation, T cell activation, immune checkpoint regulation, and cytokine signaling, contributing to immune evasion but also presenting unique therapeutic vulnerabilities. Targeting AS has emerged as a promising strategy in cancer immunotherapy. Splicing-derived neoantigens have been identified as potent inducers of CD8⁺ T cell responses, offering potential for personalized treatment. AS modulators such as PRMT5 inhibitor GSK3326595 enhance immunotherapy efficacy by upregulating MHC class II expression and promoting T cell infiltration, while RBM39 inhibitor indisulam induces tumor-specific neoantigens. Furthermore, combining AS-targeting drugs with immune checkpoint inhibitors (ICIs) has demonstrated synergistic effects, improved response rates and overcoming resistance in preclinical models. Despite these advances, challenges remain in optimizing drug specificity and minimizing toxicity. Future efforts should focus on refining AS-targeting therapies, identifying predictive biomarkers, and integrating these approaches into clinical applications. This review highlights the therapeutic potential of AS modulation in cancer immunotherapy and its implications for advancing precision oncology. Figure. AS in T cell Response. • This study shows AS shapes immune cell function, influencing their development and immune response regulation. • This study shows AS generates neoantigens, offering unique potential for personalized cancer therapy and expanding immunotherapy applications. • This study reviews AS modulator drugs targeting splicing factors in immunotherapy, offering new strategies to boost immune responses.