Data Availability Sequence data used during the study will be deposited at the European Genome-phenome Archive (EGA), which is hosted by The European Bioinformatics Institute (EBI) and the Centre for Genomic Regulation (CRG) under the accession code: EGAS00001003458. Further information about EGA can be found at https://ega-archive.org.

SummaryFocal adhesion kinase (FAK) promotes anti-tumor immune evasion. Specifically, the kinase activity of nuclear-targeted FAK in squamous cell carcinoma (SCC) cells drives exhaustion of CD8+ T cells and recruitment of regulatory T cells (Tregs) in the tumor microenvironment by regulating chemokine/cytokine and ligand-receptor networks, including via transcription of Ccl5, which is crucial. These changes inhibit antigen-primed cytotoxic CD8+ T cell activity, permitting growth of FAK-expressing tumors. Mechanistically, nuclear FAK is associated with chromatin and exists in complex with transcription factors and their upstream regulators that control Ccl5 expression. Furthermore, FAK’s immuno-modulatory nuclear activities may be specific to cancerous squamous epithelial cells, as normal keratinocytes do not have nuclear FAK. Finally, we show that a small-molecule FAK kinase inhibitor, VS-4718, which is currently in clinical development, also drives depletion of Tregs and promotes a CD8+ T cell-mediated anti-tumor response. Therefore, FAK inhibitors may trigger immune-mediated tumor regression, providing previously unrecognized therapeutic opportunities.

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Fig. 1. Immune cell infiltration of lung carcinoma-in-situ lesions. (a-b) Immunohistochemistry images of (a) progressive CIS lesion and (b) regressive CIS lesion with CD4+ cells stained in brown, CD8+ cells in red and FOXP3+ in blue. Immune cells are separately quantified within the CIS lesion and in the surrounding stroma. c) Combined quantitative immunohistochemistry data of CD4, CD8 and FOXP3 staining (n=44; 28 progressive, 16 regressive) with total lymphocyte quantification from H&E images (n=116; 69 progressive, 47 regressive) shown. We observe increased lymphocytes (p=0.023) and CD8+ cells (p=0.037) per unit area of epithelium within regressive CIS lesions compared to progressive. Stromal regions adjacent to CIS lesions showed no significant differences in immune cells between progressive and regressive lesions. p-values are calculated using linear mixed effects models to account for samples from the same patient; *p<0.05. 2 | bioRχiv Pennycuick et al. | Immune surveillance in clinical regression of pre-invasive squamous cell lung cancer .

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Highlights d 115 pre-and post-nivolumab multiregion tumor samples in a prospective phase II study d Maintenance of pre-treatment expanded TCR clones associates with response d Expanded CD8 + T cells upregulate GZMB/K in responders d HERV expression reflects tumor purity and indirectly correlates with response

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