The nonsteroidal anti-inflammatory drug sulindac reverses obesity-driven immunosuppression and triple-negative breast cancer progression
By: Coleman, Michael F., McDonell, Shannon B., Eisenbeis, Lydia K., Devericks, Emily N., Chandi, Jobin, Dave, Om, Pearce, Jane B., Wang, Sylvia, Cody, Morgan, Bustamante-Marin, Ximena M., Glenny, Elaine M., Rezeli, Erika T., Cozzo, Alyssa J., O’Flanagan, Ciara H., Bathon, Brooke E., Shaikh, Saame Raza, Milne, Ginger L., Wendt, Michael K., Lanman, Nadia A., Teegarden, Dorothy, Hursting, Stephen D.

BioMed Central
2025-10-24; doi: 10.1186/s13058-025-02134-2

Abstract

Obesity affects over 40% of women in the US and increases the risk and progression of several cancers, including triple-negative breast cancer (TNBC), in part through chronic low-grade inflammation and impaired antitumor immunity. While weight loss can reverse obesity-driven cancer risk, cost and other factors limit the accessibility of effective weight loss interventions. This study investigated whether sulindac, a nonsteroidal anti-inflammatory drug (NSAID), could mitigate obesity-driven TNBC progression. Using multiple preclinical models, we demonstrate that sulindac treatment abrogates obesity-accelerated tumor growth and metastasis without affecting body weight or composition. Bulk transcriptomic profiling revealed obesity-driven suppression of immune-related gene signatures in the tumor microenvironment (TME)—including antigen presentation—while sulindac treatment restored these signatures. Single-cell RNA sequencing identified sulindac-mediated reprogramming of tumoral metabolism toward oxidative phosphorylation and restoration of antigen presentation machinery in tumor-associated macrophages. Sulindac also reversed obesity-driven reduction in T cell receptor diversity within the TME. We conclude that sulindac treatment remodels the TME and restores obesity-associated impairments of immunosurveillance, offering a potentially accessible intervention to limit obesity-driven TNBC progression. We demonstrate that NSAIDs, which are generally safe, cheap, and readily available, limit the burden of obesity-driven TNBC preclinically, warranting further evaluation as a targeted clinical intervention.

AbstractSection Graphical abstract




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