Bouhlal, J.; Jokinen, E.; Nygren, P.; Dias, D.; Ianevski, A.; Klievink, J.; Lähteenmäki, H.; Decombis, S.; Duan, H.; Järvelä, E.; Saarinen, E.; Näätänen, A.; Matjusinski, K.; Kasanen, T.; Hannunen, T.; Turunen, L.; Myllymäki, M.; Laajala, E.; Schenkwein, D.; Ylä-Herttuala, S.; Flagship, i.; Lee, D. A.; Korhonen, M.; Göös, H.; Aittokallio, T.; Hollmen, M.; Mitsiades, C.; Gandolfi, S.; Dufva, O.; Mustjoki, S.

Natural killer (NK) cell-based therapies are a promising approach in cancer, but their efficacy is limited by impaired effector function and tumor-intrinsic resistance. To systematically identify therapeutic strategies that target both sides of the cancer-immune interface, we designed a multimodal immunopharmacologic screening platform comprising high-throughput co-culture drug screens, cytokine secretome profiling, single-cell perturbation screens, and genome-scale CRISPR screening, followed by validation in biobanked patient-derived models. Applying the platform across five blood cancer types, we identified protein kinase C (PKC) activation to simultaneously increase effector cytotoxicity and cytokine secretion through transcriptomic rewiring, and tumor susceptibility to NK cell killing through tumor-intrinsic PKC-{delta}. In patient samples, PKC activation sensitized NK-resistant leukemic progenitors to NK cell killing. In addition, NEDD8 inhibition enhanced NK function and shifted tumor TNF signaling towards pro-apoptotic pathways. Our platform provides a systematic approach to identify drugs rewiring both sides of the cancer-immune interface to circumvent tumor immune resistance.