Site-specific immunogenicity and anti-PD1 response in mismatch repair deficient lung adenocarcinoma models

Immunotherapy has revolutionized cancer treatment, yet responses vary significantly based on tumour characteristics and microenvironment. Here, we developed and analysed subcutaneous and orthotopic immunocompetent mice models of mismatch repair-deficient (dMMR) lung adenocarcinoma (LUAD) by selectively ablating Mlh1. Subcutaneous tumours demonstrated partial sensitivity to anti-PD1 therapy, characterized by tumour volume reduction without significant changes in immune infiltration. In contrast, orthotopic tumours exhibited robust responses, with substantial reductions in tumour burden, enhanced immune infiltration, and increased CD4 ⁺ memory T cells, highlighting the critical role of anatomical site and tumour microenvironment in shaping immunotherapy outcomes. Our findings emphasise the relevance of orthotopic models for preclinical evaluation and suggest that they more accurately reflect clinical responses to immune checkpoint blockade in dMMR LUAD.