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Koelzer VH, Gisler A, Hanhart JC, Griss J, Wagner SN, Willi N, Cathomas G, Sachs M, Kempf W, Thommen DS, Mertz KD. Digital image analysis improves precision of PD-L1 scoring in cutaneous melanoma. Histopathology 2018; 73:397-406. [PMID: 29660160 DOI: 10.1111/his.13528] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 04/06/2018] [Indexed: 01/01/2023]
Abstract
AIMS Immune checkpoint inhibitors have become a successful treatment in metastatic melanoma. The high response rates in a subset of patients suggest that a sensitive companion diagnostic test is required. The predictive value of programmed death ligand 1 (PD-L1) staining in melanoma has been questioned due to inconsistent correlation with clinical outcome. Whether this is due to predictive irrelevance of PD-L1 expression or inaccurate assessment techniques remains unclear. The aim of this study was to develop a standardised digital protocol for the assessment of PD-L1 staining in melanoma and to compare the output data and reproducibility to conventional assessment by expert pathologists. METHODS AND RESULTS In two cohorts with a total of 69 cutaneous melanomas, a highly significant correlation was found between pathologist-based consensus reading and automated PD-L1 analysis (r = 0.97, P < 0.0001). Digital scoring captured the full diagnostic spectrum of PD-L1 expression at single cell resolution. An average of 150 472 melanoma cells (median 38 668 cells; range = 733-1 078 965) were scored per lesion. Machine learning was used to control for heterogeneity introduced by PD-L1-positive inflammatory cells in the tumour microenvironment. The PD-L1 image analysis protocol showed excellent reproducibility (r = 1.0, P < 0.0001) when carried out on independent workstations and reduced variability in PD-L1 scoring of human observers. When melanomas were grouped by PD-L1 expression status, we found a clear correlation of PD-L1 positivity with CD8-positive T cell infiltration, but not with tumour stage, metastasis or driver mutation status. CONCLUSION Digital evaluation of PD-L1 reduces scoring variability and may facilitate patient stratification in clinical practice.
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Affiliation(s)
- Viktor H Koelzer
- Cantonal Hospital Baselland, Institute of Pathology, Liestal, Switzerland
- Translational Research Unit (TRU), Institute of Pathology, University of Bern, Bern, Switzerland
| | - Aline Gisler
- Cantonal Hospital Baselland, Institute of Pathology, Liestal, Switzerland
| | - Jonathan C Hanhart
- Cantonal Hospital Baselland, Institute of Pathology, Liestal, Switzerland
| | - Johannes Griss
- Division of Immunology, Allergy and Infectious Diseases (DIAID), Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Stephan N Wagner
- Division of Immunology, Allergy and Infectious Diseases (DIAID), Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Niels Willi
- Cantonal Hospital Baselland, Institute of Pathology, Liestal, Switzerland
| | - Gieri Cathomas
- Cantonal Hospital Baselland, Institute of Pathology, Liestal, Switzerland
| | - Melanie Sachs
- Cantonal Hospital Baselland, Institute of Pathology, Liestal, Switzerland
| | - Werner Kempf
- Kempf und Pfaltz Histologische Diagnostik, Research Unit, Zürich, Switzerland
| | - Daniela S Thommen
- Cancer Immunology, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
- Division of Molecular Oncology and Immunology, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Kirsten D Mertz
- Cantonal Hospital Baselland, Institute of Pathology, Liestal, Switzerland
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52
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Halse H, Colebatch AJ, Petrone P, Henderson MA, Mills JK, Snow H, Westwood JA, Sandhu S, Raleigh JM, Behren A, Cebon J, Darcy PK, Kershaw MH, McArthur GA, Gyorki DE, Neeson PJ. Multiplex immunohistochemistry accurately defines the immune context of metastatic melanoma. Sci Rep 2018; 8:11158. [PMID: 30042403 PMCID: PMC6057961 DOI: 10.1038/s41598-018-28944-3] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 07/02/2018] [Indexed: 01/01/2023] Open
Abstract
A prospective study explored the heterogeneous nature of metastatic melanoma using Multiplex immunohistochemistry (IHC) and flow cytometry (FACS). Multiplex IHC data quantitated immune subset number present intra-tumoral (IT) vs the tumor stroma, plus distance of immune subsets from the tumor margin (TM). In addition, mIHC showed a close association between the presence of IT CD8+ T cells and PDL1 expression in melanoma, which was more prevalent on macrophages than on melanoma cells. In contrast, FACS provided more detailed information regarding the T cell subset differentiation, their activation status and expression of immune checkpoint molecules. Interestingly, mIHC detected significantly higher Treg numbers than FACS and showed preferential CD4+ T cell distribution in the tumor stroma. Based on the mIHC and FACS data, we provide a model which defines metastatic melanoma immune context into four categories using the presence or absence of PDL1+ melanoma cells and/or macrophages, and their location within the tumor or on the periphery, combined with the presence or absence of IT CD8+ T cells. This model interprets melanoma immune context as a spectrum of tumor escape from immune control, and provides a snapshot upon which interpretation of checkpoint blockade inhibitor (CBI) therapy responses can be built.
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Affiliation(s)
- H Halse
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - A J Colebatch
- Division of Cancer Medicine Melanoma Program, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - P Petrone
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - M A Henderson
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - J K Mills
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - H Snow
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - J A Westwood
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - S Sandhu
- Division of Cancer Medicine Melanoma Program, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, 3052, Australia
| | - J M Raleigh
- Division of Cancer Medicine Melanoma Program, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - A Behren
- Olivia Newton John Cancer Research Institute, Heidelberg, Victoria, 3084, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, 3086, Australia
| | - J Cebon
- Olivia Newton John Cancer Research Institute, Heidelberg, Victoria, 3084, Australia.,School of Cancer Medicine, La Trobe University, Bundoora, 3086, Australia
| | - P K Darcy
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, 3052, Australia
| | - M H Kershaw
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, 3052, Australia
| | - G A McArthur
- Division of Cancer Medicine Melanoma Program, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia
| | - D E Gyorki
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia.,Department of Surgery, University of Melbourne, Parkville, Victoria, 3052, Australia
| | - P J Neeson
- Cancer Immunology Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, 3000, Australia. .,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, 3052, Australia.
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53
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Chatterjee A, Rodger EJ, Ahn A, Stockwell PA, Parry M, Motwani J, Gallagher SJ, Shklovskaya E, Tiffen J, Eccles MR, Hersey P. Marked Global DNA Hypomethylation Is Associated with Constitutive PD-L1 Expression in Melanoma. iScience 2018; 4:312-325. [PMID: 30240750 PMCID: PMC6147024 DOI: 10.1016/j.isci.2018.05.021] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 05/08/2018] [Accepted: 05/29/2018] [Indexed: 12/24/2022] Open
Abstract
Constitutive expression of the immune checkpoint, PD-L1, inhibits anti-tumor immune responses in cancer, although the factors involved in PD-L1 regulation are poorly understood. Here we show that loss of global DNA methylation, particularly in intergenic regions and repeat elements, is associated with constitutive (PD-L1CON), versus inducible (PD-L1IND), PD-L1 expression in melanoma cell lines. We further show this is accompanied by transcriptomic up-regulation. De novo epigenetic regulators (e.g., DNMT3A) are strongly correlated with PD-L1 expression and methylome status. Accordingly, decitabine-mediated inhibition of global methylation in melanoma cells leads to increased PD-L1 expression. Moreover, viral mimicry and immune response genes are highly expressed in lymphocyte-negative plus PD-L1-positive melanomas, versus PD-L1-negative melanomas in The Cancer Genome Atlas (TCGA). In summary, using integrated genomic analysis we identified that global DNA methylation influences PD-L1 expression in melanoma, and hence melanoma's ability to evade anti-tumor immune responses. These results have implications for combining epigenetic therapy with immunotherapy.
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Affiliation(s)
- Aniruddha Chatterjee
- Department of Pathology, Dunedin School of Medicine, University of Otago, 270 Great King Street, Dunedin 9054, New Zealand; Maurice Wilkins Centre for Molecular Biodiscovery, Level 2, 3A Symonds Street, Auckland, New Zealand.
| | - Euan J Rodger
- Department of Pathology, Dunedin School of Medicine, University of Otago, 270 Great King Street, Dunedin 9054, New Zealand; Maurice Wilkins Centre for Molecular Biodiscovery, Level 2, 3A Symonds Street, Auckland, New Zealand
| | - Antonio Ahn
- Department of Pathology, Dunedin School of Medicine, University of Otago, 270 Great King Street, Dunedin 9054, New Zealand
| | - Peter A Stockwell
- Department of Pathology, Dunedin School of Medicine, University of Otago, 270 Great King Street, Dunedin 9054, New Zealand
| | - Matthew Parry
- Department of Mathematics & Statistics, University of Otago, 710 Cumberland Street, Dunedin 9054, New Zealand
| | - Jyoti Motwani
- Department of Pathology, Dunedin School of Medicine, University of Otago, 270 Great King Street, Dunedin 9054, New Zealand
| | - Stuart J Gallagher
- Melanoma Immunology and Oncology Group, The Centenary Institute, University of Sydney, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia
| | - Elena Shklovskaya
- Melanoma Immunology and Oncology Group, The Centenary Institute, University of Sydney, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia
| | - Jessamy Tiffen
- Melanoma Immunology and Oncology Group, The Centenary Institute, University of Sydney, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia
| | - Michael R Eccles
- Department of Pathology, Dunedin School of Medicine, University of Otago, 270 Great King Street, Dunedin 9054, New Zealand; Maurice Wilkins Centre for Molecular Biodiscovery, Level 2, 3A Symonds Street, Auckland, New Zealand.
| | - Peter Hersey
- Melanoma Immunology and Oncology Group, The Centenary Institute, University of Sydney, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia.
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Omori S, Kenmotsu H, Abe M, Watanabe R, Sugino T, Kobayashi H, Nakashima K, Wakuda K, Ono A, Taira T, Naito T, Murakami H, Ohde Y, Endo M, Akiyama Y, Nakajima T, Takahashi T. Changes in programmed death ligand 1 expression in non-small cell lung cancer patients who received anticancer treatments. Int J Clin Oncol 2018; 23:1052-1059. [DOI: 10.1007/s10147-018-1305-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/08/2018] [Indexed: 12/23/2022]
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55
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Ren M, Dai B, Kong YY, Lv JJ, Cai X. PD-L1 expression in tumour-infiltrating lymphocytes is a poor prognostic factor for primary acral melanoma patients. Histopathology 2018; 73:386-396. [PMID: 29637587 DOI: 10.1111/his.13527] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 04/03/2018] [Indexed: 12/19/2022]
Abstract
AIMS Programmed cell death protein 1-programmed death-ligand 1 (PD-L1) blockade immunotherapy has shown notable therapeutic benefit in metastatic melanoma, but the clinical relevance of PD-L1 expression remains unclear in melanoma, especially in acral melanoma, which is the most common subtype in Asians. The aim of this study was to evaluate the clinical effect of PD-L1 expression in primary acral melanoma. METHODS AND RESULTS We used immunohistochemistry to evaluate PD-L1 expression in tumour cells and tumour-infiltrating lymphocytes (TILs), and analysed its associations with clinicopathological features and survival in 78 primary acral melanoma patients. We found that expression of PD-L1 in tumour cells and TILs occurred exclusively in a tumour-stroma interface pattern, consistent with the predominant pattern of TIL distribution. The presence of peritumoral TILs was also associated with high PD-L1 expression in tumour cells. Furthermore, PD-L1 expression in tumour cells and that in TILs showed a close relationship (Spearman's rho = 0.381, P = 0.001). However, neither PD-L1 expression in tumour cells nor that in TILs was significantly correlated with clinicopathological features. In univariate analysis, cases with PD-L1-positive TILs had significantly poorer survival than those with PD-L1-negative TILs (median disease-specific survival of 40.7 months versus 78.0 months; P = 0.008). In multivariate analysis, PD-L1 expression in TILs was an independent factor for poor prognosis (P = 0.032), whereas PD-L1 expression in tumour cells was not significantly correlated with survival in univariate analysis (P = 0.378) and multivariate analysis (P = 0.354). CONCLUSION This is the first study to demonstrate that PD-L1 expression in TILs, but not that in tumour cells, is an independent predictor of poor prognosis in acral melanoma.
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Affiliation(s)
- Min Ren
- Department of Pathology, Fudan University Shanghai Cancer Centre, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Bo Dai
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Urology, Fudan University Shanghai Cancer Centre, Shanghai, China
| | - Yun-Yi Kong
- Department of Pathology, Fudan University Shanghai Cancer Centre, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiao-Jie Lv
- Department of Pathology, Fudan University Shanghai Cancer Centre, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xu Cai
- Department of Pathology, Fudan University Shanghai Cancer Centre, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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56
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Cai H, Cho EA, Li Y, Sockler J, Parish CR, Chong BH, Edwards J, Dodds TJ, Ferguson PM, Wilmott JS, Scolyer RA, Halliday GM, Khachigian LM. Melanoma protective antitumor immunity activated by catalytic DNA. Oncogene 2018; 37:5115-5126. [DOI: 10.1038/s41388-018-0306-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 02/26/2018] [Accepted: 04/17/2018] [Indexed: 12/19/2022]
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57
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Borzooee F, Asgharpour M, Quinlan E, Grant MD, Larijani M. Viral subversion of APOBEC3s: Lessons for anti-tumor immunity and tumor immunotherapy. Int Rev Immunol 2018; 37:151-164. [PMID: 29211501 DOI: 10.1080/08830185.2017.1403596] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
APOBEC3s (A3) are endogenous DNA-editing enzymes that are expressed in immune cells including T lymphocytes. A3s target and mutate the genomes of retroviruses that infect immune tissues such as the human immunodeficiency virus (HIV). Therefore, A3s were classically defined as host anti-viral innate immune factors. In contrast, we and others showed that A3s can also benefit the virus by mediating escape from adaptive immune recognition and drugs. Crucially, whether A3-mediated mutations help or hinder HIV, is not up to chance. Rather, the virus has evolved multiple mechanisms to actively and maximally subvert A3 activity. More recently, extensive A3 mutational footprints in tumor genomes have been observed in many different cancers. This suggests a role for A3s in cancer initiation and progression. On the other hand, multiple anti-tumor activities of A3s have also come to light, including impact on immune checkpoint molecules and possible generation of tumor neo-antigens. Here, we review the studies that reshaped the view of A3s from anti-viral innate immune agents to host factors exploited by HIV to escape from immune recognition. Viruses and tumors share many attributes, including rapid evolution and adeptness at exploiting mutations. Given this parallel, we then discuss the pro- and anti-tumor roles of A3s, and suggest that lessons learned from studying A3s in the context of anti-viral immunity can be applied to tumor immunotherapy.
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Affiliation(s)
- Faezeh Borzooee
- a Program in Immunology and Infectious Diseases, Division of Biomedical Sciences, Faculty of Medicine , Memorial University of Newfoundland , St. John's, Newfoundland A1B 3V6 , Canada
| | - Mahdi Asgharpour
- a Program in Immunology and Infectious Diseases, Division of Biomedical Sciences, Faculty of Medicine , Memorial University of Newfoundland , St. John's, Newfoundland A1B 3V6 , Canada
| | - Emma Quinlan
- a Program in Immunology and Infectious Diseases, Division of Biomedical Sciences, Faculty of Medicine , Memorial University of Newfoundland , St. John's, Newfoundland A1B 3V6 , Canada
| | - Michael D Grant
- a Program in Immunology and Infectious Diseases, Division of Biomedical Sciences, Faculty of Medicine , Memorial University of Newfoundland , St. John's, Newfoundland A1B 3V6 , Canada
| | - Mani Larijani
- a Program in Immunology and Infectious Diseases, Division of Biomedical Sciences, Faculty of Medicine , Memorial University of Newfoundland , St. John's, Newfoundland A1B 3V6 , Canada
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58
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Comprehensive analysis of PD-L1 expression in glioblastoma multiforme. Oncotarget 2018; 8:42214-42225. [PMID: 28178682 PMCID: PMC5522061 DOI: 10.18632/oncotarget.15031] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 01/10/2017] [Indexed: 12/16/2022] Open
Abstract
Glioblastoma multiforme are highly malignant brain tumours with frequent genetic and epigenetic alterations. The poor clinical outcome of these tumours necessitates the development of new treatment options. Immunotherapies for glioblastoma multiforme including PD1/PD-L1 inhibition are currently tested in ongoing clinical trials. The purpose of this study was to investigate the molecular background of PD-L1 expression in glioblastoma multiforme and to find associated pathway activation and genetic alterations. We show that PD-L1 is up-regulated in IDH1/2 wildtype glioblastoma multiforme compared to lower-grade gliomas. In addition, a strong association of PD-L1 with the mesenchymal expression subgroup was observed. Consistent with that, NF1 mutation and corresponding activation of the MAPK pathway was strongly connected to PD-L1 expression. Our findings may explain different response to PD-L1 inhibition of patients in ongoing trials and may help to select patients that may profit of immunotherapy in the future.
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59
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Edwards J, Wilmott JS, Madore J, Gide TN, Quek C, Tasker A, Ferguson A, Chen J, Hewavisenti R, Hersey P, Gebhardt T, Weninger W, Britton WJ, Saw RP, Thompson JF, Menzies AM, Long GV, Scolyer RA, Palendira U. CD103+ Tumor-Resident CD8+ T Cells Are Associated with Improved Survival in Immunotherapy-Naïve Melanoma Patients and Expand Significantly During Anti–PD-1 Treatment. Clin Cancer Res 2018; 24:3036-3045. [DOI: 10.1158/1078-0432.ccr-17-2257] [Citation(s) in RCA: 211] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/09/2017] [Accepted: 03/20/2018] [Indexed: 12/13/2022]
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60
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Shibahara D, Tanaka K, Iwama E, Kubo N, Ota K, Azuma K, Harada T, Fujita J, Nakanishi Y, Okamoto I. Intrinsic and Extrinsic Regulation of PD-L2 Expression in Oncogene-Driven Non-Small Cell Lung Cancer. J Thorac Oncol 2018; 13:926-937. [PMID: 29596910 DOI: 10.1016/j.jtho.2018.03.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/13/2018] [Accepted: 03/19/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The interaction of programmed cell death ligand 2 (PD-L2) with programmed cell death 1 is implicated in tumor immune escape. The regulation of PD-L2 expression in tumor cells has remained unclear, however. We here examined intrinsic and extrinsic regulation of PD-L2 expression in NSCLC. METHODS PD-L2 expression was evaluated by reverse transcription and real-time polymerase chain reaction analysis and by flow cytometry. RESULTS BEAS-2B cells stably expressing an activated mutant form of EGFR or the echinoderm microtubule associated protein like 4 (EML4)-ALK receptor tyrosine kinase fusion oncoprotein manifested increased expression of PD-L2 at both the mRNA and protein levels. Furthermore, treatment of NSCLC cell lines that harbor such driver oncogenes with corresponding EGFR or ALK tyrosine kinase inhibitors or depletion of EGFR or ALK by small interfering RNA transfection suppressed expression of PD-L2, demonstrating that activating EGFR mutations or echinoderm microtubule associated protein like 4 gene (EML4)-ALK receptor tyrosine kinase gene (ALK) fusion intrinsically induce PD-L2 expression. We also found that interferon gamma (IFN-γ) extrinsically induced expression of PD-L2 through signal transducer and activator of transcription 1 signaling in NSCLC cells. Oncogene-driven expression of PD-L2 in NSCLC cells was inhibited by knockdown of the transcription factors signal transducer and activator of transcription 3 (STAT3) or c-FOS. IFN-γ also activated STAT3 and c-FOS, suggesting that these proteins may also contribute to the extrinsic induction of PD-L2 expression. CONCLUSIONS Expression of PD-L2 is induced intrinsically by activating EGFR mutations or EML4-ALK fusion and extrinsically by IFN-γ, with STAT3 and c-FOS possibly contributing to both intrinsic and extrinsic pathways. Our results thus provide insight into the complexity of tumor immune escape in NSCLC.
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Affiliation(s)
- Daisuke Shibahara
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of Ryukyus, Okinawa, Japan
| | - Kentaro Tanaka
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiji Iwama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Kubo
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keiichi Ota
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koichi Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Taishi Harada
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Japan Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan
| | - Jiro Fujita
- Department of Infectious Disease, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of Ryukyus, Okinawa, Japan
| | - Yoichi Nakanishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Isamu Okamoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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61
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Hong AM, Vilain RE, Romanes S, Yang J, Smith E, Jones D, Scolyer RA, Lee CS, Zhang M, Rose B. PD-L1 expression in tonsillar cancer is associated with human papillomavirus positivity and improved survival: implications for anti-PD1 clinical trials. Oncotarget 2018; 7:77010-77020. [PMID: 27776338 PMCID: PMC5363566 DOI: 10.18632/oncotarget.12776] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 10/13/2016] [Indexed: 12/16/2022] Open
Abstract
In this study, we examined PD-L1 expression by immunohistochemistry in 99 patients with tonsillar cancer and known human papillomavirus (HPV) status to assess its clinical significance. We showed that the pattern of PD-L1 expression is strongly related to HPV status. The PD-L1 positivity rate was 83.3% in HPV-positive cases and 56.9% in HPV-negative cases (p < 0.05). Patients with HPV-positive/PD-L1-positive cancer had significantly better event free survival and overall survival compared with patients with HPV-negative/PD-L1-negative cancer. Relative to those patients with HPV-negative/PD-L1-negative disease who had the highest risk of death, patients with HPV-positive/PD-L1-positive cancers had a 2.85 fold lower risk of developing an event (HR 0.35, 95% CI: 0.16–0.79) and a 4.5 fold lower risk of death (HR =0.22, 95% CI: 0.09–0.53). Our findings will help to guide future clinical trial design in immunotherapy based on PD-L1 expression in tonsillar cancer.
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Affiliation(s)
- Angela M Hong
- Sydney Medical School, The University of Sydney, NSW, Australia
| | - Ricardo E Vilain
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW, Australia.,Pathology North (Hunter), John Hunter Hospital, Newcastle, NSW, Australia
| | - Sarah Romanes
- School of Mathematics and Statistics, The University of Sydney, NSW, Australia
| | - Jean Yang
- School of Mathematics and Statistics, The University of Sydney, NSW, Australia
| | - Elizabeth Smith
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW, Australia
| | - Deanna Jones
- Sydney Medical School, The University of Sydney, NSW, Australia
| | - Richard A Scolyer
- Sydney Medical School, The University of Sydney, NSW, Australia.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW, Australia
| | - C Soon Lee
- Sydney Medical School, The University of Sydney, NSW, Australia.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW, Australia.,Discipline of Pathology, School of Medicine, Western Sydney University, NSW, Australia
| | - Mei Zhang
- Sydney Medical School, The University of Sydney, NSW, Australia
| | - Barbara Rose
- Sydney Medical School, The University of Sydney, NSW, Australia
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62
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Kim HS, Lee JH, Nam SJ, Ock CY, Moon JW, Yoo CW, Lee GK, Han JY. Association of PD-L1 Expression with Tumor-Infiltrating Immune Cells and Mutation Burden in High-Grade Neuroendocrine Carcinoma of the Lung. J Thorac Oncol 2018; 13:636-648. [PMID: 29378266 DOI: 10.1016/j.jtho.2018.01.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 12/29/2017] [Accepted: 01/02/2018] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The immune microenvironment of high-grade neuroendocrine carcinoma of the lung, including programmed death ligand 1 (PD-L1) expression, has not been well characterized. METHODS On the basis of immunohistochemistry (IHC) results, PD-L1 expression on tumor cells (TCs) and tumor-infiltrating immune cells (ICs) was scored as follows: TC0 and IC0 were defined as PD-L1 expression less than 1%, TC1 and IC1 as at least 1% but less than 10%, TC2 and IC2 as 10% or more but less than 50%, and TC3 and IC3 as 50% or more. Phosphatase and tensin homolog (PTEN) IHC was scored as either lost or retained expression. The Ion AmpliSeq Comprehensive Cancer Panel (ThermoFisher Scientific, Waltham, MA) was used to identify mutations in all coding exons of 409 cancer-related genes. RESULTS A total of 192 patients with large cell neuroendocrine carcinoma (LCNEC) (n = 72) and SCLC (n = 120) were studied. The prevalence of PD-L1 expression on TCs was 15.1% (29 of 192). IC infiltration and PD-L1 expression on ICs were observed in 34.4% of patients (66 of 192) and 31.3% of patients (60 of 192), respectively. The prevalence of IC infiltration and PD-L1 expression on IC were more strongly correlated with LCNEC than with SCLC (57.6% versus 23.3%, p < 0.01; 45.8% versus 22.5%, p < 0.01) and high nonsynonymous mutations (p = 0.05 and .04). PTEN loss was found in 9.5% of patients (18 of 189) and showed no correlation with PD-L1 expression. Progression-free survival was better in patients with IC infiltration than in those without IC infiltration (median 11.3 versus 6.8 months [p < 0.01]) and in patients with PD-L1 expression of IC1/2/3 than in those with expression of IC0 (median 11.3 versus 7.0 months [p = 0.03]). CONCLUSION These findings suggest that the PD-1/PD-L1 pathway is activated in the microenvironment of pulmonary high-grade neuroendocrine carcinoma and correlated with a higher mutation burden.
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Affiliation(s)
- Hye Sook Kim
- Division of Oncology/Hematology, Department of Internal Medicine, Myongji Hospital, Goyang-si Gyeonggi-do, Republic of Korea
| | - Jeong Hyeon Lee
- Department of Pathology, Korea University Medical Center, Anam Hospital, Seoul, Republic of Korea
| | - Soo Jeong Nam
- Department of Pathology, Asan Medical Center, Seoul, Republic of Korea
| | - Chan-Young Ock
- Theragen Etex Bio Institute, Suwon-si Gyeonggi-do, Republic of Korea
| | - Jae-Woo Moon
- Theragen Etex Bio Institute, Suwon-si Gyeonggi-do, Republic of Korea
| | - Chong Woo Yoo
- Center for Uterine Cancer, Department of Pathology, Research Institute and Hospital, National Cancer Center, Goyang-si Gyeonggi-do, Republic of Korea
| | - Geon Kook Lee
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si Gyeonggi-do, Republic of Korea
| | - Ji-Youn Han
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si Gyeonggi-do, Republic of Korea.
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Derakhshandeh R, Sanadhya S, Lee Han K, Chen H, Goloubeva O, Webb TJ, Younis RH. Semaphorin 4D in human head and neck cancer tissue and peripheral blood: A dense fibrotic peri-tumoral stromal phenotype. Oncotarget 2018. [PMID: 29541402 PMCID: PMC5834246 DOI: 10.18632/oncotarget.24277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The search for stromal biomarkers in carcinoma patients is a challenge in the field. Semaphorin 4D (Sema4D), known for its various developmental, physiological and pathological effects, plays a role in pro and anti-inflammatory responses. It is expressed in many epithelial tumors including head and neck squamous cell carcinoma (HNSCC). Recently, we found that HNSCC-associated Sema4D modulates an immune-suppressive, tumor-permissible environment by inducing the expansion of myeloid derived suppressor cells. The purpose of this study was to determine the value of Sema4D as a biomarker for the peri-tumoral stromal phenotype in human HNSCC. Our data showed Sema4D+ve/high tumor cells in 34% of the studied cohort with positive correlation to Stage III (p=0.0001). Sema4D+ve/high tumor cells correlated directly with dense fibrotic peri-tumoral stroma (p=0.0001) and inversely with infiltrate of Sema4D+ve/high tumor-associated inflammatory cells (TAIs) (p=0.01). Most of the Sema4D+ve/high TAIs were co-positive for the macrophage biomarker CD163. Knockdown of Sema4D in WSU-HN6 cells inhibited collagen production by fibroblasts, and decreased activated TGF-β1 levels in culture medium of HNSCC cell lines. In a stratification model of HNSCC using combined Sema4D and the programmed death ligand 1 (PDL-1), Sema4D+ve/high tumor cells represented a phenotype distinct from the PDL-1 positive tumors. Finally,Sema4D was detected in plasma of HNC patients at significantly higher levels (115.44, ± 39.37) compared to healthy donors (38.60± 12.73) (p <0.0001). In conclusion, we present a novel HNSCC tumor stratification model, based on the expression of the biomarker Sema4D. This model opens new avenues to novel targeted therapeutic strategies.
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Affiliation(s)
- Roshanak Derakhshandeh
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland, USA.,Department of Microbiology and Immunology, School of Medicine, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Sonia Sanadhya
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Kyu Lee Han
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Haiyan Chen
- Department of Dental Public Health, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Olga Goloubeva
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland Baltimore, Baltimore, Maryland, USA.,The Marlene and Stewart Greenebaum Cancer Center, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Tonya J Webb
- Department of Microbiology and Immunology, School of Medicine, University of Maryland Baltimore, Baltimore, Maryland, USA.,The Marlene and Stewart Greenebaum Cancer Center, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Rania H Younis
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland, USA.,Oral Pathology Consultants, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland, USA.,Department of oral Pathology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.,The Marlene and Stewart Greenebaum Cancer Center, University of Maryland Baltimore, Baltimore, Maryland, USA
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64
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Chauhan A, Horn M, Magee G, Hodges K, Evers M, Arnold S, Anthony L. Immune checkpoint inhibitors in neuroendocrine tumors: A single institution experience with review of literature. Oncotarget 2017; 9:8801-8809. [PMID: 29507655 PMCID: PMC5823629 DOI: 10.18632/oncotarget.23753] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 12/18/2017] [Indexed: 12/17/2022] Open
Abstract
This unique case series and review of literature suggests that immune checkpoint inhibitors may have clinical activity in neuroendocrine tumors. Objective Summarize advances of immuno-oncology in neuroendocrine tumors with the help of a case series. Design Case series and review of literature. Intervention or Exposure The patients were treated with immune checkpoint inhibitors (pembrolizumab or nivolumab). Main Outcomes and Measuress Life expectancy, quality of life, disease progression. Results Maximum durable response of 16 months in one of the patients so far. All patients showed improvement in quality of life before disease progression. Two out of four are still on therapy. None of the patients experienced immune checkpoint inhibitor associated side-effects. All patients had failed standard of care therapy prior to the initiation of immune checkpoint inhibitors and were on the verge of hospice. Conclusions Immune checkpoint inhibitors have revolutionized cancer management and the last 5 years have seen a rapid expansion in the indications for this class of drug. Neuroendocrine tumors, unfortunately, have been slow to catch on to the immuno-oncology, partly due to difficulties in establishing relevant preclinical neuroendocrine tumors models for immune-oncology studies. In this manuscript, we review the current status of immunotherapy in neuroendocrine tumors.
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Affiliation(s)
- Aman Chauhan
- Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Millicent Horn
- School of Medicine, University of Kentucky, Lexington, KY, USA
| | - Gray Magee
- School of Medicine, University of Kentucky, Lexington, KY, USA
| | - Kurt Hodges
- Department of Pathology, University of Kentucky, Lexington, KY, USA
| | - Mark Evers
- Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Susanne Arnold
- Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Lowell Anthony
- Markey Cancer Center, University of Kentucky, Lexington, KY, USA
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Kakavand H, Jackett LA, Menzies AM, Gide TN, Carlino MS, Saw RPM, Thompson JF, Wilmott JS, Long GV, Scolyer RA. Negative immune checkpoint regulation by VISTA: a mechanism of acquired resistance to anti-PD-1 therapy in metastatic melanoma patients. Mod Pathol 2017; 30:1666-1676. [PMID: 28776578 DOI: 10.1038/modpathol.2017.89] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/15/2017] [Accepted: 05/15/2017] [Indexed: 12/20/2022]
Abstract
Understanding the mechanisms of acquired resistance to anti-PD-1 will allow development of better treatment strategies for cancer patients. This study evaluated potential mechanisms of acquired resistance to anti-PD-1 in longitudinally collected metastatic melanoma patient biopsies. Thirty-four metastatic melanoma biopsies were collected from 16 patients who had initially responded to either anti-PD-1 (n=13) alone or combination of anti-PD-1 and ipilimumab (n=3) and then progressed. Biopsies were taken prior to treatment (PRE, n=12) and following progression of disease (PROG, n=22). Immunohistochemistry was performed on all biopsies to detect CD8, FOXP3, PD-1 and VISTA expression on T-cells and PTEN, β-catenin, PD-L1, HLA-A, and HLA-DPB1 expression in the tumor. The majority of patients showed significantly increased density of VISTA+ lymphocytes from PRE to PROG (12/18) (P=0.009) and increased expression of tumor PD-L1 from PRE to PROG (11/18). Intratumoral expression of FOXP3+ lymphocytes significantly increased (P=0.018) from PRE to PROG (10/18). Loss of tumor PTEN and downregulation of tumor HLA-A from PRE to PROG were each identified in 5/18 and 4/18 PROG biopsies, respectively. Downregulation of HLA-DPB1 from PRE to PROG was present in 3/18 PROG biopsies, whereas nuclear β-catenin activation was only identified in 2/18 PROG biopsies. Negative immune checkpoint regulation by VISTA represents an important potential mechanism of acquired resistance in melanoma patients treated with anti-PD-1. Downregulation of HLA-associated antigen presentation also occurs with acquired resistance. Augmentation of the VISTA immune checkpoint pathway may hold promise as a therapeutic strategy in metastatic melanoma patients, particularly those failing anti-PD-1 therapy, and warrants assessment in clinical trials.
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Affiliation(s)
- Hojabr Kakavand
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia
| | - Louise A Jackett
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Alexander M Menzies
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia.,Royal North Shore and Mater Hospitals, St. Leonards, NSW, Australia
| | - Tuba N Gide
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia
| | - Matteo S Carlino
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia.,Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
| | - Robyn P M Saw
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia.,Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - John F Thompson
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia.,Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - James S Wilmott
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia.,Royal North Shore and Mater Hospitals, St. Leonards, NSW, Australia
| | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia.,Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
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Gide TN, Wilmott JS, Scolyer RA, Long GV. Primary and Acquired Resistance to Immune Checkpoint Inhibitors in Metastatic Melanoma. Clin Cancer Res 2017; 24:1260-1270. [PMID: 29127120 DOI: 10.1158/1078-0432.ccr-17-2267] [Citation(s) in RCA: 262] [Impact Index Per Article: 37.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 10/15/2017] [Accepted: 11/06/2017] [Indexed: 11/16/2022]
Abstract
Immune checkpoint inhibitors have revolutionized the treatment of patients with advanced-stage metastatic melanoma, as well as patients with many other solid cancers, yielding long-lasting responses and improved survival. However, a subset of patients who initially respond to immunotherapy, later relapse and develop therapy resistance (termed "acquired resistance"), whereas others do not respond at all (termed "primary resistance"). Primary and acquired resistance are key clinical barriers to further improving outcomes of patients with metastatic melanoma, and the known mechanisms underlying each involves various components of the cancer immune cycle, and interactions between multiple signaling molecules and pathways. Due to this complexity, current knowledge on resistance mechanisms is still incomplete. Overcoming therapy resistance requires a thorough understanding of the mechanisms underlying immune evasion by tumors. In this review, we explore the mechanisms of primary and acquired resistance to immunotherapy in melanoma and detail potential therapeutic strategies to prevent and overcome them. Clin Cancer Res; 24(6); 1260-70. ©2017 AACR.
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Affiliation(s)
- Tuba N Gide
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - James S Wilmott
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Royal North Shore Hospital, Sydney, NSW, Australia
- Mater Hospital, North Sydney, NSW, Australia
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67
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Saletta F, Vilain RE, Gupta AK, Nagabushan S, Yuksel A, Catchpoole D, Scolyer RA, Byrne JA, McCowage G. Programmed Death-Ligand 1 Expression in a Large Cohort of Pediatric Patients With Solid Tumor and Association With Clinicopathologic Features in Neuroblastoma. JCO Precis Oncol 2017; 1:1-12. [DOI: 10.1200/po.16.00049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Programmed death-ligand 1 (PD-L1) expression represents a potential predictive biomarker of immune checkpoint blockade response. However, literature about the prevalence of PD-L1 expression in the pediatric cancer setting is discordant. Methods PD-L1 expression was analyzed using immunohistochemistry in 500 pediatric tumors (including neuroblastoma, sarcomas, and brain cancers). Tumors with ≥ 1% cells showing PD-L1 membrane staining of any intensity were scored as positive. Positive cases were further characterized, with cases with weak intensity PD-L1 staining reported as having low PD-L1 expression and cases with a moderate or strong intensity of staining considered to have high PD-L1 expression. Results PD-L1–positive staining was identified in 13% of cases, whereas high PD-L1 expression was found in 3% of cases. Neuroblastoma (n = 254) showed PD-L1 expression of any intensity in 18.9% of cases and was associated with longer overall survival ( P = .045). However, high PD-L1 expression in neuroblastoma (3.1%) was significantly associated with an increased risk of relapse ( P = .002). Positive PD-L1 staining was observed more frequently in low- and intermediate-risk patients ( P = .037) and in cases lacking MYCN amplification ( P = .002). Conclusion In summary, high PD-L1 expression in patients with neuroblastoma may represent an unfavorable prognostic factor associated with a higher risk of cancer relapse. This work proposes PD-L1 immunohistochemical assessment as a novel parameter for identifying patients with an increased likelihood of cancer recurrence.
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Affiliation(s)
- Federica Saletta
- Federica Saletta, Aditya Kumar Gupta, Sumanth Nagabushan, Aysen Yuksel, Daniel Catchpoole, Jennifer A. Byrne, and Geoffrey McCowage, The Children's Hospital at Westmead; Daniel Catchpoole, Jennifer A. Byrne, The University of Sydney, Discipline of Child and Adolescent Health, Westmead; Ricardo E. Vilain, John Hunter Hospital, Newcastle; Richard A. Scolyer, Royal Prince Alfred Hospital; Richard A. Scolyer, The University of Sydney, Camperdown; and Richard A. Scolyer, Melanoma Institute Australia, North
| | - Ricardo E. Vilain
- Federica Saletta, Aditya Kumar Gupta, Sumanth Nagabushan, Aysen Yuksel, Daniel Catchpoole, Jennifer A. Byrne, and Geoffrey McCowage, The Children's Hospital at Westmead; Daniel Catchpoole, Jennifer A. Byrne, The University of Sydney, Discipline of Child and Adolescent Health, Westmead; Ricardo E. Vilain, John Hunter Hospital, Newcastle; Richard A. Scolyer, Royal Prince Alfred Hospital; Richard A. Scolyer, The University of Sydney, Camperdown; and Richard A. Scolyer, Melanoma Institute Australia, North
| | - Aditya Kumar Gupta
- Federica Saletta, Aditya Kumar Gupta, Sumanth Nagabushan, Aysen Yuksel, Daniel Catchpoole, Jennifer A. Byrne, and Geoffrey McCowage, The Children's Hospital at Westmead; Daniel Catchpoole, Jennifer A. Byrne, The University of Sydney, Discipline of Child and Adolescent Health, Westmead; Ricardo E. Vilain, John Hunter Hospital, Newcastle; Richard A. Scolyer, Royal Prince Alfred Hospital; Richard A. Scolyer, The University of Sydney, Camperdown; and Richard A. Scolyer, Melanoma Institute Australia, North
| | - Sumanth Nagabushan
- Federica Saletta, Aditya Kumar Gupta, Sumanth Nagabushan, Aysen Yuksel, Daniel Catchpoole, Jennifer A. Byrne, and Geoffrey McCowage, The Children's Hospital at Westmead; Daniel Catchpoole, Jennifer A. Byrne, The University of Sydney, Discipline of Child and Adolescent Health, Westmead; Ricardo E. Vilain, John Hunter Hospital, Newcastle; Richard A. Scolyer, Royal Prince Alfred Hospital; Richard A. Scolyer, The University of Sydney, Camperdown; and Richard A. Scolyer, Melanoma Institute Australia, North
| | - Aysen Yuksel
- Federica Saletta, Aditya Kumar Gupta, Sumanth Nagabushan, Aysen Yuksel, Daniel Catchpoole, Jennifer A. Byrne, and Geoffrey McCowage, The Children's Hospital at Westmead; Daniel Catchpoole, Jennifer A. Byrne, The University of Sydney, Discipline of Child and Adolescent Health, Westmead; Ricardo E. Vilain, John Hunter Hospital, Newcastle; Richard A. Scolyer, Royal Prince Alfred Hospital; Richard A. Scolyer, The University of Sydney, Camperdown; and Richard A. Scolyer, Melanoma Institute Australia, North
| | - Daniel Catchpoole
- Federica Saletta, Aditya Kumar Gupta, Sumanth Nagabushan, Aysen Yuksel, Daniel Catchpoole, Jennifer A. Byrne, and Geoffrey McCowage, The Children's Hospital at Westmead; Daniel Catchpoole, Jennifer A. Byrne, The University of Sydney, Discipline of Child and Adolescent Health, Westmead; Ricardo E. Vilain, John Hunter Hospital, Newcastle; Richard A. Scolyer, Royal Prince Alfred Hospital; Richard A. Scolyer, The University of Sydney, Camperdown; and Richard A. Scolyer, Melanoma Institute Australia, North
| | - Richard A. Scolyer
- Federica Saletta, Aditya Kumar Gupta, Sumanth Nagabushan, Aysen Yuksel, Daniel Catchpoole, Jennifer A. Byrne, and Geoffrey McCowage, The Children's Hospital at Westmead; Daniel Catchpoole, Jennifer A. Byrne, The University of Sydney, Discipline of Child and Adolescent Health, Westmead; Ricardo E. Vilain, John Hunter Hospital, Newcastle; Richard A. Scolyer, Royal Prince Alfred Hospital; Richard A. Scolyer, The University of Sydney, Camperdown; and Richard A. Scolyer, Melanoma Institute Australia, North
| | - Jennifer A. Byrne
- Federica Saletta, Aditya Kumar Gupta, Sumanth Nagabushan, Aysen Yuksel, Daniel Catchpoole, Jennifer A. Byrne, and Geoffrey McCowage, The Children's Hospital at Westmead; Daniel Catchpoole, Jennifer A. Byrne, The University of Sydney, Discipline of Child and Adolescent Health, Westmead; Ricardo E. Vilain, John Hunter Hospital, Newcastle; Richard A. Scolyer, Royal Prince Alfred Hospital; Richard A. Scolyer, The University of Sydney, Camperdown; and Richard A. Scolyer, Melanoma Institute Australia, North
| | - Geoffrey McCowage
- Federica Saletta, Aditya Kumar Gupta, Sumanth Nagabushan, Aysen Yuksel, Daniel Catchpoole, Jennifer A. Byrne, and Geoffrey McCowage, The Children's Hospital at Westmead; Daniel Catchpoole, Jennifer A. Byrne, The University of Sydney, Discipline of Child and Adolescent Health, Westmead; Ricardo E. Vilain, John Hunter Hospital, Newcastle; Richard A. Scolyer, Royal Prince Alfred Hospital; Richard A. Scolyer, The University of Sydney, Camperdown; and Richard A. Scolyer, Melanoma Institute Australia, North
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Goodman AM, Kato S, Bazhenova L, Patel SP, Frampton GM, Miller V, Stephens PJ, Daniels GA, Kurzrock R. Tumor Mutational Burden as an Independent Predictor of Response to Immunotherapy in Diverse Cancers. Mol Cancer Ther 2017; 16:2598-2608. [PMID: 28835386 DOI: 10.1158/1535-7163.mct-17-0386] [Citation(s) in RCA: 1562] [Impact Index Per Article: 223.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 07/24/2017] [Accepted: 08/10/2017] [Indexed: 02/06/2023]
Abstract
Immunotherapy induces durable responses in a subset of patients with cancer. High tumor mutational burden (TMB) may be a response biomarker for PD-1/PD-L1 blockade in tumors such as melanoma and non-small cell lung cancer (NSCLC). Our aim was to examine the relationship between TMB and outcome in diverse cancers treated with various immunotherapies. We reviewed data on 1,638 patients who had undergone comprehensive genomic profiling and had TMB assessment. Immunotherapy-treated patients (N = 151) were analyzed for response rate (RR), progression-free survival (PFS), and overall survival (OS). Higher TMB was independently associated with better outcome parameters (multivariable analysis). The RR for patients with high (≥20 mutations/mb) versus low to intermediate TMB was 22/38 (58%) versus 23/113 (20%; P = 0.0001); median PFS, 12.8 months vs. 3.3 months (P ≤ 0.0001); median OS, not reached versus 16.3 months (P = 0.0036). Results were similar when anti-PD-1/PD-L1 monotherapy was analyzed (N = 102 patients), with a linear correlation between higher TMB and favorable outcome parameters; the median TMB for responders versus nonresponders treated with anti-PD-1/PD-L1 monotherapy was 18.0 versus 5.0 mutations/mb (P < 0.0001). Interestingly, anti-CTLA4/anti-PD-1/PD-L1 combinations versus anti-PD-1/PD-L1 monotherapy was selected as a factor independent of TMB for predicting better RR (77% vs. 21%; P = 0.004) and PFS (P = 0.024). Higher TMB predicts favorable outcome to PD-1/PD-L1 blockade across diverse tumors. Benefit from dual checkpoint blockade did not show a similarly strong dependence on TMB. Mol Cancer Ther; 16(11); 2598-608. ©2017 AACR.
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Affiliation(s)
- Aaron M Goodman
- Division of Hematology/Oncology, Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla, California. .,Center for Personalized Cancer Therapy, University of California San Diego, Moores Cancer Center, La Jolla, California.,Division of Blood and Marrow Transplantation, Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla, California
| | - Shumei Kato
- Division of Hematology/Oncology, Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla, California.,Center for Personalized Cancer Therapy, University of California San Diego, Moores Cancer Center, La Jolla, California
| | - Lyudmila Bazhenova
- Division of Hematology/Oncology, Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla, California
| | - Sandip P Patel
- Division of Hematology/Oncology, Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla, California
| | | | | | | | - Gregory A Daniels
- Division of Hematology/Oncology, Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla, California
| | - Razelle Kurzrock
- Division of Hematology/Oncology, Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla, California.,Center for Personalized Cancer Therapy, University of California San Diego, Moores Cancer Center, La Jolla, California
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69
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PD-L1 Expression and Immune Escape in Melanoma Resistance to MAPK Inhibitors. Clin Cancer Res 2017; 23:6054-6061. [DOI: 10.1158/1078-0432.ccr-16-1688] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 05/11/2017] [Accepted: 07/14/2017] [Indexed: 11/16/2022]
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Gallagher SJ, Shklovskaya E, Hersey P. Epigenetic modulation in cancer immunotherapy. Curr Opin Pharmacol 2017; 35:48-56. [PMID: 28609681 DOI: 10.1016/j.coph.2017.05.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/23/2017] [Accepted: 05/25/2017] [Indexed: 02/07/2023]
Abstract
The success of immune checkpoint inhibitors in cancer immunotherapy has been widely heralded. However many cancer patients do not respond to immune checkpoint therapy and some relapse due to acquired tumor resistance. Epigenetic targeting may be beneficial in cancer immunotherapy by reversing immune avoidance and escape mechanisms employed by cancer cells, as well as by modulating immune cell differentiation and function. In this manuscript we review recent findings suggesting how epigenetics may be used to improve cancer immunotherapy. We focus on the inhibitors of the CTLA4 and PD1 immune checkpoints and epigenetic modifiers of histone acetylation and methylation and DNA methylation.
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Affiliation(s)
- Stuart J Gallagher
- Melanoma Immunology and Oncology Group, The Centenary Institute, University of Sydney, Camperdown, NSW, Australia; Melanoma Institute Australia, Crow's Nest 2065, Sydney, Australia.
| | - Elena Shklovskaya
- Melanoma Immunology and Oncology Group, The Centenary Institute, University of Sydney, Camperdown, NSW, Australia; Melanoma Institute Australia, Crow's Nest 2065, Sydney, Australia
| | - Peter Hersey
- Melanoma Immunology and Oncology Group, The Centenary Institute, University of Sydney, Camperdown, NSW, Australia; Melanoma Institute Australia, Crow's Nest 2065, Sydney, Australia
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Abstract
Melanoma is a malignant tumor of melanocytes and is considered to be the most aggressive cancer among all skin diseases. The pathogenesis of melanoma has not been well documented, which may restrict the research and development of biomarkers and therapies. To date, several genetic and epigenetic factors have been identified as contributing to the development and progression of melanoma. Besides the findings on genetic susceptibilities, the recent progress in epigenetic studies has revealed that loss of the DNA hydroxymethylation mark, 5-hydroxymethylcytosine (5-hmC), along with high levels of DNA methylation at promoter regions of several tumor suppressor genes in melanoma, may serve as biomarkers for melanoma. Moreover, 5-Aza-2′-deoxycytidine, an epigenetic modifier causing DNA demethylation, and ten-eleven translocation family dioxygenase (TET), which catalyzes the generation of 5-hmC, demonstrate therapeutic potential in melanoma treatment. In this review, we will summarize the latest progress in research on DNA methylation/hydroxymethylation in melanoma, and we will discuss and provide insight for epigenetic biomarkers and therapies for melanoma. Particularly, we will discuss the role of DNA hydroxymethylation in melanoma infiltrating immune cells, which may also serve as a potential target for melanoma treatment.
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72
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Eifert C, Pantazi A, Sun R, Xu J, Cingolani P, Heyer J, Russell M, Lvova M, Ring J, Tse JY, Lyle S, Protopopov A. Clinical application of a cancer genomic profiling assay to guide precision medicine decisions. Per Med 2017; 14:309-325. [PMID: 28890729 PMCID: PMC5580078 DOI: 10.2217/pme-2017-0011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 05/09/2017] [Indexed: 12/17/2022]
Abstract
Aim: Develop and apply a comprehensive and accurate next-generation sequencing based assay to help clinicians to match oncology patients to therapies. Materials & methods: The performance of the CANCERPLEX® assay was assessed using DNA from well-characterized routine clinical formalin-fixed paraffin-embedded (FFPE) specimens and cell lines. Results: The maximum sensitivity of the assay is 99.5% and its accuracy is virtually 100% for detecting somatic alterations with an allele fraction of as low as 10%. Clinically actionable variants were identified in 93% of patients (930 of 1000) who underwent testing. Conclusion: The test's capacity to determine all of the critical genetic changes, tumor mutation burden, microsatellite instability status and viral associations has important ramifications on clinical decision support strategies, including identification of patients who are likely to benefit from immune checkpoint blockage therapies.
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Affiliation(s)
- Cheryl Eifert
- KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA
| | - Angeliki Pantazi
- KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA
| | - Ruobai Sun
- KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA
| | - Jia Xu
- KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,IBM Watson Health, 75 Binney St., Cambridge, MA 02142, USA.,KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,IBM Watson Health, 75 Binney St., Cambridge, MA 02142, USA
| | - Pablo Cingolani
- KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA
| | - Joerg Heyer
- KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA
| | - Meaghan Russell
- KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA
| | - Maria Lvova
- KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA
| | - Jennifer Ring
- KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA
| | - Julie Y Tse
- KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,Department of Pathology, Tufts Medical Center, Tufts University School of Medicine, 800 Washington St., Boston, MA 02111, USA.,KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,Department of Pathology, Tufts Medical Center, Tufts University School of Medicine, 800 Washington St., Boston, MA 02111, USA
| | - Stephen Lyle
- KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,University of Massachusetts Medical School, 364 Plantation St., Worcester, MA 01605, USA.,KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,University of Massachusetts Medical School, 364 Plantation St., Worcester, MA 01605, USA
| | - Alexei Protopopov
- KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA.,KEW, Inc., 840 Memorial Dr., Cambridge, MA 02139, USA
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73
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Wongchenko MJ, McArthur GA, Dréno B, Larkin J, Ascierto PA, Sosman J, Andries L, Kockx M, Hurst SD, Caro I, Rooney I, Hegde PS, Molinero L, Yue H, Chang I, Amler L, Yan Y, Ribas A. Gene Expression Profiling in BRAF-Mutated Melanoma Reveals Patient Subgroups with Poor Outcomes to Vemurafenib That May Be Overcome by Cobimetinib Plus Vemurafenib. Clin Cancer Res 2017; 23:5238-5245. [PMID: 28536307 DOI: 10.1158/1078-0432.ccr-17-0172] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/24/2017] [Accepted: 05/18/2017] [Indexed: 11/16/2022]
Abstract
Purpose: The association of tumor gene expression profiles with progression-free survival (PFS) outcomes in patients with BRAFV600-mutated melanoma treated with vemurafenib or cobimetinib combined with vemurafenib was evaluated.Experimental Design: Gene expression of archival tumor samples from patients in four trials (BRIM-2, BRIM-3, BRIM-7, and coBRIM) was evaluated. Genes significantly associated with PFS (P < 0.05) were identified by univariate Cox proportional hazards modeling, then subjected to unsupervised hierarchical clustering, principal component analysis, and recursive partitioning to develop optimized gene signatures.Results: Forty-six genes were identified as significantly associated with PFS in both BRIM-2 (n = 63) and the vemurafenib arm of BRIM-3 (n = 160). Two distinct signatures were identified: cell cycle and immune. Among vemurafenib-treated patients, the cell-cycle signature was associated with shortened PFS compared with the immune signature in the BRIM-2/BRIM-3 training set [hazard ratio (HR) 1.8; 95% confidence interval (CI), 1.3-2.6, P = 0.0001] and in the coBRIM validation set (n = 101; HR, 1.6; 95% CI, 1.0-2.5; P = 0.08). The adverse impact of the cell-cycle signature on PFS was not observed in patients treated with cobimetinib combined with vemurafenib (n = 99; HR, 1.1; 95% CI, 0.7-1.8; P = 0.66).Conclusions: In vemurafenib-treated patients, the cell-cycle gene signature was associated with shorter PFS. However, in cobimetinib combined with vemurafenib-treated patients, both cell cycle and immune signature subgroups had comparable PFS. Cobimetinib combined with vemurafenib may abrogate the adverse impact of the cell-cycle signature. Clin Cancer Res; 23(17); 5238-45. ©2017 AACR.
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Affiliation(s)
| | - Grant A McArthur
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia, and University of Melbourne, Parkville, Victoria, Australia
| | | | - James Larkin
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | | | | | | | | | - Ivor Caro
- Genentech, Inc., South San Francisco, California
| | | | | | | | - Huibin Yue
- Genentech, Inc., South San Francisco, California
| | - Ilsung Chang
- Genentech, Inc., South San Francisco, California
| | - Lukas Amler
- Genentech, Inc., South San Francisco, California
| | - Yibing Yan
- Genentech, Inc., South San Francisco, California
| | - Antoni Ribas
- Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, Los Angeles, California
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74
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Guan J, Lim KS, Mekhail T, Chang CC. Programmed Death Ligand-1 (PD-L1) Expression in the Programmed Death Receptor-1 (PD-1)/PD-L1 Blockade: A Key Player Against Various Cancers. Arch Pathol Lab Med 2017; 141:851-861. [DOI: 10.5858/arpa.2016-0361-ra] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
Immune checkpoint pathways, including programmed death receptor-1/programmed death ligand-1 (PD-1/PD-L1) signaling pathway, which are important in mediating self-tolerance and controlling self-damage, can sometimes be manipulated by cancer cells to evade immune surveillance. Recent clinical trials further demonstrate the efficacy of PD-1/PD-L1–targeted therapy in various cancers and reveal a new era of cancer immunotherapy.
Objective.—
To review the mechanism of the PD-1/PD-L1 signaling pathway, the regulation of this pathway, PD-1/PD-L1 as a predictive and/or prognostic marker in various cancers, and strategies of measuring PD-L1 expression.
Data Sources.—
Representative medical literature regarding PD-L1 expression in various cancers, including the preliminary results of the Blue Proposal, which compares different immunohistochemical stains for PD-L1 reported in the recent American Association of Cancer Research (AACR) Annual Meeting (April 16–20, 2016).
Conclusion.—
Either PD-1/PD-L1–targeted therapy alone or in combination with other treatment modalities provides benefit for patients with advanced cancers. Because of the complexity of cancer immunity, we still do not have a reliable biomarker to predict the response of PD-1/PD-L1–targeted therapy. Future studies, including methods beyond immunohistochemical stains, are needed to develop reliable biomarker/biomarkers for pathology laboratories to aid in selecting patients who will benefit most from PD-1/PD-L1–targeted therapy.
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Affiliation(s)
| | | | | | - Chung-Che Chang
- From the Departments of Internal Medicine (Drs Guan, Lim, and Mekhail) and Pathology and Laboratory Medicine (Dr Chang), Florida Hospital, Orlando; and the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Chang)
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75
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Jacquelot N, Pitt JM, Enot DP, Roberti MP, Duong CPM, Rusakiewicz S, Eggermont AM, Zitvogel L. Immune biomarkers for prognosis and prediction of responses to immune checkpoint blockade in cutaneous melanoma. Oncoimmunology 2017; 6:e1299303. [PMID: 28919986 DOI: 10.1080/2162402x.2017.1299303] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 02/19/2017] [Indexed: 01/05/2023] Open
Abstract
Existing clinical, anatomopathological and molecular biomarkers fail to reliably predict the prognosis of cutaneous melanoma. Biomarkers for determining which patients receive adjuvant therapies are needed. The emergence of new technologies and the discovery of new immune populations with different prognostic values allow the immune network in the tumor to be better understood. Importantly, new molecules identified and expressed by immune cells have been shown to reduce the antitumor immune efficacy of therapies, prompting researchers to develop antibodies targeting these so-called "immune checkpoints", which have now entered the oncotherapeutic armamentarium.
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Affiliation(s)
- Nicolas Jacquelot
- Gustave Roussy, Université Paris-Saclay, INSERM U1015, Villejuif, F-94805, France
| | - Jonathan M Pitt
- Gustave Roussy, Université Paris-Saclay, INSERM U1015, Villejuif, F-94805, France
| | - David P Enot
- Gustave Roussy, Université Paris-saclay, Metabolomics and Cell Biology Platforms, Villejuif, F-94805, France
| | - Maria Paula Roberti
- Gustave Roussy, Université Paris-Saclay, INSERM U1015, Villejuif, F-94805, France
| | - Connie P M Duong
- Gustave Roussy, Université Paris-Saclay, INSERM U1015, Villejuif, F-94805, France
| | - Sylvie Rusakiewicz
- Gustave Roussy, Université Paris-Saclay, INSERM U1015, Villejuif, F-94805, France.,Gustave Roussy, Université Paris-saclay, CIC Biothérapie IGR Curie CIC 1428, Villejuif, F-94805, France
| | | | - Laurence Zitvogel
- Gustave Roussy, Université Paris-Saclay, INSERM U1015, Villejuif, F-94805, France.,Gustave Roussy, Université Paris-saclay, CIC Biothérapie IGR Curie CIC 1428, Villejuif, F-94805, France
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76
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Prognostic role of PD-L1 in malignant solid tumors: a meta-analysis. Int J Biol Markers 2017; 32:e68-e74. [PMID: 27470134 DOI: 10.5301/jbm.5000225] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2016] [Indexed: 12/20/2022]
Abstract
PURPOSE The aim of this study was to elucidate the rates and prognostic roles of programmed cell death ligand 1 (PD-L1) immunohistochemical (IHC) expression in various malignant tumors through a systematic review and meta-analysis. METHOD The current study included 16,176 patients from 97 eligible studies. We investigated PD-L1 expression and its correlation with survival rate in various malignant tumors. RESULTS The estimated rate of PD-L1 IHC expression was 0.449 (95% confidence interval [CI] 0.404-0.495). The highest and lowest PD-L1 expression levels were found in thyroid cancer (0.829, 95% CI 0.781-0.868) and small-cell neuroendocrine carcinoma (0.005, 95% CI 0.000-0.080), respectively. PD-L1 expression was significantly correlated with poorer overall survival and disease-free survival rates (hazard ratios 1.276, 95% CI 1.097-1.486 and 1.304, 95% CI 1.034-1.644, respectively). However, PD-L1 IHC expression was significantly correlated with worse overall survival rates in patients with esophageal cancer and renal cell carcinoma and with worse disease-free survival rates in patients with colorectal cancer, hepatocellular carcinoma, and renal cell carcinoma. CONCLUSIONS Our results show that PD-L1 expression rates and the correlations with survival varied between tumor types. Detailed evaluation criteria for PD-L1 will have to be standardized before application to specific tumor types.
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77
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Boichard A, Tsigelny IF, Kurzrock R. High expression of PD-1 ligands is associated with kataegis mutational signature and APOBEC3 alterations. Oncoimmunology 2017; 6:e1284719. [PMID: 28405512 PMCID: PMC5384346 DOI: 10.1080/2162402x.2017.1284719] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 01/11/2017] [Accepted: 01/13/2017] [Indexed: 01/20/2023] Open
Abstract
Immunotherapy with checkpoint inhibitors, such as antibodies blocking the programmed cell-death receptor-1 (PD-1), has resulted in remarkable responses in patients having traditionally refractory cancers. Although response to PD-1 inhibitors correlates with PD-1 ligand (PD-L1 or PD-L2) expression, PD-1 ligand positivity represents only a part of the predictive model necessary for selecting patients predisposed to respond to immunotherapy. We used all genomic, transcriptomic, proteomic and phenotypic data related to 8,475 pan-cancer samples available in The Cancer Genome Atlas (TCGA) and conducted a logistic regression analysis based on a large set of variables, such as microsatellite instability (MSI-H), mismatch repair (MMR) alterations, polymerase δ (POLD1) and polymerase ε (POLE) mutations, activation-induced/apolipoprotein-B editing cytidine deaminases (AID/APOBEC) alterations, lymphocyte markers and mutation burden estimates to determine independent factors that associate with PD-1 ligand overexpression. PD-1 ligand overexpression was independently and significantly correlated with overexpression of and mutations in APOBEC3 paralogs. Additionally, while high tumor mutation burden and overexpression of PD-L1 have been previously correlated with each other, we demonstrate that the specific mutation pattern caused by APOBEC enzymes and called kataegis—rather than overall mutation burden, MSI-H or MMR alterations—correlates independently with PD-L1/PD-L2 expression. These observations suggest that APOBEC3 alterations, APOBEC3 overexpression and kataegis play an important role in the regulation of PD-1 ligand overexpression, and thus, their relationship with immune checkpoint inhibitor response warrants exploration.
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Affiliation(s)
- Amélie Boichard
- Center for Personalized Cancer Therapy and Division of Hematology and Oncology, University of California San Diego, Moores Cancer Center , La Jolla, CA, USA
| | - Igor F Tsigelny
- Center for Personalized Cancer Therapy and Division of Hematology and Oncology, University of California San Diego, Moores Cancer Center, La Jolla, CA, USA; San Diego Supercomputer Center, University of California San Diego, La Jolla, CA, USA; Department of Neurosciences, University of California San Diego, La Jolla, CA, USA; CureMatch Inc., San Diego, CA, USA
| | - Razelle Kurzrock
- Center for Personalized Cancer Therapy and Division of Hematology and Oncology, University of California San Diego, Moores Cancer Center , La Jolla, CA, USA
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78
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Sato Y, Kinoshita M, Takemura S, Tanaka S, Hamano G, Nakamori S, Fujikawa M, Sugawara Y, Yamamoto T, Arimoto A, Yamamura M, Sasaki M, Harada K, Nakanuma Y, Kubo S. The PD-1/PD-L1 axis may be aberrantly activated in occupational cholangiocarcinoma. Pathol Int 2017; 67:163-170. [PMID: 28139862 DOI: 10.1111/pin.12511] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 01/08/2017] [Indexed: 12/15/2022]
Abstract
An outbreak of cholangiocarcinoma in a printing company was reported in Japan, and these cases were regarded as an occupational disease (occupational cholangiocarcinoma). This study examined the expression status of programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) in occupational cholangiocarcinoma. Immunostaining of PD-1, PD-L1, CD3, CD8, and CD163 was performed using tissue sections of occupational cholangiocarcinoma (n = 10), and the results were compared with those of control cases consisting of intrahepatic (n = 23) and extrahepatic (n = 45) cholangiocarcinoma. Carcinoma cells expressed PD-L1 in all cases of occupational cholangiocarcinoma, whereas the detection of PD-L1 expression in cholangiocarcinoma cells was limited to a low number of cases (less than 10%) in the control subjects. In cases of occupational cholangiocarcinoma, occasional PD-L1 expression was also noted in precancerous/preinvasive lesions such as biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct. Additionally, tumor-associated macrophages and tumor-infiltrating T cells expressed PD-L1 and PD-1, respectively. The number of PD-L1-positive mononuclear cells, PD-1-positive lymphocytes, and CD8-positive lymphocytes infiltrating within the tumor was significantly higher in occupational cholangiocarcinoma compared with that in control cases. These results indicate that immune escape via the PD-1/PD-L1 axis may be occurring in occupational cholangiocarcinoma.
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Affiliation(s)
- Yasunori Sato
- Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Masahiko Kinoshita
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shigekazu Takemura
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shogo Tanaka
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Genya Hamano
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shoji Nakamori
- Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan
| | | | - Yasuhiko Sugawara
- Artificial Organ & Transplantation Division, Department of Surgery, University of Tokyo, Tokyo, Japan
| | | | - Akira Arimoto
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka Red Cross Hospital, Osaka, Japan
| | - Minako Yamamura
- Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Motoko Sasaki
- Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Kenichi Harada
- Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Yasuni Nakanuma
- Department of Diagnostic Pathology, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Shoji Kubo
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
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79
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[Tissue biomarkers of response to anti-PD-1 immunotherapies in melanoma]. Ann Pathol 2017; 37:55-60. [PMID: 28111041 DOI: 10.1016/j.annpat.2016.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 12/08/2016] [Indexed: 11/20/2022]
Abstract
Prognosis and treatment of advanced melanoma have been transformed by the success of immunotherapies, in particular agents targeting PD-1. PD-L1 expression assessed by immunohistochemistry in not an effective predictive biomarker to select patients in this tumor type, since significant clinical benefit was observed in the group of patients with negative tumors. The predictive value of PD-L1 testing to select patients for combination of anti-PD-1 and anti-CTLA-4 agents is under evaluation. Other tissue biomarkers are emerging to identify sensitive tumors to anti-PD-1 agents. In particular, assessment of immune infiltrates in tumor tissue, mutational load and tumor neoantigens seem promising in melanoma.
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80
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Akiyama Y, Kondou R, Iizuka A, Ohshima K, Urakami K, Nagashima T, Shimoda Y, Tanabe T, Ohnami S, Ohnami S, Kusuhara M, Mochizuki T, Yamaguchi K. Immune response-associated gene analysis of 1,000 cancer patients using whole-exome sequencing and gene expression profiling-Project HOPE. Biomed Res 2017; 37:233-42. [PMID: 27544999 DOI: 10.2220/biomedres.37.233] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Project HOPE (High-tech Omics-based Patient Evaluation) has been progressing since its implementation in 2014 using whole-exome sequencing (WES) and gene expression profiling (GEP). With the aim of evaluating immune status in cancer patients, a gene panel consisting of 164 immune response-associated genes (56 antigen-presenting cell and T-cell-associated genes, 34 cytokine- and metabolism-associated genes, 47 TNF and TNF receptor superfamily genes, and 27 regulatory T-cell-associated genes) was established, and its expression and mutation status were investigated using 1,000 cancer patient-derived tumors. Regarding WES, sequencing and variant calling were performed using the Ion Proton system. The average number of single-nucleotide variants (SNVs) detected per sample was 183 ± 507, and the number of hypermutators with more than 500 total SNVs was 51 cases. Regarding GEP, seven immune response-associated genes (VTCN1, IL2RA, ULBP2, TREM1, MSR1, TNFSF9 and TNFRSF12A) were more than 2-fold overexpressed compared with normal tissues in more than 2 organs. Specifically, the positive rate of PD-L1 expression in all patients was 25.8%, and PD-L1 expression was significantly upregulated in hypermutators. The simultaneous analyses of WES and GEP based on immune response-associated genes are very intriguing tools to screen cancer patients suitable for immune checkpoint antibody therapy.
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Affiliation(s)
- Yasuto Akiyama
- Immunotherapy Division, Shizuoka Cancer Center Research Institute
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81
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Abstract
The term "antitumor immunity" refers to innate and adaptive immune responses which lead to tumor control. Turning the immune system into a destructive force against tumors has been achieved in a broad range of human cancers with the use of non-specific immunotherapies, vaccines, adoptive-cell therapy, and, more recently with significant success, through blockade of immune checkpoints. Nevertheless, the efficacy of these approaches is not universal, and tools to identify long-term responders and primarily refractory patients are warranted. In this article, we review recent advances in understanding the complex mechanisms of antitumor immunity and how these developments can be used to address open questions in a setting of growing clinical indications for the use of immunotherapy.
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Affiliation(s)
| | - Michael Andrew Postow
- Melanoma and Immunotherapeutics Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA
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82
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Mandalà M, Merelli B, Massi D. PD-L1 in melanoma: facts and myths. Melanoma Manag 2016; 3:187-194. [PMID: 30190888 DOI: 10.2217/mmt-2016-0013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 06/22/2016] [Indexed: 11/21/2022] Open
Abstract
The use of monoclonal antibodies that block immunologic checkpoints that would otherwise mediate the adaptive immune resistance have paved the way in cancer treatment. There is evidence that blocking the PD-1/PD-L1 axis is a strategy of overriding importance in the treatment of patients with metastatic melanoma and other solid malignancies, some of which (NSCLC, colorectal cancer, renal cell cancer, head and neck cancer) were not considered to be 'immune-responsive' diseases until recently. In this perspective article, the biological and clinical relevance of PD-L1 is summarized in the context of the immune checkpoint inhibitors as a therapeutic strategy in metastatic melanoma patients.
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Affiliation(s)
- Mario Mandalà
- Unit of Medical Oncology, Department of Oncology & Hematology, Papa Giovanni XXIII Cancer Center Hospital, Piazza OMS 1, 24100, Bergamo, Italy.,Unit of Medical Oncology, Department of Oncology & Hematology, Papa Giovanni XXIII Cancer Center Hospital, Piazza OMS 1, 24100, Bergamo, Italy
| | - Barbara Merelli
- Unit of Medical Oncology, Department of Oncology & Hematology, Papa Giovanni XXIII Cancer Center Hospital, Piazza OMS 1, 24100, Bergamo, Italy.,Unit of Medical Oncology, Department of Oncology & Hematology, Papa Giovanni XXIII Cancer Center Hospital, Piazza OMS 1, 24100, Bergamo, Italy
| | - Daniela Massi
- Division of Pathological Anatomy, Department of Surgery & Translational Medicine, University of Florence, Italy.,Division of Pathological Anatomy, Department of Surgery & Translational Medicine, University of Florence, Italy
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