1
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Gunawardana J, Law SC, Sabdia MB, Fennell É, Hennessy A, Leahy CI, Murray PG, Bednarska K, Brosda S, Trotman J, Berkahn L, Zaharia A, Birch S, Burgess M, Talaulikar D, Lee JN, Jude E, Hawkes EA, Jain S, Nath K, Snell C, Swain F, Tobin JWD, Keane C, Shanavas M, Blyth E, Steidl C, Savage K, Farinha P, Boyle M, Meissner B, Green MR, Vega F, Gandhi MK. Intra-tumoral and peripheral blood TIGIT and PD-1 as immune biomarkers in nodular lymphocyte predominant Hodgkin lymphoma. Am J Hematol 2024; 99:2096-2107. [PMID: 39152767 PMCID: PMC11469944 DOI: 10.1002/ajh.27459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/12/2024] [Accepted: 07/28/2024] [Indexed: 08/19/2024]
Abstract
In classical Hodgkin lymphoma (cHL), responsiveness to immune-checkpoint blockade (ICB) is associated with specific tumor microenvironment (TME) and peripheral blood features. The role of ICB in nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is not established. To gain insights into its potential in NLPHL, we compared TME and peripheral blood signatures between HLs using an integrative multiomic analysis. A discovery/validation approach in 121 NLPHL and 114 cHL patients highlighted >2-fold enrichment in programmed cell death-1 (PD-1) and T-cell Ig and ITIM domain (TIGIT) gene expression for NLPHL versus cHL. Multiplex imaging showed marked increase in intra-tumoral protein expression of PD-1+ (and/or TIGIT+) CD4+ T-cells and PD-1+CD8+ T-cells in NLPHL compared to cHL. This included T-cells that rosetted with lymphocyte predominant (LP) and Hodgkin Reed-Sternberg (HRS) cells. In NLPHL, intra-tumoral PD-1+CD4+ T-cells frequently expressed TCF-1, a marker of heightened T-cell response to ICB. The peripheral blood signatures between HLs were also distinct, with higher levels of PD-1+TIGIT+ in TH1, TH2, and regulatory CD4+ T-cells in NLPHL versus cHL. Circulating PD-1+CD4+ had high levels of TCF-1. Notably, in both lymphomas, highly expanded populations of clonal TIGIT+PD-1+CD4+ and TIGIT+PD-1+CD8+ T-cells in the blood were also present in the TME, indicating that immune-checkpoint expressing T-cells circulated between intra-tumoral and blood compartments. In in vitro assays, ICB was capable of reducing rosette formation around LP and HRS cells, suggesting that disruption of rosetting may be a mechanism of action of ICB in HL. Overall, results indicate that further evaluation of ICB is warranted in NLPHL.
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Affiliation(s)
- Jay Gunawardana
- Blood Cancer Research Group, Mater Research, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Soi C. Law
- Blood Cancer Research Group, Mater Research, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Muhammed B. Sabdia
- Blood Cancer Research Group, Mater Research, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Éanna Fennell
- School of Medicine, Limerick Digital Cancer Research Centre, Health Research Institute and Bernal Institute, University of Limerick, Limerick, Ireland
| | - Aoife Hennessy
- School of Medicine, Limerick Digital Cancer Research Centre, Health Research Institute and Bernal Institute, University of Limerick, Limerick, Ireland
| | - Ciara I. Leahy
- School of Medicine, Limerick Digital Cancer Research Centre, Health Research Institute and Bernal Institute, University of Limerick, Limerick, Ireland
| | - Paul G. Murray
- School of Medicine, Limerick Digital Cancer Research Centre, Health Research Institute and Bernal Institute, University of Limerick, Limerick, Ireland
- Royal College of Surgeons Ireland, Adliya, Bahrain
| | - Karolina Bednarska
- Blood Cancer Research Group, Mater Research, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Sandra Brosda
- Frazer Institute, University of Queensland, Translational Research Institute Brisbane, Australia
| | - Judith Trotman
- Concord Repatriation General Hospital, University of Sydney, Sydney, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW
| | - Leanne Berkahn
- Department of Haematology, Auckland City Hospital, Auckland, New Zealand
| | - Andreea Zaharia
- Blood Cancer Research Group, Mater Research, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Simone Birch
- Princess Alexandra Hospital, Brisbane, Australia
| | - Melinda Burgess
- School of Medicine, Limerick Digital Cancer Research Centre, Health Research Institute and Bernal Institute, University of Limerick, Limerick, Ireland
- Princess Alexandra Hospital, Brisbane, Australia
| | - Dipti Talaulikar
- Haematology Translational Research Unit, ACT Pathology, Canberra Health Services, Canberra, Australia
- College of Health and Medicine, Australian National University, Canberra, Australia
| | - Justina N. Lee
- Blood Cancer Research Group, Mater Research, University of Queensland, Translational Research Institute, Brisbane, Australia
| | | | - Eliza A. Hawkes
- Olivia Newton John Cancer Research and Wellness Centre, Austin Health, Melbourne, Australia
- Transfusion Research Unit, School of Public Health and Preventative Medicine, Monash University, Melbourne Australia
| | - Sanjiv Jain
- Anatomical Pathology Department, The Canberra Hospital, Canberra, Australia
| | - Karthik Nath
- Blood Cancer Research Group, Mater Research, University of Queensland, Translational Research Institute, Brisbane, Australia
- Memorial Sloan Kettering Cancer Center, NY, USA
| | - Cameron Snell
- Peter MacCallum Cancer Centre, Melbourne, Australia
- Mater Pathology, Brisbane, Australia
| | - Fiona Swain
- Royal College of Surgeons Ireland, Adliya, Bahrain
- Princess Alexandra Hospital, Brisbane, Australia
| | - Joshua W. D. Tobin
- Blood Cancer Research Group, Mater Research, University of Queensland, Translational Research Institute, Brisbane, Australia
- Princess Alexandra Hospital, Brisbane, Australia
| | - Colm Keane
- Frazer Institute, University of Queensland, Translational Research Institute Brisbane, Australia
- Princess Alexandra Hospital, Brisbane, Australia
| | - Mohamed Shanavas
- Blood Cancer Research Group, Mater Research, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Emily Blyth
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW
- Department of Haematology, Westmead Hospital, Westmead, NSW, Australia
- Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW
| | | | - Kerry Savage
- British Columbia Cancer Agency, Vancouver, Canada
| | | | | | | | | | - Francisco Vega
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Maher K. Gandhi
- Blood Cancer Research Group, Mater Research, University of Queensland, Translational Research Institute, Brisbane, Australia
- Princess Alexandra Hospital, Brisbane, Australia
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Libert D, Zhao S, Younes S, Mosquera AP, Bharadwaj S, Ferreira C, Natkunam Y. TIGIT is Frequently Expressed in the Tumor Microenvironment of Select Lymphomas: Implications for Targeted Therapy. Am J Surg Pathol 2024; 48:337-352. [PMID: 38148663 PMCID: PMC10876169 DOI: 10.1097/pas.0000000000002168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Immune checkpoint inhibitors against Programmed Cell Death Protein 1/Programmed Cell (PD-1/PD-L1) and CTLA-4/B7 axes have had limited success in hematologic malignancies, requiring the need to explore alternative targets such as T-cell immunoreceptor with Ig and ITIM domains (TIGIT)/CD155 to improve durable clinical responses. We undertook this study to investigate the expression profile of TIGIT such that the potential efficacy of TIGIT blockade could be mapped among lymphoma subtypes. We validated an immunohistochemical assay for TIGIT and evaluated its expression in lymphoma and tumor microenvironment (TME) cells in 661 lymphoma/leukemia biopsies. Multiplex immunofluorescence was used for correlation with normal TME cell subsets. Tumor or TME TIGIT-positivity was defined as moderate to strong membrane staining in at least 10% of tumor or TME cells, respectively. TME TIGIT expression was correlated with overall survival and progression-free survival and comparison with PD-L1 expression. In most cases, lymphoma cells were TIGIT-negative except for angioimmunoblastic and peripheral T-cell lymphomas, which showed 91% and 47% positivity, respectively. A high proportion of small B-cell lymphoma and anaplastic large cell lymphoma cases had TIGIT-positive TME cells. Chronic lymphocytic leukemia/small lymphocytic lymphoma patients with TIGIT-negative TME cells showed significantly shorter overall survival ( P =0.04). No other statistically significant differences were found. When TIGIT was expressed in TME cells, there were a comparable number of TIGIT-positive only and dual TIGIT/PD-L1 positive cases except for more TIGIT-positive only cases in CLL/SLL. TIGIT expression shows distinctive profiles among lymphoma subtypes. Chronic lymphocytic leukemia/small lymphocytic lymphoma and anaplastic large cell lymphoma demonstrated high TME TIGIT expression compared with PD-L1, with a high proportion of dual TIGIT and PD-L1-positivity. Our results are likely to contribute to the design and correlative study of therapeutic response in clinical trials targeting TIGIT alone or in combination with PD1/PDL1.
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3
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Takeuchi M, Miyoshi H, Semba Y, Yamada K, Nakashima K, Sato K, Furuta T, Moritsubo M, Ogura Y, Tanaka K, Imamoto T, Arakawa F, Kohno K, Ohshima K. Co-stimulatory and immune checkpoint molecules are important in the tumor microenvironment of Hodgkin-like adult T-cell leukemia/lymphoma. Haematologica 2023; 108:3496-3501. [PMID: 37439334 PMCID: PMC10690911 DOI: 10.3324/haematol.2023.283163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/30/2023] [Indexed: 07/14/2023] Open
Affiliation(s)
- Mai Takeuchi
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Yuichiro Semba
- Department of Medicine and Biosystemic Science, Kyusyu University Faculty of Medicine, Fukuoka city, Fukuoka
| | - Kyohei Yamada
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Kazutaka Nakashima
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Kensaku Sato
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Yusuke Ogura
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Ken Tanaka
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Teppei Imamoto
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Fumiko Arakawa
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Kei Kohno
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka.
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Randall MP, Spinner MA. Optimizing Treatment for Relapsed/Refractory Classic Hodgkin Lymphoma in the Era of Immunotherapy. Cancers (Basel) 2023; 15:4509. [PMID: 37760478 PMCID: PMC10526852 DOI: 10.3390/cancers15184509] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Most patients with classic Hodgkin lymphoma (cHL) are cured with combination chemotherapy, but approximately 10-20% will relapse, and another 5-10% will have primary refractory disease. The treatment landscape of relapsed/refractory (R/R) cHL has evolved significantly over the past decade following the approval of brentuximab vedotin (BV), an anti-CD30 antibody-drug conjugate, and the PD-1 inhibitors nivolumab and pembrolizumab. These agents have significantly expanded options for salvage therapy prior to autologous hematopoietic cell transplantation (AHCT), post-transplant maintenance, and treatment of relapse after AHCT, which have led to improved survival in the modern era. In this review, we highlight our approach to the management of R/R cHL in 2023 with a focus on choosing first salvage therapy, post-transplant maintenance, and treatment of relapse after AHCT. We also discuss the management of older adults and transplant-ineligible patients, who require a separate approach. Finally, we review novel immunotherapy approaches in clinical trials, including combinations of PD-1 inhibitors with other immune-activating agents as well as novel antibody-drug conjugates, bispecific antibodies, and cellular immunotherapies. Ongoing studies assessing biomarkers of response to immunotherapy and dynamic biomarkers such as circulating tumor DNA may further inform treatment decisions and enable a more personalized approach in the future.
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Affiliation(s)
| | - Michael A. Spinner
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA;
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Jin S, Zhang Y, Zhou F, Chen X, Sheng J, Zhang J. TIGIT: A promising target to overcome the barrier of immunotherapy in hematological malignancies. Front Oncol 2022; 12:1091782. [PMID: 36605439 PMCID: PMC9807865 DOI: 10.3389/fonc.2022.1091782] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Immune evasion through up-regulating checkpoint inhibitory receptors on T cells plays an essential role in tumor initiation and progression. Therefore, immunotherapy, including immune checkpoint inhibitor targeting programmed cell death protein 1 (PD-1) and chimeric antigen receptor T cell (CAR-T) therapy, has become a promising strategy for hematological malignancies. T cell immunoreceptor with immunoglobulin and ITIM domain (TIGIT) is a novel checkpoint inhibitory receptor expressed on immune cells, including cytotoxic T cells, regulatory T cells, and NK cells. TIGIT participates in immune regulation via binding to its ligand CD155. Blockage of TIGIT has provided evidence of considerable efficacy in solid tumors in preclinical research and clinical trials, especially when combined with PD-1 inhibition. However, the mechanism and function of TIGIT in hematological malignancies have not been comprehensively studied. In this review, we focus on the role of TIGIT in hematological malignancies and discuss therapeutic strategies targeting TIGIT, which may provide a promising immunotherapy target for hematological malignancies.
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Affiliation(s)
- Shenhe Jin
- Department of Hematology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ye Zhang
- Department of Hematology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Fengping Zhou
- Department of Hematology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaochang Chen
- Department of Hematology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jianpeng Sheng
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | - Jin Zhang
- Department of Hematology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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6
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Annese T, Tamma R, Ribatti D. Update in TIGIT Immune-Checkpoint Role in Cancer. Front Oncol 2022; 12:871085. [PMID: 35656508 PMCID: PMC9152184 DOI: 10.3389/fonc.2022.871085] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/14/2022] [Indexed: 12/12/2022] Open
Abstract
The in-depth characterization of cross-talk between tumor cells and T cells in solid and hematological malignancies will have to be considered to develop new therapeutical strategies concerning the reactivation and maintenance of patient-specific antitumor responses within the patient tumor microenvironment. Activation of immune cells depends on a delicate balance between activating and inhibitory signals mediated by different receptors. T cell immunoreceptor with immunoglobulin and ITIM domain (TIGIT) is an inhibitory receptor expressed by regulatory T cells (Tregs), activated T cells, and natural killer (NK) cells. TIGIT pathway regulates T cell-mediated tumor recognition in vivo and in vitro and represents an exciting target for checkpoint blockade immunotherapy. TIGIT blockade as monotherapy or in combination with other inhibitor receptors or drugs is emerging in clinical trials in patients with cancer. The purpose of this review is to update the role of TIGIT in cancer progression, looking at TIGIT pathways that are often upregulated in immune cells and at possible therapeutic strategies to avoid tumor aggressiveness, drug resistance, and treatment side effects. However, in the first part, we overviewed the role of immune checkpoints in immunoediting, the TIGIT structure and ligands, and summarized the key immune cells that express TIGIT.
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Affiliation(s)
- Tiziana Annese
- Department of Medicine and Surgery, Libera Università del Mediterraneo (LUM) Giuseppe Degennaro University, Bari, Italy.,Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Section of Human Anatomy and Histology, University of Bari Medical School, Bari, Italy
| | - Roberto Tamma
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Section of Human Anatomy and Histology, University of Bari Medical School, Bari, Italy
| | - Domenico Ribatti
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Section of Human Anatomy and Histology, University of Bari Medical School, Bari, Italy
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Casagrande N, Borghese C, Aldinucci D. Current and Emerging Approaches to Study Microenvironmental Interactions and Drug Activity in Classical Hodgkin Lymphoma. Cancers (Basel) 2022; 14:cancers14102427. [PMID: 35626032 PMCID: PMC9139207 DOI: 10.3390/cancers14102427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 11/24/2022] Open
Abstract
Simple Summary In classical Hodgkin Lymphoma (cHL), the tumor microenvironment (TME) plays an important role in tumor progression and treatment response, making its evaluation critical for determining prognosis, treatment strategies and predicting an increase in drug toxicity. Therefore, there is a need to utilize more complex systems to study the cHL-TME and its interplay with tumor cells. To evaluate new anticancer drugs and to find the mechanisms of drug resistance, this review summarizes emerging approaches for the analysis of the TME composition and to identify the state of the disease; the in vitro techniques used to determine the mechanisms involved in the building of an immunosuppressive and protective TME; new 3-dimensional (3D) models, the heterospheroids (HS), developed to mimic TME interactions. Here, we describe the present and likely future clinical applications indicated by the results of these studies and propose a classification for the in vitro culture methods used to study TME interactions in cHL. Abstract Classic Hodgkin lymphoma is characterized by a few tumor cells surrounded by a protective and immunosuppressive tumor microenvironment (TME) composed by a wide variety of noncancerous cells that are an active part of the disease. Therefore, new techniques to study the cHL-TME and new therapeutic strategies targeting specifically tumor cells, reactivating the antitumor immunity, counteracting the protective effects of the TME, were developed. Here, we describe new methods used to study the cell composition, the phenotype, and the spatial distribution of Hodgkin and Reed–Sternberg (HRS) cells and of noncancerous cells in tumor tissues. Moreover, we propose a classification, with increasing complexity, of the in vitro functional studies used to clarify the interactions leading not only to HRS cell survival, growth and drug resistance, but also to the immunosuppressive tumor education of monocytes, T lymphocytes and fibroblasts. This classification also includes new 3-dimensional (3D) models, obtained by cultivating HRS cells in extracellular matrix scaffolds or in sponge scaffolds, under non-adherent conditions with noncancerous cells to form heterospheroids (HS), implanted in developing chick eggs (ovo model). We report results obtained with these approaches and their applications in clinical setting.
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Gusak A, Fedorova L, Lepik K, Volkov N, Popova M, Moiseev I, Mikhailova N, Baykov V, Kulagin A. Immunosuppressive Microenvironment and Efficacy of PD-1 Inhibitors in Relapsed/Refractory Classic Hodgkin Lymphoma: Checkpoint Molecules Landscape and Macrophage Populations. Cancers (Basel) 2021; 13:cancers13225676. [PMID: 34830831 PMCID: PMC8616219 DOI: 10.3390/cancers13225676] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/03/2021] [Accepted: 11/09/2021] [Indexed: 12/19/2022] Open
Abstract
Simple Summary Classic Hodgkin lymphoma contains rare malignant Hodgkin/Reed–Sternberg cells and abundant reactive populations in the tumor microenvironment. Many aspects of the interaction between tumor cells and immune cells remain unclear. Nevertheless, the microenvironment is believed to play a crucial role in tumor resistance and progression. Current knowledge about the role and dynamics of the tumor microenvironment in Hodgkin lymphoma during anti-PD-1 treatment is limited. The aim of this study was to identify possible predictive and prognostic morphological markers in the treatment of patients with relapsed or refractory classic Hodgkin lymphoma treated with nivolumab and to assess the variability of reactive cell populations after nivolumab therapy. The study was aimed to optimize therapeutic strategy in patients with relapsed or refractory classic Hodgkin lymphoma. Abstract To date, the impact of the tumor microenvironment on the prognosis of patients with classic Hodgkin lymphoma (cHL) during anti-PD-1 therapy has been studied insufficiently. This retrospective study included 61 primary samples of lymph nodes from patients who had relapsed/refractory (r/r) cHL and were treated with nivolumab. Repeated samples were obtained in 15 patients at relapse or disease progression after immunotherapy. Median follow-up was 55 (13–63) months. The best overall response rate and progression-free survival (PFS) were analyzed depending on the expression of CD68, CD163, PD-1, LAG-3, TIM-3, CTLA-4, TIGIT, CD163/c-maf in the tumor microenvironment in primary and sequential biopsies. The combination of CD163/c-maf antibodies was used for the identification of M2 macrophages (M2). A low number of macrophages in primary samples was associated with inferior PFS during nivolumab treatment (for CD163-positive cells p = 0.0086; for CD68-positive cells p = 0.037), while a low number of M2 with higher PFS (p = 0.014). Complete response was associated with a lower level of M2 (p = 0.011). In sequential samples (before and after nivolumab therapy) an increase in PD-1 (p = 0.011) and LAG-3 (p = 0.0045) and a depletion of CD68 (p = 0.057) and CD163 (p = 0.0049)-positive cells were observed. The study expands understanding of the cHL microenvironment structure and dynamics during nivolumab therapy in patients with r/r cHL.
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Loghin A, Nechifor-Boilă A, Borda A, Nechifor-Boilă IA, Voidazan S, Decaussin-Petrucci M. Programmed death ligand-1 (PD-L1) immunohistochemical assessment using the QR1 clone in muscle-invasive urothelial carcinomas: a comparison with reference clones 22C3 and SP263. Virchows Arch 2021; 480:303-313. [PMID: 34669047 DOI: 10.1007/s00428-021-03215-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/20/2021] [Accepted: 09/26/2021] [Indexed: 11/28/2022]
Abstract
Programmed death ligand-1 (PD-L1) immunohistochemical (IHC) status is used to predict which patients with metastatic urothelial carcinoma (UC) will respond to immunotherapy. We aimed to compare QR1(Quartett), 22C3 (Dako), and SP263 (Ventana) detection of PD-L1 expression in muscle-invasive UCs and determine the best scoring algorithm for assessment of PD-L1 expression when using the QR1 clone. Our study included 69 UCs. For SP263 and 22C3, PD-L1-positive tumor cell (TC) and/or immune cell (IC) percentages (TC%/IC%) and the Combined Positive Score (CPS) were assessed, respectively (positivity cut-offs of ≥ 25% and ≥ 10). For QR1, both interpretation systems were evaluated. The concordances between assays were calculated. PD-L1 IHC staining characteristics were comparable between QR1, 22C3, and SP263 in both conventional and variant histology UCs. We demonstrated strong or very strong correlations between clones; the strongest correlation for TCs was between QR1 and SP263 (r = 0.92; p = 0.001) and for ICs was between QR1 and 22C3 (r = 0.85; p = 0.001). Our comparative analysis of the scoring algorithms revealed very good concordances among the three assays (range 0.791-0.878); the highest concordance was between QR1 and SP263 when CPS was used as the scoring algorithm for QR1 (0.878; p < 0.001). Our study is the first to demonstrate that the QR1 clone can be used to evaluate PD-L1 status in UCs, with a very good agreement rate with the reference clones. QR1 appeared to be more similar to the SP263 clone. With regard to the scoring algorithm, when evaluating PD-L1 expression using QR1 clone, CPS performed better compared with the TC%/IC% score.
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Affiliation(s)
- Andrada Loghin
- Department of Histology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 38th Gh. Marinescu Street, 540139, Târgu-Mureş, Romania.,Department of Pathology, Târgu-Mureş County Hospital, 28th 1 December 1918 Street, 540061, Târgu-Mureş, Romania
| | - Adela Nechifor-Boilă
- Department of Histology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 38th Gh. Marinescu Street, 540139, Târgu-Mureş, Romania. .,Department of Pathology, Târgu-Mureş County Hospital, 28th 1 December 1918 Street, 540061, Târgu-Mureş, Romania.
| | - Angela Borda
- Department of Histology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 38th Gh. Marinescu Street, 540139, Târgu-Mureş, Romania.,Department of Pathology, Târgu-Mureş Emergency County Hospital, 50th Gh. Marinescu Street, 540139, Târgu-Mureş, Romania
| | - Ioan Alin Nechifor-Boilă
- Department of Anatomy and Embryology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 38th Gh Marinescu Street, 540139, Târgu-Mureş, Romania.,Department of Urology, Târgu-Mureş Emergency County Hospital, 50th Gh. Marinescu Street, 540139, Târgu-Mureş, Romania
| | - Septimiu Voidazan
- Department of Epidemiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 38th Gh Marinescu Street, 540139, Târgu-Mureş, Romania
| | - Myriam Decaussin-Petrucci
- Department of Pathology, Hospices Civils de Lyon, Hôpital Lyon Sud, 69495, Pierre Bénite, France.,Université Lyon-1, EA 3738 CICLY, 69921, Oullins cedex, France
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