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Lee SE, Wang F, Grefe M, Trujillo-Ocampo A, Ruiz-Vasquez W, Takahashi K, Abbas HA, Borges P, Antunes DA, Al-Atrash G, Daver N, Molldrem JJ, Futreal A, Garcia-Manero G, Im JS. Immunologic Predictors for Clinical Responses during Immune Checkpoint Blockade in Patients with Myelodysplastic Syndromes. Clin Cancer Res 2023; 29:1938-1951. [PMID: 36988276 PMCID: PMC10192218 DOI: 10.1158/1078-0432.ccr-22-2601] [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: 08/22/2022] [Revised: 12/10/2022] [Accepted: 02/27/2023] [Indexed: 03/30/2023]
Abstract
PURPOSE The aim of this study is to determine immune-related biomarkers to predict effective antitumor immunity in myelodysplastic syndrome (MDS) during immunotherapy (IMT, αCTLA-4, and/or αPD-1 antibodies) and/or hypomethylating agent (HMA). EXPERIMENTAL DESIGN Peripheral blood samples from 55 patients with MDS were assessed for immune subsets, T-cell receptor (TCR) repertoire, mutations in 295 acute myeloid leukemia (AML)/MDS-related genes, and immune-related gene expression profiling before and after the first treatment. RESULTS Clinical responders treated with IMT ± HMA but not HMA alone showed a significant expansion of central memory (CM) CD8+ T cells, diverse TCRβ repertoire pretreatment with increased clonality and emergence of novel clones after the initial treatment, and a higher mutation burden pretreatment with subsequent reduction posttreatment. Autophagy, TGFβ, and Th1 differentiation pathways were the most downregulated in nonresponders after treatment, while upregulated in responders. Finally, CTLA-4 but not PD-1 blockade attributed to favorable changes in immune landscape. CONCLUSIONS Analysis of tumor-immune landscape in MDS during immunotherapy provides clinical response biomarkers.
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Affiliation(s)
- Sung-Eun Lee
- Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
- Department of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea
| | - Feng Wang
- Department of Genomic Medicine, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
| | - Maison Grefe
- Department of Hematopoietic Biology and Malignancy, Division of Cancer Medicine, The University of Texas M.D, Anderson Cancer Center
| | - Abel Trujillo-Ocampo
- Department of Hematopoietic Biology and Malignancy, Division of Cancer Medicine, The University of Texas M.D, Anderson Cancer Center
| | - Wilfredo Ruiz-Vasquez
- Department of Hematopoietic Biology and Malignancy, Division of Cancer Medicine, The University of Texas M.D, Anderson Cancer Center
| | - Koichi Takahashi
- Department of Genomic Medicine, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
- Department of Leukemia, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
| | - Hussein A. Abbas
- Department of Leukemia, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
| | - Pamella Borges
- Department of Leukemia, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
- Department of Biology and Biochemistry, The University of Houston
| | | | - Gheath Al-Atrash
- Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
- Department of Hematopoietic Biology and Malignancy, Division of Cancer Medicine, The University of Texas M.D, Anderson Cancer Center
- Department of Leukemia, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
| | - Navel Daver
- Department of Leukemia, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
| | - Jeffrey J. Molldrem
- Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
- Department of Hematopoietic Biology and Malignancy, Division of Cancer Medicine, The University of Texas M.D, Anderson Cancer Center
- Department of Leukemia, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
| | - Andrew Futreal
- Department of Genomic Medicine, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
| | - Guillermo Garcia-Manero
- Department of Hematopoietic Biology and Malignancy, Division of Cancer Medicine, The University of Texas M.D, Anderson Cancer Center
| | - Jin S. Im
- Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
- Department of Hematopoietic Biology and Malignancy, Division of Cancer Medicine, The University of Texas M.D, Anderson Cancer Center
- Department of Leukemia, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center
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Liang H, Feng Y, Guo Y, Jian J, Zhao L, Luo X, Tao L, Liu B. Development and validation of a novel prognosis prediction model for patients with myelodysplastic syndrome. Front Oncol 2022; 12:1014504. [PMID: 36313674 PMCID: PMC9597308 DOI: 10.3389/fonc.2022.1014504] [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: 08/08/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background Somatic mutations are widespread in patients with Myelodysplastic Syndrome (MDS) and are associated with prognosis. However, a practical prognostic model for MDS that incorporates somatic mutations urgently needs to be developed. Methods A cohort of 201 MDS patients from the Gene Expression Omnibus (GEO) database was used to develop the model, and a single-center cohort of 115 MDS cohorts from Northwest China was used for external validation. Kaplan-Meier analysis was performed to compare the effects of karyotype classifications and gene mutations on the prognosis of MDS patients. Univariate and multivariate Cox regression analyses and Lasso regression were used to screen for key prognostic factors. The shinyapps website was used to create dynamic nomograms with multiple variables. The time-dependent receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA) were used to evaluate the model’s discrimination, accuracy and clinical utility. Results Six risk factors (age, bone morrow blast percentage, ETV6, TP53, EZH2, and ASXL1) were considered as predictor variables in the nomogram. The nomogram showed excellent discrimination, with respective the area under the ROC curve (AUC) values of 0.850, 0.839, 0.933 for the training cohort at 1 year, 3 years and 5 years; 0.715, 0.802 and 0.750 for the testing cohort at 1 year, 3 years and 5 years; and 0.668, 0.646 and 0.731 for the external validation cohort at 1 year, 3 years and 5 years. The calibration curves and decision curve showed that the nomogram had good consistency and clinical practical benefit. Finally, a stratified analysis showed that MDS patients with high risk had worse survival outcomes than patients with low risk. Conclusion We developed a nomogram containing six risk factors, which provides reliable and objective predictions of prognosis for MDS patients.
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Affiliation(s)
- Haiping Liang
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Yue Feng
- Department of Blood Transfusion, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yuancheng Guo
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Jinli Jian
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Long Zhao
- Department of Hematology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Xingchun Luo
- Department of Hematology, Xi’an Central Hospital, Xi’an, China
| | - Lili Tao
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Bei Liu
- Department of Hematology, The First Hospital of Lanzhou University, Lanzhou, China
- *Correspondence: Bei Liu,
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