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van der Woude LL, Gorris MAJ, Wortel IMN, Creemers JHA, Verrijp K, Monkhorst K, Grünberg K, van den Heuvel MM, Textor J, Figdor CG, Piet B, Theelen WSME, de Vries IJM. Tumor microenvironment shows an immunological abscopal effect in patients with NSCLC treated with pembrolizumab-radiotherapy combination. J Immunother Cancer 2022; 10:jitc-2022-005248. [PMID: 36252995 PMCID: PMC9577911 DOI: 10.1136/jitc-2022-005248] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2022] [Indexed: 11/06/2022] Open
Abstract
Background Immunotherapy is currently part of the standard of care for patients with advanced-stage non-small cell lung cancer (NSCLC). However, many patients do not respond to this treatment, therefore combination strategies are being explored to increase clinical benefit. The PEMBRO-RT trial combined the therapeutic programmed cell death 1 (PD-1) antibody pembrolizumab with stereotactic body radiation therapy (SBRT) to increase the overall response rate and study the effects on the tumor microenvironment (TME). Methods Here, immune infiltrates in the TME of patients included in the PEMBRO-RT trial were investigated. Tumor biopsies of patients treated with pembrolizumab alone or combined with SBRT (a biopsy of the non-irradiated site) at baseline and during treatment were stained with multiplex immunofluorescence for CD3, CD8, CD20, CD103 and FoxP3 for lymphocytes, pan-cytokeratin for tumors, and HLA-ABC expression was determined. Results The total number of lymphocytes increased significantly after 6 weeks of treatment in the anti-PD-1 group (fold change: 1.87, 95% CI: 1.06 to 3.29) and the anti-PD-1+SBRT group (fold change: 2.29, 95% CI: 1.46 to 3.60). The combination of SBRT and anti-PD-1 induced a 4.87-fold increase (95% CI: 2.45 to 9.68) in CD103+ cytotoxic T-cells 6 weeks on treatment and a 2.56-fold increase (95% CI: 1.03 to 6.36) after anti-PD-1 therapy alone. Responders had a significantly higher number of lymphocytes at baseline than non-responders (fold difference 1.85, 95% CI: 1.04 to 3.29 for anti-PD-1 and fold change 1.93, 95% CI: 1.08 to 3.44 for anti-PD-1+SBRT). Conclusion This explorative study shows that that lymphocyte infiltration in general, instead of the infiltration of a specific lymphocyte subset, is associated with response to therapy in patients with NSCLC. Furthermore, anti-PD-1+SBRT combination therapy induces an immunological abscopal effect in the TME represented by a superior infiltration of cytotoxic T cells as compared with anti-PD-1 monotherapy.
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Affiliation(s)
- Lieke L van der Woude
- Department of Tumour Immunology, Radboudumc, Nijmegen, The Netherlands,Department of Pathology, Radboudumc, Nijmegen, The Netherlands,Division of Immunotherapy, Oncode Institute, Radboudumc, Nijmegen, the Netherlands
| | - Mark A J Gorris
- Department of Tumour Immunology, Radboudumc, Nijmegen, The Netherlands,Division of Immunotherapy, Oncode Institute, Radboudumc, Nijmegen, the Netherlands
| | - Inge M N Wortel
- Data Science, Institute for Computing and Information Sciences, Radboud University, Nijmegen, the Netherlands
| | - Jeroen H A Creemers
- Department of Tumour Immunology, Radboudumc, Nijmegen, The Netherlands,Division of Immunotherapy, Oncode Institute, Radboudumc, Nijmegen, the Netherlands
| | - Kiek Verrijp
- Department of Tumour Immunology, Radboudumc, Nijmegen, The Netherlands,Department of Pathology, Radboudumc, Nijmegen, The Netherlands,Division of Immunotherapy, Oncode Institute, Radboudumc, Nijmegen, the Netherlands
| | - Kim Monkhorst
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | | | - Johannes Textor
- Department of Tumour Immunology, Radboudumc, Nijmegen, The Netherlands,Data Science, Institute for Computing and Information Sciences, Radboud University, Nijmegen, the Netherlands
| | - Carl G Figdor
- Department of Tumour Immunology, Radboudumc, Nijmegen, The Netherlands
| | - Berber Piet
- Department of Pulmonary Diseases, Radboudumc, Nijmegen, The Netherlands
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Ryu S, Park JS, Kim HY, Kim JH. Lipid-Reactive T Cells in Immunological Disorders of the Lung. Front Immunol 2018; 9:2205. [PMID: 30319649 PMCID: PMC6168663 DOI: 10.3389/fimmu.2018.02205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 09/05/2018] [Indexed: 11/13/2022] Open
Abstract
Regulation of T cell-mediated immunity in the lungs is critical for prevention of immune-related lung disorders and for host protection from pathogens. While the prevalent view of pulmonary T cell responses is based on peptide recognition by antigen receptors, called T cell receptors (TCR), on the T cell surface in the context of classical major histocompatibility complex (MHC) molecules, novel pathways involving the presentation of lipid antigens by cluster of differentiation 1 (CD1) molecules to lipid-reactive T cells are emerging as key players in pulmonary immune system. Whereas, genetic conservation of group II CD1 (CD1d) in mouse and human genomes facilitated numerous in vivo studies of CD1d-restricted invariant natural killer T (iNKT) cells in lung diseases, the recent development of human CD1-transgenic mice has made it possible to examine the physiological roles of group I CD1 (CD1a-c) molecules in lung immunity. Here, we discuss current understanding of the biology of CD1-reactive T cells with a specific focus on their roles in several pulmonary disorders.
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Affiliation(s)
- Seungwon Ryu
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea
| | - Joon Seok Park
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA, United States
| | - Hye Young Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea
| | - Ji Hyung Kim
- College of Life Sciences and Biotechnology, Korea University, Seoul, South Korea
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