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Simonds EF, Lu ED, Badillo O, Karimi S, Liu EV, Tamaki W, Rancan C, Downey KM, Stultz J, Sinha M, McHenry LK, Nasholm NM, Chuntova P, Sundström A, Genoud V, Shahani SA, Wang LD, Brown CE, Walker PR, Swartling FJ, Fong L, Okada H, Weiss WA, Hellström M. Deep immune profiling reveals targetable mechanisms of immune evasion in immune checkpoint inhibitor-refractory glioblastoma. J Immunother Cancer 2021; 9:e002181. [PMID: 34083417 PMCID: PMC8183210 DOI: 10.1136/jitc-2020-002181] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Glioblastoma (GBM) is refractory to immune checkpoint inhibitor (ICI) therapy. We sought to determine to what extent this immune evasion is due to intrinsic properties of the tumor cells versus the specialized immune context of the brain, and if it can be reversed. METHODS We used CyTOF mass cytometry to compare the tumor immune microenvironments (TIME) of human tumors that are generally ICI-refractory (GBM and sarcoma) or ICI-responsive (renal cell carcinoma), as well as mouse models of GBM that are ICI-responsive (GL261) or ICI-refractory (SB28). We further compared SB28 tumors grown intracerebrally versus subcutaneously to determine how tumor site affects TIME and responsiveness to dual CTLA-4/PD-1 blockade. Informed by these data, we explored rational immunotherapeutic combinations. RESULTS ICI-sensitivity in human and mouse tumors was associated with increased T cells and dendritic cells (DCs), and fewer myeloid cells, in particular PD-L1+ tumor-associated macrophages. The SB28 mouse model of GBM responded to ICI when grown subcutaneously but not intracerebrally, providing a system to explore mechanisms underlying ICI resistance in GBM. The response to ICI in the subcutaneous SB28 model required CD4 T cells and NK cells, but not CD8 T cells. Recombinant FLT3L expanded DCs, improved antigen-specific T cell priming, and prolonged survival of mice with intracerebral SB28 tumors, but at the cost of increased Tregs. Targeting PD-L1 also prolonged survival, especially when combined with stereotactic radiation. CONCLUSIONS Our data suggest that a major obstacle for effective immunotherapy of GBM is poor antigen presentation in the brain, rather than intrinsic immunosuppressive properties of GBM tumor cells. Deep immune profiling identified DCs and PD-L1+ tumor-associated macrophages as promising targetable cell populations, which was confirmed using therapeutic interventions in vivo.
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Affiliation(s)
- Erin F Simonds
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Edbert D Lu
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Oscar Badillo
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Shokoufeh Karimi
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Eric V Liu
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Whitney Tamaki
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Chiara Rancan
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Kira M Downey
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Jacob Stultz
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Meenal Sinha
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Lauren K McHenry
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Nicole M Nasholm
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Pavlina Chuntova
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Anders Sundström
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Vassilis Genoud
- Translational Research Centre in Oncohaematology, Department of Medicine, University of Geneva, Geneva, Switzerland
| | - Shilpa A Shahani
- Department of Pediatrics, City of Hope National Medical Center, Duarte, California, USA
| | - Leo D Wang
- Department of Pediatrics, City of Hope National Medical Center, Duarte, California, USA
- Department of Immuno-Oncology, City of Hope National Medical Center, Duarte, California, USA
| | - Christine E Brown
- Departments of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte CA, Duarte, California, USA
| | - Paul R Walker
- Translational Research Centre in Oncohaematology, Department of Medicine, University of Geneva, Geneva, Switzerland
| | - Fredrik J Swartling
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Lawrence Fong
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Parker Institute for Cancer Immunotherapy, San Francisco, California, USA
| | - Hideho Okada
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Parker Institute for Cancer Immunotherapy, San Francisco, California, USA
| | - William A Weiss
- Parker Institute for Cancer Immunotherapy, San Francisco, California, USA
- Departments of Neurology, Neurological Surgery, and Pediatrics, University of California San Francisco, San Francisco, California, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California, USA
| | - Mats Hellström
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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Werlinger F, Villalón M, Duarte V, Acevedo R, Aguilera R, Alcocer D, Badillo O, Briones R, Condal C, Del Río M, García R, Herrera M, Jaramillo J, Merchan F, Nasi M, Osbén R, Rivera A, Riviello S, Rojas P, Vidal C, Rodríguez G, Schild S, Arroyo E, Alvarado MJ, Sepúlveda P, Cortés J. Trends of maxillofacial trauma: An update from the prospective register of a multicenter study in emergency services of Chile. Med Oral Patol Oral Cir Bucal 2019; 24:e588-e594. [PMID: 31433390 PMCID: PMC6764707 DOI: 10.4317/medoral.22985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 05/17/2019] [Indexed: 11/08/2022] Open
Abstract
Background Determine the behavior of the maxillofacial trauma of adults treated in 3 tertiary care centers in the central zone of Chile. Material and Methods Descriptive, cross-sectional, multicenter study, based on the prospective records of maxillofacial trauma cases attended between May 2016 and April 2017 by dental and maxillofacial clinical teams of Adult Emergency Units of hospitals Dr. Sótero del Río (metropolitan region), Carlos Van Buren and Dr. Gustavo Fricke (region V). Age, sex, date of occurrence, type of trauma according to ICD-10, etiology, legal medical prognosis and associated injuries were recorded, stratifying by sex and age. Chi square and unpaired Wilcoxon tests were used to compare by groups. Results 2.485 cases and 3.285 injuries were investigated. The male: female ratio was 1.7: 1 with age under 30 predominant, followed by older adults. Variability was observed in the yearly, weekly and daily presentation. The highest frequencies were in January and September, weekends and at night. The main etiologies were violence (42.3%), falls (13.1%) and road traffic crashes (12.9%) with differences by age and sex (p<0.05). 31,9% of the injuries occurred in hard tissue, being fractures in nasal bones predominant (S02.2). Conclusions The profile of the maxillofacial trauma in Chile seems to be mixed by age, affecting young people and the elderly. The male sex predominates; the main cause, which varies by age group, is violence. Their surveillance is possible from hospital emergency records. Key words:Maxillofacial trauma, emergency department, multicenter study.
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Affiliation(s)
- F Werlinger
- Sergio Livingstone Polhammer 943, Independencia, Santiago, Chile,
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Badillo O, Osben R, Vidal C, Duarte V. Design and use of an instrument for video-assisted surgical treatment of unstable fractures of the zygomatic arch: the Z instrument. Br J Oral Maxillofac Surg 2015; 53:767-8. [PMID: 26009148 DOI: 10.1016/j.bjoms.2015.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 05/01/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Oscar Badillo
- Department of Oral and Maxillofacial Surgery Hospital Carlos Van Buren, Valparaíso, Chile, San Ignacio 725, Valparaíso, Chile
| | - Roberto Osben
- Department of Oral and Maxillofacial Surgery Hospital Carlos Van Buren, Valparaíso, Chile, San Ignacio 725, Valparaíso, Chile
| | - Constanza Vidal
- Department of Oral and Maxillofacial Surgery Hospital Carlos Van Buren, Valparaíso, Chile, San Ignacio 725, Valparaíso, Chile
| | - Valentina Duarte
- Department of Oral and Maxillofacial Surgery Hospital Carlos Van Buren, Valparaíso, Chile, San Ignacio 725, Valparaíso, Chile; Pontificia Universidad Católica de Valparaíso, Av. Brasil 2950, Valparaíso, Chile.
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