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Adamo A, Frusteri C, Pilotto S, Caligola S, Belluomini L, Poffe O, Giacobazzi L, Dusi S, Musiu C, Hu Y, Wang T, Rizzini D, Vella A, Canè S, Sartori G, Insolda J, Sposito M, Incani UC, Carbone C, Piro G, Pettinella F, Qi F, Wang D, Sartoris S, De Sanctis F, Scapini P, Dusi S, Cassatella MA, Bria E, Milella M, Bronte V, Ugel S. Immune checkpoint blockade therapy mitigates systemic inflammation and affects cellular FLIP-expressing monocytic myeloid-derived suppressor cells in non-progressor non-small cell lung cancer patients. Oncoimmunology 2023; 12:2253644. [PMID: 37720688 PMCID: PMC10503454 DOI: 10.1080/2162402x.2023.2253644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/10/2023] [Accepted: 08/26/2023] [Indexed: 09/19/2023] Open
Abstract
Cancer cells favor the generation of myeloid cells with immunosuppressive and inflammatory features, including myeloid-derived suppressor cells (MDSCs), which support tumor progression. The anti-apoptotic molecule, cellular FLICE (FADD-like interleukin-1β-converting enzyme)-inhibitory protein (c-FLIP), which acts as an important modulator of caspase-8, is required for the development and function of monocytic (M)-MDSCs. Here, we assessed the effect of immune checkpoint inhibitor (ICI) therapy on systemic immunological landscape, including FLIP-expressing MDSCs, in non-small cell lung cancer (NSCLC) patients. Longitudinal changes in peripheral immunological parameters were correlated with patients' outcome. In detail, 34 NSCLC patients were enrolled and classified as progressors (P) or non-progressors (NP), according to the RECIST evaluation. We demonstrated a reduction in pro-inflammatory cytokines such as IL-8, IL-6, and IL-1β in only NP patients after ICI treatment. Moreover, using t-distributed stochastic neighbor embedding (t-SNE) and cluster analysis, we characterized in NP patients a significant increase in the amount of lymphocytes and a slight contraction of myeloid cells such as neutrophils and monocytes. Despite this moderate ICI-associated alteration in myeloid cells, we identified a distinctive reduction of c-FLIP expression in M-MDSCs from NP patients concurrently with the first clinical evaluation (T1), even though NP and P patients showed the same level of expression at baseline (T0). In agreement with the c-FLIP expression, monocytes isolated from both P and NP patients displayed similar immunosuppressive functions at T0; however, this pro-tumor activity was negatively influenced at T1 in the NP patient cohort exclusively. Hence, ICI therapy can mitigate systemic inflammation and impair MDSC-dependent immunosuppression.
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Affiliation(s)
- Annalisa Adamo
- Immunology section, Department of Medicine University and Hospital Trust of Verona, Verona, Italy
| | - Cristina Frusteri
- Immunology section, Department of Medicine University and Hospital Trust of Verona, Verona, Italy
| | - Sara Pilotto
- Oncology section, Department of Engineering for Innovative Medicine and Hospital Trust of Verona, Verona, Italy
| | - Simone Caligola
- Veneto Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IOV-IRCCS), Padova, Italy
| | - Lorenzo Belluomini
- Oncology section, Department of Engineering for Innovative Medicine and Hospital Trust of Verona, Verona, Italy
| | - Ornella Poffe
- Immunology section, Department of Medicine University and Hospital Trust of Verona, Verona, Italy
| | - Luca Giacobazzi
- Immunology section, Department of Medicine University and Hospital Trust of Verona, Verona, Italy
| | - Silvia Dusi
- Veneto Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IOV-IRCCS), Padova, Italy
| | - Chiara Musiu
- Immunology section, Department of Medicine University and Hospital Trust of Verona, Verona, Italy
| | - Yushu Hu
- Immunology section, Department of Medicine University and Hospital Trust of Verona, Verona, Italy
| | - Tian Wang
- Immunology section, Department of Medicine University and Hospital Trust of Verona, Verona, Italy
| | - Davide Rizzini
- Immunology section, Department of Medicine University and Hospital Trust of Verona, Verona, Italy
| | - Antonio Vella
- Immunology section, Department of Medicine University and Hospital Trust of Verona, Verona, Italy
| | - Stefania Canè
- Veneto Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IOV-IRCCS), Padova, Italy
| | - Giulia Sartori
- Oncology section, Department of Engineering for Innovative Medicine and Hospital Trust of Verona, Verona, Italy
| | - Jessica Insolda
- Oncology section, Department of Engineering for Innovative Medicine and Hospital Trust of Verona, Verona, Italy
| | - Marco Sposito
- Oncology section, Department of Engineering for Innovative Medicine and Hospital Trust of Verona, Verona, Italy
| | - Ursula Cesta Incani
- Oncology section, Department of Engineering for Innovative Medicine and Hospital Trust of Verona, Verona, Italy
| | - Carmine Carbone
- Medical Oncology, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Geny Piro
- Medical Oncology, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesca Pettinella
- General Pathology section, Department of Medicine University of Verona, Verona, Italy
| | - Fang Qi
- Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, P.R. China
| | - Dali Wang
- Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, P.R. China
| | - Silvia Sartoris
- Immunology section, Department of Medicine University and Hospital Trust of Verona, Verona, Italy
| | - Francesco De Sanctis
- Immunology section, Department of Medicine University and Hospital Trust of Verona, Verona, Italy
| | - Patrizia Scapini
- General Pathology section, Department of Medicine University of Verona, Verona, Italy
| | - Stefano Dusi
- General Pathology section, Department of Medicine University of Verona, Verona, Italy
| | | | - Emilio Bria
- Veneto Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IOV-IRCCS), Padova, Italy
| | - Michele Milella
- Oncology section, Department of Engineering for Innovative Medicine and Hospital Trust of Verona, Verona, Italy
| | - Vincenzo Bronte
- Veneto Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IOV-IRCCS), Padova, Italy
| | - Stefano Ugel
- Immunology section, Department of Medicine University and Hospital Trust of Verona, Verona, Italy
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