Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer Immunol Res. 2017 Feb;5(2):100-105. doi: 10.1158/2326-6066.CIR-16-0223. Epub 2017 Jan 6.
We report here on a patient with metastatic melanoma who had extensive brain metastases. After being treated with the sequential combination of whole brain radiation therapy followed by the PD-1-inhibitory antibody, pembrolizumab, the patient had a durable complete response. Retrospective laboratory studies of T cells revealed that, after treatment with anti-PD-1 commenced, effector CD8 T cells in the blood expanded and the ratio of CD8:Treg T cells increased. A CD8 T-cell clone present in the initial brain metastases was expanded in the blood after anti-PD-1 treatment, which suggested an antitumor role for this clone. Immunohistochemical analysis confirmed the presence of CD8 T cells and low PD-L1 expression in the brain metastases before immunotherapy initiation. This sequence of therapy may provide an option for melanoma patients with unresponsive brain metastases. Cancer Immunol Res; 5(2); 100-5. ©2017 AACR.
我们在此报告一例转移性黑色素瘤患者，其患有广泛的脑转移。在接受全脑放疗序贯联合 PD-1 抑制剂 pembrolizumab 治疗后，患者获得了持久的完全缓解。对 T 细胞的回顾性实验室研究表明，抗 PD-1 治疗开始后，血液中效应性 CD8 T 细胞扩增，CD8:Treg T 细胞的比例增加。在抗 PD-1 治疗后，初始脑转移灶中存在的 CD8 T 细胞克隆在血液中扩增，提示该克隆具有抗肿瘤作用。免疫组化分析证实，在免疫治疗开始前，脑转移灶中存在 CD8 T 细胞和低 PD-L1 表达。这种治疗顺序可能为无反应性脑转移的黑色素瘤患者提供一种选择。Cancer Immunol Res; 5(2); 100-5. ©2017 AACR.
