Erbe Amy K, Wang Wei, Reville Patrick K, Carmichael Lakeesha, Kim KyungMann, Mendonca Eneida A, Song Yiqiang, Hank Jacquelyn A, London Wendy B, Naranjo Arlene, Hong Fangxin, Hogarty Michael D, Maris John M, Park Julie R, Ozkaynak M F, Miller Jeffrey S, Gilman Andrew L, Kahl Brad, Yu Alice L, Sondel Paul M
Department of Human Oncology, University of Wisconsin, Madison, WI, United States.
Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, United States.
Front Immunol. 2017 Jun 12;8:675. doi: 10.3389/fimmu.2017.00675. eCollection 2017.
Killer-cell immunoglobulin-like receptors (KIRs) are a family of glycoproteins expressed primarily on natural killer cells that can regulate their function. Inhibitory KIRs recognize MHC class I molecules (KIR-ligands) as ligands. We have reported associations of KIRs and KIR-ligands for patients in two monoclonal antibody (mAb)-based trials: (1) A Children's Oncology Group (COG) trial for children with high-risk neuroblastoma randomized to immunotherapy treatment with dinutuximab (anti-GD2 mAb) + GM-CSF + IL-2 + isotretinion or to treatment with isotretinoin alone and (2) An Eastern Cooperative Oncology Group (ECOG) trial for adults with low-tumor burden follicular lymphoma responding to an induction course of rituximab (anti-CD20 mAb) and randomized to treatment with maintenance rituximab or no-maintenance rituximab. In each trial, certain KIR/KIR-ligand genotypes were associated with clinical benefit for patients randomized to immunotherapy treatment (immunotherapy in COG; maintenance rituximab in ECOG) as compared to patients that did not receive the immunotherapy [isotretinoin alone (COG); no-maintenance (ECOG)]. Namely, patients with both KIR3DL1 and its HLA-Bw4 ligand (KIR3DL1+/HLA-Bw4+ genotype) had improved clinical outcomes if randomized to immunotherapy regimens, as compared to patients with the KIR3DL1+/HLA-Bw4+ genotype randomized to the non-immunotherapy regimen. Conversely, patients that did not have the KIR3DL1+/HLA-Bw4+ genotype showed no evidence of a difference in outcome if receiving the immunotherapy vs. no-immunotherapy. For each trial, HLA-Bw4 status was determined by assessing the genotypes of three separate isoforms of HLA-Bw4: (1) HLA-B-Bw4 with threonine at amino acid 80 (B-Bw4-T80); (2) HLA-B-Bw4 with isoleucine at amino acid 80 (HLA-B-Bw4-I80); and (3) HLA-A with a Bw4 epitope (HLA-A-Bw4). Here, we report on associations with clinical outcome for patients with KIR3DL1 and these separate isoforms of HLA-Bw4. Patients randomized to immunotherapy with KIR3DL1+/A-Bw4+ or with KIR3DL1+/B-Bw4-T80+ had better outcome vs. those randomized to no-immunotherapy, whereas for those with KIR3DL1+/B-Bw4-I80+ there was no evidence of a difference based on immunotherapy vs. no-immunotherapy. Additionally, we observed differences within treatment types (either within immunotherapy or no-immunotherapy) that were associated with the genotype status for the different KIR3DL1/HLA-Bw4-isoforms. These studies suggest that specific HLA-Bw4 isoforms may differentially influence response to these mAb-based immunotherapy, further confirming the involvement of KIR-bearing cells in tumor-reactive mAb-based cancer immunotherapy.
杀伤细胞免疫球蛋白样受体(KIR)是一类主要表达于自然杀伤细胞上的糖蛋白家族,可调节其功能。抑制性KIR将MHC I类分子(KIR配体)识别为配体。我们在两项基于单克隆抗体(mAb)的试验中报告了KIR及其配体与患者的关联:(1)儿童肿瘤学组(COG)针对高危神经母细胞瘤儿童的试验,随机分为接受地努图希单抗(抗GD2 mAb)+GM-CSF+IL-2+异维A酸的免疫治疗或单独接受异维A酸治疗;(2)东部肿瘤协作组(ECOG)针对低肿瘤负荷滤泡性淋巴瘤成人患者的试验,这些患者对利妥昔单抗(抗CD20 mAb)诱导疗程有反应,随机分为接受利妥昔单抗维持治疗或不接受维持治疗。在每项试验中,与未接受免疫治疗的患者[单独使用异维A酸(COG);不接受维持治疗(ECOG)]相比,某些KIR/KIR配体基因型与随机接受免疫治疗的患者(COG中的免疫治疗;ECOG中的利妥昔单抗维持治疗)的临床获益相关。具体而言,与随机接受非免疫治疗方案的KIR3DL1+/HLA-Bw4+基因型患者相比,同时具有KIR3DL1及其HLA-Bw4配体(KIR3DL1+/HLA-Bw4+基因型)的患者若随机接受免疫治疗方案,则临床结局更佳。相反,不具有KIR3DL1+/HLA-Bw4+基因型的患者,接受免疫治疗与不接受免疫治疗相比,未显示出结局差异。对于每项试验,通过评估HLA-Bw4三种不同亚型的基因型来确定HLA-Bw4状态:(1)氨基酸80位为苏氨酸的HLA-B-Bw4(B-Bw4-T80);(2)氨基酸80位为异亮氨酸的HLA-B-Bw4(HLA-B-Bw4-I80);(3)具有Bw4表位的HLA-A(HLA-A-Bw4)。在此,我们报告了KIR3DL1与这些不同HLA-Bw4亚型患者临床结局的关联。随机接受KIR3DL1+/A-Bw4+或KIR3DL1+/B-Bw4-T80+免疫治疗的患者比随机接受非免疫治疗的患者结局更好,而对于KIR3DL1+/B-Bw4-I80+的患者,基于免疫治疗与非免疫治疗未显示出差异。此外,我们在治疗类型内(免疫治疗或非免疫治疗)观察到与不同KIR3DL1/HLA-Bw4亚型的基因型状态相关的差异。这些研究表明,特定的HLA-Bw4亚型可能对这些基于mAb的免疫治疗反应产生不同影响,进一步证实了携带KIR的细胞参与基于肿瘤反应性mAb的癌症免疫治疗。