PD-L1 表达与黑色素瘤对 MAPK 抑制剂耐药的免疫逃逸。

PD-L1 Expression and Immune Escape in Melanoma Resistance to MAPK Inhibitors.

机构信息

Melanoma Institute Australia, North Sydney, New South Wales, Australia.

Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.

出版信息

Clin Cancer Res. 2017 Oct 15;23(20):6054-6061. doi: 10.1158/1078-0432.CCR-16-1688. Epub 2017 Jul 19.

Abstract

To examine the relationship between immune activity, PD-L1 expression, and tumor cell signaling, in metastatic melanomas prior to and during treatment with targeted MAPK inhibitors. Thirty-eight tumors from 17 patients treated with BRAF inhibitor ( = 12) or combination BRAF/MEK inhibitors ( = 5) with known PD-L1 expression were analyzed. RNA expression arrays were performed on all pretreatment (PRE, = 17), early during treatment (EDT, = 8), and progression (PROG, = 13) biopsies. HLA-A/HLA-DPB1 expression was assessed by IHC. Gene set enrichment analysis (GSEA) of PRE, EDT, and PROG melanomas revealed that transcriptome signatures indicative of immune cell activation were strongly positively correlated with PD-L1 staining. In contrast, MAPK signaling and canonical Wnt/-β-catenin activity was negatively associated with PD-L1 melanoma expression. The expression of PD-L1 and immune activation signatures did not simply reflect the degree or type of immune cell infiltration, and was not sufficient for tumor response to MAPK inhibition. PD-L1 expression correlates with immune cells and immune activity signatures in melanoma, but is not sufficient for tumor response to MAPK inhibition, as many PRE and PROG melanomas displayed both PD-L1 positivity and immune activation signatures. This confirms that immune escape is common in MAPK inhibitor-treated tumors. This has important implications for the selection of second-line immunotherapy because analysis of mechanisms of immune escape will likely be required to identify patients likely to respond to such therapies. .

摘要

为了研究在接受靶向 MAPK 抑制剂治疗之前和期间,转移性黑色素瘤中的免疫活性、PD-L1 表达和肿瘤细胞信号之间的关系。对 17 名接受 BRAF 抑制剂(=12)或联合 BRAF/MEK 抑制剂(=5)治疗且已知 PD-L1 表达的患者的 38 个肿瘤进行了分析。对所有预处理(PRE,=17)、早期治疗期间(EDT,=8)和进展期(PROG,=13)活检进行了 RNA 表达谱分析。通过 IHC 评估 HLA-A/HLA-DPB1 表达。对 PRE、EDT 和 PROG 黑色素瘤的基因集富集分析(GSEA)显示,提示免疫细胞激活的转录组特征与 PD-L1 染色呈强烈正相关。相比之下,MAPK 信号和经典 Wnt/-β-catenin 活性与 PD-L1 黑色素瘤表达呈负相关。PD-L1 表达和免疫激活特征并不仅仅反映免疫细胞浸润的程度或类型,并且不足以预测 MAPK 抑制的肿瘤反应。PD-L1 表达与黑色素瘤中的免疫细胞和免疫激活特征相关,但不足以预测 MAPK 抑制的肿瘤反应,因为许多 PRE 和 PROG 黑色素瘤均显示 PD-L1 阳性和免疫激活特征。这证实了免疫逃逸在 MAPK 抑制剂治疗的肿瘤中很常见。这对于二线免疫治疗的选择具有重要意义,因为分析免疫逃逸的机制可能需要识别可能对这些治疗有反应的患者。

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