Capone Mariaelena, Fratangelo Federica, Giannarelli Diana, Sorrentino Claudia, Turiello Roberta, Zanotta Serena, Galati Domenico, Madonna Gabriele, Tuffanelli Marilena, Scarpato Luigi, Grimaldi Antonio M, Esposito Assunta, Azzaro Rosa, Pinto Antonio, Cavalcanti Ernesta, Pinto Aldo, Morello Silvana, Ascierto Paolo A
Istituto Nazionale Tumori - IRCCS - Fondazione "G. Pascale", Naples, Italy.
Istituto Nazionale Tumori Regina Elena, IRCCS, Rome, Italy.
J Transl Med. 2020 Mar 11;18(1):121. doi: 10.1186/s12967-020-02285-0.
PD-1 blocking agents, such as nivolumab, have demonstrated clear anti-tumor effects and clinical benefits in a subset of patients with advanced malignancies. Nonetheless, more efforts are needed to identify reliable biomarkers for outcome, to correctly select patients who will benefit from anti-PD-1 treatment. The aim of this study was to investigate the role of peripheral CD8+T cells expressing CD73, involved in the generation of the immune suppressive molecule adenosine, in predicting outcome after nivolumab treatment in advanced melanoma patients.
PBMCs from 100 melanoma patients treated with nivolumab were collected at National Cancer Institute "G. Pascale" of Naples. Frequencies of CD8+ lymphocytes phenotypes were assessed by flow cytometry at baseline before nivolumab treatment, along with clinical characteristics and blood count parameters. Healthy controls (n = 20) were also analysed. Percentages of baseline T cells expressing PD-1 and CD73 were correlated with outcome after nivolumab treatment.
Melanoma patients presented a lower frequency of total circulating CD8+ lymphocytes than control subjects (p = 0.008). Patients with low baseline percentage of circulating CD8+PD-1+CD73+ lymphocytes (< 2.3%) had better survival (22.4 months vs 6.9 months, p = 0.001). Patients (39%) with clinical benefit from nivolumab therapy presented a significantly lower frequency of circulating CD8+PD-1+CD73+ lymphocytes than patients who progressed to nivolumab treatment (p = 0.02).
Our observations suggest that baseline CD73 expression on circulating CD8+PD-1+ lymphocytes appear a promising biomarker of response to anti-PD-1 treatment in melanoma patients. Further investigations are needed for validation and for clarifying its role as prognostic or predictive marker.
程序性死亡受体1(PD-1)阻断剂,如纳武单抗,已在部分晚期恶性肿瘤患者中显示出明确的抗肿瘤作用和临床益处。尽管如此,仍需要更多努力来确定可靠的预后生物标志物,以正确选择将从抗PD-1治疗中获益的患者。本研究的目的是调查表达CD73的外周CD8+T细胞(参与免疫抑制分子腺苷的生成)在预测晚期黑色素瘤患者接受纳武单抗治疗后的预后中的作用。
在那不勒斯国家癌症研究所“G. Pascale”收集了100例接受纳武单抗治疗的黑色素瘤患者的外周血单核细胞(PBMC)。在纳武单抗治疗前的基线时,通过流式细胞术评估CD8+淋巴细胞表型的频率,以及临床特征和血常规参数。还分析了健康对照者(n = 20)。基线时表达PD-1和CD73的T细胞百分比与纳武单抗治疗后的预后相关。
黑色素瘤患者循环CD8+淋巴细胞的总频率低于对照受试者(p = 0.008)。循环CD8+PD-1+CD73+淋巴细胞基线百分比低(<2.3%)的患者生存期更长(22.4个月对6.9个月,p = 0.001)。从纳武单抗治疗中获得临床益处的患者(39%)循环CD8+PD-1+CD73+淋巴细胞的频率明显低于进展至纳武单抗治疗的患者(p = 0.02)。
我们的观察结果表明,循环CD8+PD-1+淋巴细胞上的基线CD73表达似乎是黑色素瘤患者对抗PD-1治疗反应的一个有前景的生物标志物。需要进一步研究以进行验证并阐明其作为预后或预测标志物的作用。