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经典型霍奇金淋巴瘤患者对 PD-1 阻断治疗反应的外周免疫特征。

A peripheral immune signature of responsiveness to PD-1 blockade in patients with classical Hodgkin lymphoma.

机构信息

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.

AstraZeneca, City House, Cambridge, UK.

出版信息

Nat Med. 2020 Sep;26(9):1468-1479. doi: 10.1038/s41591-020-1006-1. Epub 2020 Aug 10.

Abstract

PD-1 blockade is highly effective in classical Hodgkin lymphomas (cHLs), which exhibit frequent copy-number gains of CD274 (PD-L1) and PDC1LG2 (PD-L2) on chromosome 9p24.1. However, in this largely MHC-class-I-negative tumor, the mechanism of action of anti-PD-1 therapy remains undefined. We utilized the complementary approaches of T cell receptor (TCR) sequencing and cytometry by time-of-flight analysis to obtain a peripheral immune signature of responsiveness to PD-1 blockade in 56 patients treated in the CheckMate 205 phase II clinical trial (NCT02181738). Anti-PD-1 therapy was most effective in patients with a diverse baseline TCR repertoire and an associated expansion of singleton clones during treatment. CD4, but not CD8, TCR diversity significantly increased during therapy, most strikingly in patients who had achieved complete responses. Additionally, patients who responded to therapy had an increased abundance of activated natural killer cells and a newly identified CD3CD68CD4GrB subset. These studies highlight the roles of recently expanded, clonally diverse CD4 T cells and innate effectors in the efficacy of PD-1 blockade in cHL.

摘要

PD-1 阻断在经典霍奇金淋巴瘤(cHL)中非常有效,cHL 在染色体 9p24.1 上频繁出现 CD274(PD-L1)和 PDC1LG2(PD-L2)的拷贝数增加。然而,在这种主要 MHC 类 I 阴性的肿瘤中,抗 PD-1 治疗的作用机制尚不清楚。我们利用 T 细胞受体(TCR)测序和飞行时间分析的互补方法,对 56 例接受 CheckMate 205 二期临床试验(NCT02181738)治疗的患者进行了外周免疫应答 PD-1 阻断的分析。抗 PD-1 治疗在基线 TCR 谱多样化且治疗过程中单一克隆扩增的患者中最有效。CD4,而不是 CD8,TCR 多样性在治疗过程中显著增加,在完全缓解的患者中最为明显。此外,对治疗有反应的患者具有更多的活化自然杀伤细胞和新发现的 CD3CD68CD4GrB 亚群。这些研究强调了最近扩增的、克隆多样性的 CD4 T 细胞和先天效应细胞在 cHL 中 PD-1 阻断疗效中的作用。

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