Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium.
VIB Center for Cancer Biology, Leuven, Belgium.
Nat Med. 2021 May;27(5):820-832. doi: 10.1038/s41591-021-01323-8. Epub 2021 May 6.
Immune-checkpoint blockade (ICB) combined with neoadjuvant chemotherapy improves pathological complete response in breast cancer. To understand why only a subset of tumors respond to ICB, patients with hormone receptor-positive or triple-negative breast cancer were treated with anti-PD1 before surgery. Paired pre- versus on-treatment biopsies from treatment-naive patients receiving anti-PD1 (n = 29) or patients receiving neoadjuvant chemotherapy before anti-PD1 (n = 11) were subjected to single-cell transcriptome, T cell receptor and proteome profiling. One-third of tumors contained PD1-expressing T cells, which clonally expanded upon anti-PD1 treatment, irrespective of tumor subtype. Expansion mainly involved CD8 T cells with pronounced expression of cytotoxic-activity (PRF1, GZMB), immune-cell homing (CXCL13) and exhaustion markers (HAVCR2, LAG3), and CD4 T cells characterized by expression of T-helper-1 (IFNG) and follicular-helper (BCL6, CXCR5) markers. In pre-treatment biopsies, the relative frequency of immunoregulatory dendritic cells (PD-L1), specific macrophage phenotypes (CCR2 or MMP9) and cancer cells exhibiting major histocompatibility complex class I/II expression correlated positively with T cell expansion. Conversely, undifferentiated pre-effector/memory T cells (TCF7, GZMK) or inhibitory macrophages (CX3CR1, C3) were inversely correlated with T cell expansion. Collectively, our data identify various immunophenotypes and associated gene sets that are positively or negatively correlated with T cell expansion following anti-PD1 treatment. We shed light on the heterogeneity in treatment response to anti-PD1 in breast cancer.
免疫检查点阻断(ICB)联合新辅助化疗可提高乳腺癌的病理完全缓解率。为了了解为什么只有一部分肿瘤对 ICB 有反应,对激素受体阳性或三阴性乳腺癌患者在术前接受抗 PD1 治疗。对接受抗 PD1(n=29)或接受新辅助化疗后接受抗 PD1(n=11)的治疗初治患者的术前与治疗期间配对活检进行单细胞转录组、T 细胞受体和蛋白质组谱分析。三分之一的肿瘤含有表达 PD1 的 T 细胞,这些细胞在抗 PD1 治疗后克隆扩增,与肿瘤亚型无关。扩增主要涉及 CD8 T 细胞,这些细胞表达强烈的细胞毒性活性(PRF1、GZMB)、免疫细胞归巢(CXCL13)和衰竭标志物(HAVCR2、LAG3),以及表达 T 辅助 1(IFNG)和滤泡辅助(BCL6、CXCR5)标志物的 CD4 T 细胞。在治疗前活检中,免疫调节树突状细胞(PD-L1)、特定巨噬细胞表型(CCR2 或 MMP9)和表现出主要组织相容性复合体 I/II 表达的癌细胞的相对频率与 T 细胞扩增呈正相关。相反,未分化的前效应器/记忆 T 细胞(TCF7、GZMK)或抑制性巨噬细胞(CX3CR1、C3)与 T 细胞扩增呈负相关。总的来说,我们的数据确定了各种免疫表型和相关基因集,它们与抗 PD1 治疗后 T 细胞扩增呈正相关或负相关。我们阐明了乳腺癌对抗 PD1 治疗反应的异质性。
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