Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Cancer Immunol Immunother. 2023 Jul;72(7):2099-2111. doi: 10.1007/s00262-023-03383-w. Epub 2023 Feb 23.
Bempegaldesleukin (BEMPEG), a CD122-preferential IL2 pathway agonist, has been shown to induce proliferation and activation of NK cells. NK activation is dependent on the balance of inhibitory and excitatory signals transmitted by NK receptors, including Fc-gamma receptors (FCγRs) and killer immunoglobulin-like receptors (KIRs) along with their KIR-ligands. The repertoire of KIRs/KIR-ligands an individual inherits and the single-nucleotide polymorphisms (SNPs) of FCγRs can influence NK function and affect responses to immunotherapies. In this retrospective analysis of the single-arm PIVOT-02 trial, 200 patients with advanced solid tumors were genotyped for KIR/KIR-ligand gene status and FCγR SNP status and evaluated for associations with clinical outcome. Patients with inhibitory KIR2DL2 and its ligand (HLA-C1) observed significantly greater tumor shrinkage (TS, median change -13.0 vs. 0%) and increased PFS (5.5 vs. 3.3 months) and a trend toward improved OR (31.2 vs. 19.5%) compared to patients with the complementary genotype. Furthermore, patients with KIR2DL2 and its ligand together with inhibitory KIR3DL1 and its ligand (HLA-Bw4) had improved OR (36.5 vs. 19.6%), greater TS (median change -16.1 vs. 0%), and a trend toward prolonged PFS (8.4 vs. 3.6 months) as compared to patients with the complementary genotype. FCγR polymorphisms did not influence OR/PFS/TS.These data show that clinical response to BEMPEG plus nivolumab treatment in the PIVOT-02 trial may be associated with the repertoire of KIR/KIR-ligands an individual inherits. Further investigation and validation of these results may enable KIR/KIR-ligand genotyping to be utilized prospectively for identifying patients likely to benefit from certain cancer immunotherapy regimens.
贝马珠单抗(BEMPEG)是一种 CD122 优先的 IL2 途径激动剂,已被证明可诱导 NK 细胞增殖和激活。NK 细胞的激活取决于 NK 受体(包括 Fc-γ 受体(FCγR)和杀伤免疫球蛋白样受体(KIR)及其 KIR 配体)传递的抑制性和兴奋性信号之间的平衡。个体遗传的 KIR/KIR 配体谱以及 FCγR 的单核苷酸多态性(SNP)可影响 NK 功能,并影响对免疫疗法的反应。在这项对单臂 PIVOT-02 试验的回顾性分析中,对 200 名晚期实体瘤患者进行了 KIR/KIR 配体基因状态和 FCγR SNP 状态的基因分型,并评估了与临床结局的关联。与互补基因型相比,具有抑制性 KIR2DL2 及其配体(HLA-C1)的患者观察到肿瘤明显更大的缩小(TS,中位数变化-13.0%对 0%)和延长的 PFS(5.5 对 3.3 个月),并且具有改善的 OR(31.2 对 19.5%)的趋势。此外,与互补基因型相比,具有 KIR2DL2 及其配体和抑制性 KIR3DL1 及其配体(HLA-Bw4)的患者具有改善的 OR(36.5 对 19.6%)、更大的 TS(中位数变化-16.1%对 0%)和延长的 PFS(8.4 对 3.6 个月)的趋势。FCγR 多态性不影响 OR/PFS/TS。这些数据表明,PIVOT-02 试验中 BEMPEG 加nivolumab 治疗的临床反应可能与个体遗传的 KIR/KIR 配体谱有关。进一步研究和验证这些结果可能使 KIR/KIR 配体基因分型能够前瞻性地用于识别可能从某些癌症免疫治疗方案中获益的患者。
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