Ma Yuxiang, Zhou Huaqiang, Luo Fan, Zhang Yang, Zhu Changbin, Li Weiwei, Huang Zhan, Zhao Jingbo, Xue Jinhui, Zhao Yuanyuan, Fang Wenfeng, Yang Yunpeng, Huang Yan, Zhang Li, Zhao Hongyun
Department of Clinical Research, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China.
Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China.
NPJ Precis Oncol. 2024 Mar 6;8(1):65. doi: 10.1038/s41698-024-00558-1.
Sequential immunotherapy has shown certain advantages in malignancy. Here, we aim to evaluate the efficacy of sequential anti-CTLA-4 and anti-PD-1 treatment for recurrent or metastatic nasopharyngeal carcinoma patients (R/M NPC). We retrospectively analysis 2 phase I trial of ipilimumab and camrelizumab in Chinese R/M NPC patients. These patients were initially treated with ipilimumab, a CTLA4 blockade, followed by anti-PD-1 treatment. We observed a durable tumor remission in these patients (mPFS: 12.3 months; mDoR: 20.9 months). Multimodal investigations of biopsy samples disclosed remodeling of tumor-immune microenvironment triggered by ipilimumab. In responders, we found increased tumoral PD-L1/PD-L2 expression and T-cell infiltration after ipilimumab treatment, accompanied by reduced stroma and malignant cell components. In contrast, non-responders exhibited increased B-cell infiltration and increased peripheral CD19 + B cells, suggesting a defective transition from memory B cells to plasma cells. This study proposes that sequential therapy can potentially enhance treatment efficacy in chemotherapy-resistant NPC patients and provides insights into how preexisting anti-CTLA4 blockade can influence subsequent anti-PD-1 efficacy by remodeling the TME. Additionally, our results highlight the need for therapeutic strategies targeting naïve/memory B cells.
序贯免疫疗法在恶性肿瘤治疗中已显示出一定优势。在此,我们旨在评估序贯抗CTLA-4和抗PD-1治疗对复发或转移性鼻咽癌患者(R/M NPC)的疗效。我们回顾性分析了两项针对中国R/M NPC患者的伊匹木单抗和卡瑞利珠单抗的I期试验。这些患者最初接受CTLA4阻断剂伊匹木单抗治疗,随后接受抗PD-1治疗。我们观察到这些患者出现了持久的肿瘤缓解(中位无进展生存期:12.3个月;中位缓解持续时间:20.9个月)。对活检样本的多模态研究揭示了由伊匹木单抗引发的肿瘤免疫微环境重塑。在缓解者中,我们发现伊匹木单抗治疗后肿瘤PD-L1/PD-L2表达增加和T细胞浸润,同时基质和恶性细胞成分减少。相比之下,无反应者表现出B细胞浸润增加和外周CD19 + B细胞增加,提示从记忆B细胞向浆细胞的转变存在缺陷。本研究提出序贯疗法可能会提高化疗耐药NPC患者的治疗疗效,并深入了解预先存在的抗CTLA4阻断如何通过重塑肿瘤微环境影响后续抗PD-1疗效。此外,我们的结果强调了针对幼稚/记忆B细胞的治疗策略的必要性。