Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Tumor Microenvironment Center, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Cancer Immunology and Immunotherapy Program, UPMC Hillman Cancer Center, Pittsburgh, PA, USA.
Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Tumor Microenvironment Center, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Cell. 2024 Aug 8;187(16):4373-4388.e15. doi: 10.1016/j.cell.2024.06.036.
Relatlimab (rela; anti-LAG-3) plus nivolumab (nivo; anti-PD-1) is safe and effective for treatment of advanced melanoma. We designed a trial (NCT03743766) where advanced melanoma patients received rela, nivo, or rela+nivo to interrogate the immunologic mechanisms of rela+nivo. Analysis of biospecimens from this ongoing trial demonstrated that rela+nivo led to enhanced capacity for CD8 T cell receptor signaling and altered CD8 T cell differentiation, leading to heightened cytotoxicity despite the retention of an exhaustion profile. Co-expression of cytotoxic and exhaustion signatures was driven by PRDM1, BATF, ETV7, and TOX. Effector function was upregulated in clonally expanded CD8 T cells that emerged after rela+nivo. A rela+nivo intratumoral CD8 T cell signature was associated with a favorable prognosis. This intratumoral rela+nivo signature was validated in peripheral blood as an elevated frequency of CD38TIM3CD8 T cells. Overall, we demonstrated that cytotoxicity can be enhanced despite the retention of exhaustion signatures, which will inform future therapeutic strategies.
Relatlimab(rela;抗 LAG-3)联合 nivolumab(nivo;抗 PD-1)可安全有效地治疗晚期黑色素瘤。我们设计了一项试验(NCT03743766),其中晚期黑色素瘤患者接受 rela、nivo 或 rela+nivo 治疗,以探究 rela+nivo 的免疫机制。对正在进行的试验的生物标本进行分析表明, rela+nivo 导致 CD8 T 细胞受体信号增强和分化改变,从而提高了细胞毒性,尽管仍保留衰竭表型。细胞毒性和衰竭特征的共表达由 PRDM1、BATF、ETV7 和 TOX 驱动。在 rela+nivo 后出现的克隆扩增 CD8 T 细胞中,效应功能上调。肿瘤内 rela+nivo CD8 T 细胞特征与预后良好相关。肿瘤内 rela+nivo 特征在外周血中得到验证,表现为 CD38TIM3CD8 T 细胞频率升高。总的来说,我们证明了尽管保留了衰竭特征,但仍可以增强细胞毒性,这将为未来的治疗策略提供信息。
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