联合抗 PD-1 和抗 CTLA-4 治疗会产生包括祖细胞耗竭 CD8 T 细胞在内的克隆反应波。

Combination anti-PD-1 and anti-CTLA-4 therapy generates waves of clonal responses that include progenitor-exhausted CD8 T cells.

机构信息

Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.

Immunai Inc, New York, NY 10016, USA.

出版信息

Cancer Cell. 2024 Sep 9;42(9):1582-1597.e10. doi: 10.1016/j.ccell.2024.08.007. Epub 2024 Aug 29.

Abstract

Combination checkpoint blockade with anti-PD-1 and anti-CTLA-4 antibodies has shown promising efficacy in melanoma. However, the underlying mechanism in humans remains unclear. Here, we perform paired single-cell RNA and T cell receptor (TCR) sequencing across time in 36 patients with stage IV melanoma treated with anti-PD-1, anti-CTLA-4, or combination therapy. We develop the algorithm Cyclone to track temporal clonal dynamics and underlying cell states. Checkpoint blockade induces waves of clonal T cell responses that peak at distinct time points. Combination therapy results in greater magnitude of clonal responses at 6 and 9 weeks compared to single-agent therapies, including melanoma-specific CD8 T cells and exhausted CD8 T cell (T) clones. Focused analyses of T identify that anti-CTLA-4 induces robust expansion and proliferation of progenitor T, which synergizes with anti-PD-1 to reinvigorate T during combination therapy. These next generation immune profiling approaches can guide the selection of drugs, schedule, and dosing for novel combination strategies.

摘要

抗 PD-1 和抗 CTLA-4 抗体的联合检查点阻断在黑色素瘤中显示出有希望的疗效。然而,其在人类中的潜在机制尚不清楚。在这里,我们对 36 名接受抗 PD-1、抗 CTLA-4 或联合治疗的 IV 期黑色素瘤患者进行了跨时间的配对单细胞 RNA 和 T 细胞受体 (TCR) 测序。我们开发了算法 Cyclone 来跟踪时空克隆动态和潜在的细胞状态。检查点阻断诱导克隆 T 细胞反应的波,这些波在不同的时间点达到高峰。与单药治疗相比,联合治疗在 6 周和 9 周时产生更大幅度的克隆反应,包括黑色素瘤特异性 CD8 T 细胞和耗竭的 CD8 T 细胞 (T) 克隆。对 T 的重点分析表明,抗 CTLA-4 诱导祖 T 的强烈扩增和增殖,与抗 PD-1 协同作用,在联合治疗期间使 T 恢复活力。这些下一代免疫分析方法可以为新型联合策略的药物选择、方案和剂量提供指导。

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