Virazels Mathieu, Lusque Amélie, Brayer Stéphanie, Genais Matthieu, Dufau Carine, Milhès Jean, Filleron Thomas, Pagès Cécile, Sibaud Vincent, Mortier Laurent, Dereure Olivier, Ayyoub Maha, Fabre Amandine, Andrieu-Abadie Nathalie, Pancaldi Vera, Colacios Céline, Meyer Nicolas, Ségui Bruno, Montfort Anne
Unité Mixte de Recherche INSERM 1037, CNRS 5071, Université Toulouse III-Paul Sabatier, Centre de Recherches en Cancérologie de Toulouse (CRCT), Toulouse, France.
Equipe Labellisée Fondation ARC pour la recherche sur le cancer, Toulouse, France.
Int J Cancer. 2025 Aug 1;157(3):534-548. doi: 10.1002/ijc.35416. Epub 2025 Mar 18.
Resistance to immune checkpoint inhibitors (ICI) in cancer patients is not fully understood, and predictive biomarkers are lacking. MELANFα (NCT03348891) is an open-label, prospective, multicenter cohort of 60 patients with advanced melanoma receiving ICI (bitherapy: ipilimumab + nivolumab; monotherapy: pembrolizumab or nivolumab). The primary objective was to evaluate whether changes in plasma TNF between baseline (W0) and week 12 (W12) identified patients with non-progressive disease at W12. Secondary and exploratory objectives were to assess the association between plasma TNF, tumor response, and changes in circulating T cells. Plasma TNF increased along therapy, but its W12/W0 fold change was not associated with non-progressive disease at W12. However, plasma TNF levels at W12 were significantly higher in non-responders than in responders across therapies (p = .0129). The remodeling of circulating T cell subpopulations was mostly triggered by bitherapy. Increased proportions of circulating central memory and effector memory CD8 T cells after bitherapy were positively and negatively associated with response to treatment, respectively. In this cohort, circulating T cells from responders and non-responders also displayed distinct molecular characteristics. Indeed, responders showed an increased proportion of CD8 T cells with low enrichment of TNF-related pathways and high cytotoxic potential, while non-responders displayed increased proportions of circulating CD8 EM T cells enriched for TNF-related pathways and directed toward cytokine expression. In conclusion, our study shows that elevated plasma TNF and enriched TNF pathways in T cells are associated with poorer clinical outcomes, reinforcing the notion that TNF may dampen ICI efficacy.
癌症患者对免疫检查点抑制剂(ICI)产生耐药性的原因尚未完全明确,且缺乏预测性生物标志物。MELANFα(NCT03348891)是一项开放标签、前瞻性、多中心队列研究,纳入了60例接受ICI治疗的晚期黑色素瘤患者(联合治疗:伊匹木单抗+纳武单抗;单药治疗:帕博利珠单抗或纳武单抗)。主要目的是评估基线(W0)至第12周(W12)血浆TNF的变化是否能识别出在W12时疾病无进展的患者。次要和探索性目的是评估血浆TNF、肿瘤反应和循环T细胞变化之间的关联。血浆TNF水平在治疗过程中升高,但其W12/W0倍数变化与W12时的疾病无进展无关。然而,在所有治疗组中,无反应者在W12时的血浆TNF水平显著高于反应者(p = 0.0129)。联合治疗大多引发了循环T细胞亚群的重塑。联合治疗后循环中枢记忆性和效应记忆性CD8 T细胞比例增加,分别与治疗反应呈正相关和负相关。在该队列中,反应者和无反应者的循环T细胞也表现出不同的分子特征。事实上,反应者中TNF相关通路富集程度低且细胞毒性潜力高的CD8 T细胞比例增加,而无反应者中富集TNF相关通路并指向细胞因子表达的循环CD8 EM T细胞比例增加。总之,我们的研究表明,血浆TNF升高和T细胞中TNF通路富集与较差的临床结局相关,强化了TNF可能削弱ICI疗效的观点。
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