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接受免疫检查点抑制剂治疗的晚期黑色素瘤患者的TNF特征:MELANFα临床研究结果

TNF signature in advanced melanoma patients treated with immune checkpoint inhibitors: Results from the MELANFα clinical study.

作者信息

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

机构信息

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.

出版信息

Int J Cancer. 2025 Aug 1;157(3):534-548. doi: 10.1002/ijc.35416. Epub 2025 Mar 18.


DOI:10.1002/ijc.35416
PMID:40098565
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12141980/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4be1/12141980/bf48f3b173ec/IJC-157-534-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4be1/12141980/4ceac8ad6fdf/IJC-157-534-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4be1/12141980/8174832486a0/IJC-157-534-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4be1/12141980/fee23c9336e0/IJC-157-534-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4be1/12141980/736f7111fc01/IJC-157-534-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4be1/12141980/bf48f3b173ec/IJC-157-534-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4be1/12141980/4ceac8ad6fdf/IJC-157-534-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4be1/12141980/8174832486a0/IJC-157-534-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4be1/12141980/fee23c9336e0/IJC-157-534-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4be1/12141980/736f7111fc01/IJC-157-534-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4be1/12141980/bf48f3b173ec/IJC-157-534-g004.jpg

相似文献

[1]
TNF signature in advanced melanoma patients treated with immune checkpoint inhibitors: Results from the MELANFα clinical study.

Int J Cancer. 2025-8-1

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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J Immunother Cancer. 2021-5

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Nat Rev Clin Oncol. 2022-4

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