anti-PD1 immunotherapy

抗 PD1 免疫疗法
  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/fimmu.2024.1302903。].
    [This corrects the article DOI: 10.3389/fimmu.2024.1302903.].
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  • 文章类型: Journal Article
    免疫检查点治疗,涉及程序性细胞死亡1(PD-1)单克隆抗体,彻底改变了癌症的治疗方法。三级淋巴结构(TLS)作为预测PD-1抗体治疗效果的免疫指标。然而,没有明确的结果是否分布,数量,TLS的成熟度可作为预测结直肠癌患者抗PD1免疫治疗临床疗效的有效指标。
    57例接受手术切除的患者和39例接受抗PD-1免疫治疗的患者被纳入这项回顾性研究。免疫组织化学染色和多重荧光免疫组织化学用于评估错配修复(MMR)亚型和TLS分布,数量,和成熟,分别。
    建立了基于TLS数量和成熟度的综合患者评分系统。我们发现,缺乏错配修复(dMMR)组的评分>1的患者比例远高于熟练错配修复(pMMR)组,这种差异主要是由于肿瘤内TLS。患者评分,基于对整个肿瘤的TLS评估,perumor,或瘤内,用于评估抗PD1免疫疗法的疗效。仅基于肿瘤内TLS评估,评分>1的患者比例在缓解(PR+CR)组中高于无缓解(PD)组.多因素分析显示患者评分与免疫治疗的临床疗效呈正相关。对接受抗PD-1免疫疗法的CRC患者进行了免疫相关的无进展生存期的进一步分析。基于肿瘤内TLS评估的评分>1的患者具有显著更好的生存率。
    这些结果表明,基于肿瘤内TLS评估的患者评分可能是CRC患者PD-1抗体治疗的良好免疫预测指标。
    Immune checkpoint therapy, involving the programmed cell death 1 (PD-1) monoclonal antibody, has revolutionized the treatment of cancer. Tertiary lymphatic structure (TLS) serves as an immune indicator to predict the efficacy of PD-1 antibody therapy. However, there is no clear result whether the distribution, quantity, and maturity of TLS can be effective indicators for predicting the clinical efficacy of anti-PD1 immunotherapy in patients with colorectal cancer (CRC).
    Fifty-seven patients who underwent surgical resection and thirty-nine patients who received anti-PD-1 immunotherapy were enrolled in this retrospective study. Immunohistochemical staining and multiple fluorescence immunohistochemistry were used to evaluate the mismatch repair (MMR) subtypes and TLS distribution, quantity, and maturity, respectively.
    A comprehensive patient score system was built based on TLS quantity and maturity. We found that the proportion of patients with score >1 was much higher in the deficient mismatch repair(dMMR) group than in the proficient mismatch repair(pMMR) group, and this difference was mainly due to intratumoral TLS. Patient score, based on the TLS evaluation of whole tumor, peritumor, or intratumor, was used to evaluate the efficacy of anti-PD1 immunotherapy. Based only on the intratumor TLS evaluation, the proportion of patients with a score >1 was higher in the response (PR + CR) group than in the non-response (PD) group. Multivariate analysis revealed that patient scores were positively correlated with the clinical efficacy of immunotherapy. Further analysis of immune-related progression-free survival was performed in patients with CRC who received anti-PD-1 immunotherapy. Patients with score >1 based on the intratumor TLS evaluation had significantly better survival.
    These results suggest that the patient score based on intratumor TLS evaluation may be a good immune predictive indicator for PD-1 antibody therapy in patients with CRC.
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  • 文章类型: Letter
    免疫治疗是食管鳞状细胞癌(ESCC)的一线治疗,然而,许多患者由于耐药性和缺乏可靠的预测标志物而没有反应。我们收集了73例ESCC患者(包括发现队列和验证队列),这些患者没有免疫性血小板减少症并接受抗PD1免疫治疗。通过基于质谱的无标记定量对73例ESCC处理过的样品进行蛋白质组学和磷酸化蛋白质组学分析,以探索潜在的抗性和敏感性机制,并确定ESCC免疫治疗的预测标志物。比较分析发现免疫和线粒体功能相关通路与ESCC免疫治疗敏感性相关;而血小板活化生物过程与CD8+T细胞呈负相关,与ESCC免疫治疗非敏感性相关。最后,我们确定了10个ESCC免疫治疗预测生物标志物,具有高准确性(≥0.90)来预测免疫治疗反应,这在独立队列中得到了验证。
    Immunotherapy is the first-line therapy for esophageal squamous cell carcinoma (ESCC), yet many patients do not respond due to drug resistance and the lack of reliable predictive markers. We collected 73 ESCC patients (including discovery cohort and validation cohort) without immune thrombocytopenia and undergoing anti-PD1 immunotherapy. Proteomic and phosphoproteomic analysis of 73 ESCC treatment-naive samples by mass spectrometry-based label-free quantification were applied to explore the potential resistant and sensitive mechanisms, and identify predictive markers of ESCC immunotherapy. Comparative analysis found the pathways related to immune and mitochondrial functions were associated with ESCC immunotherapy sensitivity; while platelet activation bioprocess showed negative correlation with CD8+ T cells and related to ESCC immunotherapy non-sensitivity. Finally, we identified 10 ESCC immunotherapy predictive biomarkers with high accuracy (≥ 0.90) to predict the immunotherapeutic response, which was validated in the independent cohort.
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  • 文章类型: Journal Article
    由于抗PD1免疫疗法(IT)的应答率差异很大,发现用于预测免疫检查点抑制剂(ICI)疗效的创新生物标志物的需求尚未满足.我们的研究包括62名接受抗PD1ICI治疗的白种人晚期非小细胞肺癌(NSCLC)患者。通过宏基因组测序评估肠道细菌特征,并与无进展生存期(PFS)相关。PD-L1表达和其他临床病理参数。我们使用多变量统计模型(Lasso和Cox回归)证实了PFS相关关键细菌的预测作用,并在其他患者队列中进行了验证(n=60)。我们发现α-多样性在任何比较中都没有显着差异。然而,长期(>6个月)患者的β-多样性与短期(≤6个月)PFS和化疗(CHT)治疗与之间CHT-naivecases.短PFS与Firmicutes(F)和放线菌门的丰度增加有关,而Euryarcheota的丰度升高是PD-L1低表达的特异性。短PFS患者的F/拟杆菌(F/B)比率显着增加。多变量分析显示,阿里斯提斯之间存在关联,Alistipesfinegoldii,内脏巴尼菌,长PFS。相比之下,唾液链球菌,前庭链球菌,短双歧杆菌与短PFS相关。使用随机森林机器学习方法,我们发现分类谱在预测PFS方面表现优越(AUC=0.74),而包括氨基酸合成和发酵在内的代谢途径是PD-L1表达的更好预测因子(AUC=0.87)。我们得出结论,肠道微生物组的特定宏基因组特征,包括细菌分类学和代谢途径可能提示NSCLC患者ICI疗效和PD-L1表达。
    Due to the high variance in response rates concerning anti-PD1 immunotherapy (IT), there is an unmet need to discover innovative biomarkers to predict immune checkpoint inhibitor (ICI)-efficacy. Our study included 62 Caucasian advanced-stage non-small cell lung cancer (NSCLC) patients treated with anti-PD1 ICI. Gut bacterial signatures were evaluated by metagenomic sequencing and correlated with progression-free survival (PFS), PD-L1 expression and other clinicopathological parameters. We confirmed the predictive role of PFS-related key bacteria with multivariate statistical models (Lasso- and Cox-regression) and validated on an additional patient cohort (n = 60). We find that alpha-diversity showed no significant difference in any comparison. However, there was a significant difference in beta-diversity between patients with long- (>6 months) vs. short (≤6 months) PFS and between chemotherapy (CHT)-treated vs. CHT-naive cases. Short PFS was associated with increased abundance of Firmicutes (F) and Actinobacteria phyla, whereas elevated abundance of Euryarchaeota was specific for low PD-L1 expression. F/Bacteroides (F/B) ratio was significantly increased in patients with short PFS. Multivariate analysis revealed an association between Alistipes shahii, Alistipes finegoldii, Barnesiella visceriola, and long PFS. In contrast, Streptococcus salivarius, Streptococcus vestibularis, and Bifidobacterium breve were associated with short PFS. Using Random Forest machine learning approach, we find that taxonomic profiles performed superiorly in predicting PFS (AUC = 0.74), while metabolic pathways including Amino Acid Synthesis and Fermentation were better predictors of PD-L1 expression (AUC = 0.87). We conclude that specific metagenomic features of the gut microbiome, including bacterial taxonomy and metabolic pathways might be suggestive of ICI efficacy and PD-L1 expression in NSCLC patients.
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  • 文章类型: Journal Article
    免疫检查点抑制剂(ICIs)改变了我们对肿瘤管理的看法。抗程序性死亡配体-1(PD-L1)免疫疗法的组合已成为许多晚期癌症的标准治疗。包括一线治疗.除了提高抗肿瘤免疫力,免疫检查点抑制剂(ICIs)的作用机制揭示了一种新的毒性特征,即免疫相关不良反应(irAEs).这种新的毒性可以损害任何器官,但是皮肤,消化系统和内分泌系统是最常见的疾病。大多数ICI归因于的毒性症状是轻微的,但有些是严重的,需要多学科的副作用管理。获得关于各种形式的免疫相关毒性的知识并迅速改变治疗技术以降低经历严重irAE的概率已成为肿瘤护理中的优先事项。近年来,越来越多的人了解肠道微生物组和ICI结局之间的有趣联系.多项研究表明,在恶性黑色素瘤中,微生物宏基因组和转移基因组模式与ICI功效之间存在联系。肺癌和结肠直肠癌。肠道微生物组的免疫调节作用也可以对irAE的生物学背景产生实际影响。此外,特定的微生物特征和代谢产物可能与毒性症状的发生和严重程度相关.通过识别这些生物因素,新型生物标志物可用于临床实践,以预测和管理潜在的IRAE。这篇综合综述旨在总结ICI相关irAE的临床方面和生物学背景,以及它们与肠道微生物组和代谢组的潜在关联。我们的目标是探索关于最重要和最可靠的irAE相关微生物生物标志物的知识现状,并讨论ICI功效和毒性之间的有趣联系。
    Immune checkpoint inhibitors (ICIs) have changed how we think about tumor management. Combinations of anti-programmed death ligand-1 (PD-L1) immunotherapy have become the standard of care in many advanced-stage cancers, including as a first-line therapy. Aside from improved anti-tumor immunity, the mechanism of action of immune checkpoint inhibitors (ICIs) exposes a new toxicity profile known as immune-related adverse effects (irAEs). This novel toxicity can damage any organ, but the skin, digestive and endocrine systems are the most frequently afflicted. Most ICI-attributed toxicity symptoms are mild, but some are severe and necessitate multidisciplinary side effect management. Obtaining knowledge on the various forms of immune-related toxicities and swiftly changing treatment techniques to lower the probability of experiencing severe irAEs has become a priority in oncological care. In recent years, there has been a growing understanding of an intriguing link between the gut microbiome and ICI outcomes. Multiple studies have demonstrated a connection between microbial metagenomic and metatranscriptomic patterns and ICI efficacy in malignant melanoma, lung and colorectal cancer. The immunomodulatory effect of the gut microbiome can have a real effect on the biological background of irAEs as well. Furthermore, specific microbial signatures and metabolites might be associated with the onset and severity of toxicity symptoms. By identifying these biological factors, novel biomarkers can be used in clinical practice to predict and manage potential irAEs. This comprehensive review aims to summarize the clinical aspects and biological background of ICI-related irAEs and their potential association with the gut microbiome and metabolome. We aim to explore the current state of knowledge on the most important and reliable irAE-related biomarkers of microbial origin and discuss the intriguing connection between ICI efficacy and toxicity.
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  • 文章类型: Journal Article
    Harmine是一种双特异性酪氨酸调节激酶1A(DYRK1A)抑制剂,具有许多生物学和药理学特性。也称为ACB1801分子,我们以前报道过,harmine增加黑色素瘤细胞上主要组织相容性复合物(MHC)-I依赖性抗原的呈递.这里,我们显示ACB1801上调了黑色素瘤细胞中MHC-I的几种蛋白质的mRNA表达,例如与抗原加工相关的转运蛋白TAP1和2,Tapasin和Lmp2(以下称为MHC-I签名)。用ACB1801治疗携带黑色素瘤B16-F10的小鼠抑制了肿瘤的生长和重量,并诱导了肿瘤免疫景观的深刻改变。引人注目的是,将ACB1801与抗PD1组合显著改善其在携带B16-F10黑色素瘤的小鼠中的治疗益处。这些结果表明,通过增加MHC-I,ACB1801可以与抗PD1/PD-L1疗法组合以改善显示MHC-I表达缺陷的癌症患者的生存益处。这进一步得到以下数据的支持:i)在响应抗PD1的黑素瘤患者中观察到TAP1、Tapasin和Lmp2的高表达水平;ii)相对于表达低MHC-I特征的黑素瘤患者,在表达高MHC-I特征的黑素瘤患者中的存活率显著改善;以及iii)黑素瘤患者中的I特征的高表达与CD8和NK细胞标志物的表达增加以及参与的趋化因子的
    Harmine is a dual-specificity tyrosine-regulated kinase 1A (DYRK1A) inhibitor that displays a number of biological and pharmacological properties. Also referred to as ACB1801 molecule, we have previously reported that harmine increases the presentation of major histocompatibility complex (MHC)-I-dependent antigen on melanoma cells. Here, we show that ACB1801 upregulates the mRNA expression of several proteins of the MHC-I such as Transporter Associated with antigen Processing TAP1 and 2, Tapasin and Lmp2 (hereafter referred to as MHC-I signature) in melanoma cells. Treatment of mice bearing melanoma B16-F10 with ACB1801 inhibits the growth and weight of tumors and induces a profound modification of the tumor immune landscape. Strikingly, combining ACB1801 with anti-PD1 significantly improves its therapeutic benefit in B16-F10 melanoma-bearing mice. These results suggest that, by increasing the MHC-I, ACB1801 can be combined with anti-PD1/PD-L1 therapy to improve the survival benefit in cancer patients displaying a defect in MHC-I expression. This is further supported by data showing that i) high expression levels of TAP1, Tapasin and Lmp2 was observed in melanoma patients that respond to anti-PD1; ii) the survival is significantly improved in melanoma patients who express high MHC-I signature relative to those expressing low MHC-I signature; and iii) high expression of MHC-I signature in melanoma patients was correlated with increased expression of CD8 and NK cell markers and overexpression of proinflammatory chemokines involved in the recruitment of CD8+ T cells.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    尽管免疫疗法取得了进展,只有一小部分患者获得长期生存获益.这一事实代表了开发可以预测肿瘤对免疫疗法的反应的免疫PET成像的令人信服的理由。越来越多的研究表明,肿瘤特异性主要组织相容性复合物II(tsMHC-II)与靶向免疫疗法的反应改善有关。这项研究的目的是研究tsMHC-II蛋白表达的潜力及其在干扰素γ(IFNγ)作为免疫PET预测免疫反应的新靶标治疗中的动态变化。方法:用DOTA螯合的64Cu对主要组织相容性复合物II(MHC-II)抗体进行放射性标记,以衍生出MHC-II免疫PET示踪剂。两种黑色素瘤模型(B16SIY,B16F10)是受访者和非受访者,分别,使用PD1/PD-L1检查点抑制剂。两种肿瘤模型均用抗PD1和IFNγ治疗,能够观察tsMHC-II的动态变化。小动物PET成像,生物分布,进行组织学研究以验证tsMHC-II与免疫治疗的肿瘤反应的相关性。结果:2种肿瘤的荧光激活细胞分选分析支持tsMHC-II的一致识别与肿瘤对免疫疗法的反应相关。体内PET成像显示反应者tsMHC-II的基础水平较高,B16SIY,而不是在无应答者中,B16F10.当用抗PD1抗体在动物中治疗时,与B16F10肿瘤相比,B16SIY肿瘤显示tsMHC-II的敏感增加。在IFNγ刺激组中,当IFNγ信号在B16SIY肿瘤中被激活时,更大量的tsMHC-II被进一步放大,在肿瘤免疫中,IFNγ信号传导正上调tsMHC-II。随后的组织病理学分析支持tsMHC-II与肿瘤免疫和对癌症免疫疗法反应的相关特征。结论:集体,我们验证了tsMHC-II免疫PET对肿瘤免疫治疗应答者和无应答者的预测价值.监测tsMHC-II对IFNγ刺激的敏感性可能为预测肿瘤对免疫疗法的反应提供有效的策略。
    Despite the advance of immunotherapy, only a small subset of patients gains long-term survival benefit. This fact represents a compelling rationale to develop immuno-PET imaging that can predict tumor response to immunotherapy. An increasing number of studies have shown that tumor-specific major histocompatibility complex II (tsMHC-II) is associated with improved responses to targeted immunotherapy. The aim of this study was to investigate the potential of tsMHC-II protein expression and its dynamic change on treatment with interferon γ (IFNγ) as a new target for immuno-PET to predict response to immunotherapy. Methods: Major histocompatibility complex II (MHC-II) antibody was radiolabeled with DOTA-chelated 64Cu to derive an MHC-II immuno-PET tracer. Two melanoma models (B16SIY, B16F10) that are respondent and nonrespondent, respectively, to PD1/PD-L1 checkpoint inhibitor were used. Both tumor models were treated with anti-PD1 and IFNγ, enabling observation of dynamic changes in tsMHC-II. Small-animal PET imaging, biodistribution, and histologic studies were performed to validate the correlation of tsMHC-II with the tumor response to the immunotherapy. Results: Fluorescence-activated cell sorting analysis of the 2 tumors supported the consensual recognition of tsMHC-II correlated with the tumor response to the immunotherapy. The in vivo PET imaging revealed higher basal levels of tsMHC-II in the responder, B16SIY, than in the nonresponder, B16F10. When treated with anti-PD1 antibody in animals, B16SIY tumors displayed a sensitive increase in tsMHC-II compared with B16F10 tumors. In IFNγ stimulation groups, the greater magnitude of tsMHC-II was further amplified when the IFNγ signaling was activated in the B16SIY tumors, as IFNγ signaling positively upregulates tsMHC-II in the tumor immunity. Subsequent histopathologic analysis supported the correlative characteristics of tsMHC-II with tumor immunity and response to cancer immunotherapy. Conclusion: Collectively, the predictive value of tsMHC-II immuno-PET was validated for stratifying tumor immunotherapy responders versus nonresponders. Monitoring sensitivity of tsMHC-II to IFNγ stimulation may provide an effective strategy to predict the tumor response to immunotherapy.
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  • 文章类型: Journal Article
    OBJECTIVE: Cancer patients with pre-existing autoimmune disease, such as systemic sclerosis (SSc), are excluded from clinical trials, so the data on tolerability and efficacy of immune checkpoint inhibitors in these patients are limited. This study investigated the tolerability and efficacy of anti-programmed death ligand 1 (PD (L)1) immunotherapies in patients with pre-existing SSc.
    METHODS: Scleronco-01 was a multicentre, nationwide, open-label, phase IV observational study, from 2019 to 2021.
    RESULTS: Seventeen SSc patients receiving treatment for lung carcinoma (n = 13, 77%), head and neck cancer (n = 2, 12%), melanoma (n = 1, 6%), and colorectal carcinoma (n = 1, 6%) were included. The median (interquartile range) patient age was 60 (34-82) years. Fifteen (88%) patients received anti-PD1 (nivolumab and pembrolizumab) and two (12%) anti-PD-L1 (durvalumab). The median follow-up duration was 12 (range, 2-38) months. Four patients (24%) experienced flare-up of SSc symptoms. Ten patients (59%) developed an immune-related adverse event (grade I-II in 11 patients [65%], grade III-IV in one [6%]) without grade V. The overall response rate was 41% (7/17 patients). The median overall survival was 15.8 (95% confidence interval: 7.3 to not reached) months.
    CONCLUSIONS: Anti-PD1 or PD-L1 immunotherapies are suitable options for cancer patients with pre-existing SSc. Longer follow-up periods are required for long-term safety analyses.
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  • 文章类型: Journal Article
    Despite unprecedented results of anti-programmed death protein (ligand) 1 (PD-(L)1) immune checkpoint inhibitor in the oncology\'s armamentarium, immune-related adverse events (irAEs) represent a therapeutic hurdle. Currently, there is no consensual recommendation on a routinely monitored biomarker to early detect irAE. Biological markers such as serum creatine phosphokinase (CPK) are commonly used to measure muscular tissue injury. The potential of routine serum CPK monitoring to predict cardiac or neuromuscular irAE in patients treated with immunotherapy remains unknown.
    In this retrospective study between January 2016 and December 2018 at Gustave Roussy Cancer Campus, 1151 cancer patients treated with anti-PD-(L)1 immunotherapy were systematically monitored with serum CPK measurements before each immunotherapy cycle. We considered significant CPK increases according to Common Terminology Criteria for Adverse Events v5.0 (CTCAEV5) of grade ≥2 severity. Comparisons were performed in patients with immune-related CPK (ir-CPK) elevations symptomatic versus asymptomatic.
    Overall, 53 of 1151 (4.6%) patients showed a CPK increase. Elevations of CPK were deemed to be immunotherapy-related in 31 of 1151 (2.7%) patients. Among them, 12 of 31 (38.7%) patients experienced symptomatic cardiac or neuromuscular irAE, whereas the other 19 of 31 (61.3%) patients remained asymptomatic. In patients with symptomatic irAE, the mean ir-CPK level was higher compared with asymptomatic patients (1271 versus 771 UI/L, P value = 0.02). In the asymptomatic group, all patients experienced a spontaneous resolution of the ir-CPK increase, and none required medical intervention.
    Most patients with immune-related CPK increase remained asymptomatic. The CPK serum increase did not alter the clinical management of asymptomatic patients. The results of this study did not support a significant clinical interest for a systematic routine CPK monitoring in patients amenable to anti-PD-(L)1 immunotherapy.
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