Differences in immune profiles of metastatic melanoma patients treated with anti-CTLA-4 and anti-PD-1 combined immunotherapy.

Authors

null

Tuba Nur Gide

Melanoma Institute Australia, Central Clinical School, Faculty of Medicine, The University of Sydney, Sydney, Australia

Tuba Nur Gide, Camelia Quek, Jason Madore, Alexander M. Menzies, Rebecca Dent, Matteo S. Carlino, Alex Guminski, Robyn Saw, John F. Thompson, James S. Wilmott, Richard A. Scolyer, Georgina V. Long

Organizations

Melanoma Institute Australia, Central Clinical School, Faculty of Medicine, The University of Sydney, Sydney, Australia, Melanoma Institute Australia, Sydney, Australia, Melanoma Institute Australia, Royal North Shore Hospital, The University of Sydney, North Sydney, Australia, Melanoma Institute Australia, Crown Princess Mary Cancer Centre, Westmead and Blacktown Hospitals, Sydney, Australia, Melanoma Institute Australia, The University of Sydney, Royal North Shore Hospital, Sydney, Australia, Melanoma Institute Australia, The University of Sydney, Sydney, Australia, Melanoma Institute Australia, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia, Melanoma Institute Australia, Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, Australia, Melanoma Institute Australia, The University of Sydney, Mater Hospital, Royal North Shore Hospital, Sydney, Australia

Research Funding

Other

Background: Immune checkpoint inhibitors targeting the cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death 1 (PD-1) receptor have significantly improved the outcomes of metastatic melanoma patients resulting in durable response and longer overall survival. However, while some patients exhibit a complete response to immunotherapy, others have demonstrated little to no response. The aim of this study is to examine the immune cell subsets between the good and poor responders to anti-CTLA-4 and anti-PD-1 combined immunotherapy in order to determine potential mechanisms of response and resistance. Methods: Multiplex immunofluorescent staining was performed on pre-treatment formalin-fixed, paraffin-embedded (FFPE) tissue samples from good and poor responders (n= 17; n= 11 good responders, n= 6 poor responders) for markers including CD8, PD-1, PD-L1, FOXP3 and SOX10. Spectral image analysis was conducted via the Vectra 3.0 imaging system. Quantitative analysis was carried out using the inForm software. Gene signatures associated with the T-cell signalling pathways were identified following RNA sequencing of FFPE samples. Results: Good responders displayed significantly higher levels of baseline intratumoural PD-1 and PD-L1 expression in comparison to the poor responders (P= 0.01 and P= 0.01 respectively), highlighting their roles as predictive biomarkers of response. Additionally, the CD8+ T-cell to PD-L1 ratio was significantly higher (P= 0.001) in the tumours of the poor responders, indicating a distinction in the CD8+ T-cell phenotypes between the good and poor responders. Furthermore, analysis of the RNA sequencing data revealed a panel of immune signatures that have been implicated in prognosis and responsiveness to immunotherapy in melanoma. Conclusions: In summary, these findings provide insight into the possible biomarkers of response and resistance to immunotherapy, thus improving our understanding of the mechanisms driving variations in response.

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Abstract Details

Meeting

2017 ASCO-SITC Clinical Immuno-Oncology Symposium

Session Type

Poster Session

Session Title

Poster Session B

Track

Biomarkers and Inflammatory Signatures,Humoral Immunity for Diagnosis and Therapy,Immune Checkpoints and Stimulatory Receptors,Modulating Innate Immunity,Therapies Targeting T cells

Sub Track

Prognostic and Predictive Markers

Citation

J Clin Oncol 35, 2017 (suppl 7S; abstract 51)

DOI

10.1200/JCO.2017.35.7_suppl.51

Abstract #

51

Poster Bd #

F4

Abstract Disclosures

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