Combined IL-21–primed polyclonal CTL plus CTLA4 blockade controls refractory metastatic melanoma in a patient

AG Chapuis, SM Lee, JA Thompson… - Journal of Experimental …, 2016 - rupress.org
AG Chapuis, SM Lee, JA Thompson, IM Roberts, KA Margolin, S Bhatia, HL Sloan, I Lai…
Journal of Experimental Medicine, 2016rupress.org
Adoptive transfer of peripheral blood–derived, melanoma-reactive CD8+ cytotoxic T
lymphocytes (CTLs) alone is generally insufficient to eliminate bulky tumors. Similarly,
monotherapy with anti-CTLA4 infrequently yields sustained remissions in patients with
metastatic melanoma. We postulated that a bolus of enhanced IL-21–primed polyclonal
antigen-specific CTL combined with CTLA4 blockade might boost antitumor efficacy. In this
first-in-human case study, the combination successfully led to a durable complete remission …
Adoptive transfer of peripheral blood–derived, melanoma-reactive CD8+ cytotoxic T lymphocytes (CTLs) alone is generally insufficient to eliminate bulky tumors. Similarly, monotherapy with anti-CTLA4 infrequently yields sustained remissions in patients with metastatic melanoma. We postulated that a bolus of enhanced IL-21–primed polyclonal antigen-specific CTL combined with CTLA4 blockade might boost antitumor efficacy. In this first-in-human case study, the combination successfully led to a durable complete remission (CR) in a patient whose disease was refractory to both monoclonal CTL and anti-CTLA4. Long-term persistence and sustained anti-tumor activity of transferred CTL, as well as responses to nontargeted antigens, confirmed mutually beneficial effects of the combined treatment. In this first-in-human study, Chapuis et al. demonstrate that the combination of adoptive cellular therapy with CTLA4 blockade induces long-term remission in a melanoma patient resistant to both modalities administered serially and individually.
rupress.org