Tumor immune profiling predicts response to anti–PD-1 therapy in human melanoma
Adil I. Daud, … , Matthew F. Krummel, Michael D. Rosenblum
Adil I. Daud, … , Matthew F. Krummel, Michael D. Rosenblum
Published August 15, 2016
Citation Information: J Clin Invest. 2016;126(9):3447-3452. https://doi.org/10.1172/JCI87324.
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Concise Communication Oncology

Tumor immune profiling predicts response to anti–PD-1 therapy in human melanoma

Abstract

BACKGROUND. Immune checkpoint blockade is revolutionizing therapy for advanced cancer, but many patients do not respond to treatment. The identification of robust biomarkers that predict clinical response to specific checkpoint inhibitors is critical in order to stratify patients and to rationally select combinations in the context of an expanding array of therapeutic options.

METHODS. We performed multiparameter flow cytometry on freshly isolated metastatic melanoma samples from 2 cohorts of 20 patients each prior to treatment and correlated the subsequent clinical response with the tumor immune phenotype.

RESULTS. Increasing fractions of programmed cell death 1 high/cytotoxic T lymphocyte–associated protein 4 high (PD-1hiCTLA-4hi) cells within the tumor-infiltrating CD8+ T cell subset strongly correlated with response to therapy (RR) and progression-free survival (PFS). Functional analysis of these cells revealed a partially exhausted T cell phenotype. Assessment of metastatic lesions during anti–PD-1 therapy demonstrated a release of T cell exhaustion, as measured by an accumulation of highly activated CD8+ T cells within tumors, with no effect on Tregs.

CONCLUSIONS. Our data suggest that the relative abundance of partially exhausted tumor-infiltrating CD8+ T cells predicts response to anti–PD-1 therapy. This information can be used to appropriately select patients with a high likelihood of achieving a clinical response to PD-1 pathway inhibition.

FUNDING. This work was funded by a generous gift provided by Inga-Lill and David Amoroso as well as a generous gift provided by Stephen Juelsgaard and Lori Cook.

Authors

Adil I. Daud, Kimberly Loo, Mariela L. Pauli, Robert Sanchez-Rodriguez, Priscila Munoz Sandoval, Keyon Taravati, Katy Tsai, Adi Nosrati, Lorenzo Nardo, Michael D. Alvarado, Alain P. Algazi, Miguel H. Pampaloni, Iryna V. Lobach, Jimmy Hwang, Robert H. Pierce, Iris K. Gratz, Matthew F. Krummel, Michael D. Rosenblum

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Figure 1

Relative abundance of CTLA-4hiPD-1hi CTLs predicts response to anti–PD-1 therapy.

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Relative abundance of CTLA-4hiPD-1hi CTLs predicts response to anti–PD-1...
(A) Flow cytometric data from metastatic tumors taken prior to anti–PD-1 therapy and representative pre- and post-treatment computed tomographic images from a patient who achieved a response (Responder) and one who did not (Nonresponder). Flow cytometric plots were pregated on live CD45+CD3+CD8+ cells. (B) Discovery cohort (n = 20 patients) and (C) validation cohort (n = 20 patients) of PFS for patients who had 20% or more (dotted line) or 20% or fewer (solid line) tumor-infiltrating CTLA-4hiPD-1hi CTLs. Statistical significance was determined by log-rank test.