T cell receptor sequencing of activated CD8 T cells in the blood identifies tumor-infiltrating clones that expand after PD-1 therapy and radiation in a melanoma patient.
Andreas WielandAlice Oliffson KamphorstN Volkan AdsayJonathan J MasorJuan SarmientoTahseen H NastiSam DarkoDaniel C DouekYue XueWalter J CurranDavid H LawsonRajesh M ValanparambilPublished in: Cancer immunology, immunotherapy : CII (2018)
PD-1-targeted therapy has dramatically changed advanced cancer treatment. However, many questions remain, including specificity of T cells activated by PD-1 therapy and how peripheral blood analysis correlates to effects at tumor sites. In this study, we utilized TCR sequencing to dissect the composition of peripheral blood CD8 T cells activated upon therapy, comparing it with tumor-infiltrating lymphocytes. We report on a nonagenarian melanoma patient who showed a prominent increase in peripheral blood Ki-67 + CD8 T cells following brain stereotactic radiation and anti-PD-1 immunotherapy. Proliferating CD8 T cells exhibited an effector-like phenotype with expression of CD38, HLA-DR and Granzyme B, as well as expression of the positive costimulatory molecules CD28 and CD27. TCR sequencing of peripheral blood CD8 T cells revealed a highly oligoclonal repertoire at baseline with one clonotype accounting for 30%. However, the majority of dominant clones-including a previously identified cytomegalovirus-reactive clone-did not expand following treatment. In contrast, expanding clones were present at low frequencies in the peripheral blood but were enriched in a previously resected liver metastasis. The patient has so far remained recurrence-free for 36 months, and several CD8 T cell clones that expanded after treatment were maintained at elevated levels for at least 8 months. Our data show that even in a nonagenarian individual with oligoclonal expansion of CD8 T cells, we can identify activation of tumor-infiltrating CD8 T cell clones in peripheral blood following anti-PD-1-based immunotherapies.
Keyphrases
- peripheral blood
- single cell
- case report
- poor prognosis
- regulatory t cells
- stem cells
- magnetic resonance
- small cell lung cancer
- bone marrow
- immune response
- magnetic resonance imaging
- gene expression
- big data
- genome wide
- radiation induced
- squamous cell carcinoma
- computed tomography
- epstein barr virus
- mesenchymal stem cells
- radiation therapy
- deep learning
- neoadjuvant chemotherapy
- rectal cancer
- combination therapy
- artificial intelligence
- free survival
- diffuse large b cell lymphoma