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Bence C, Hofman V, Chamorey E, Long-Mira E, Lassalle S, Albertini AF, Liolios I, Zahaf K, Picard A, Montaudié H, Lacour JP, Passeron T, Andea AA, Ilie M, Hofman P. Association of combined PD-L1 expression and tumour-infiltrating lymphocyte features with survival and treatment outcomes in patients with metastatic melanoma. J Eur Acad Dermatol Venereol 2019; 34:984-994. [PMID: 31625630 DOI: 10.1111/jdv.16016] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 09/20/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Recent advances obtained with immune checkpoint inhibitors (ICIs) targeting the programmed cell death-1 (PD-1) protein have significantly improved the outcome of patients with metastatic melanoma. The PD-L1 expression in tumour cells as detected by immunohistochemistry is a predictive biomarker in some solid tumours, but appears insufficient as prognostic or predictive factor of response to ICIs in metastatic melanomas. OBJECTIVES We investigated whether the presence and the features of pretreatment CD8+ tumour-infiltrating T lymphocytes (TILs) could be a complementary prognostic or predictive biomarker in patients with metastatic melanoma. METHODS In this retrospective study, we evaluated the association of PD-L1 expression ≥5% of tumour cells combined with TIL features (CD8, CD28, Ki67) with the overall survival (OS) among 51 patients treated with ICIs and 54 patients treated with other treatment options (non-ICIs). RESULTS PD-L1 positivity was observed in 33% and 39% of primary melanomas and matched metastases, respectively, with, however, poor concordance between the primary and the matched metastatic site (κ = 0.283). No significant association was noted between PD-L1 expression and CD8+ TIL profile analysed as single markers and OS or response to immunotherapy. Instead, their combined analysis in primary melanoma samples showed that the PD-L1-/CD8+ status was significantly associated with prolonged OS in the whole population (P = 0.04) and in the subgroup treated with non-ICIs (P = 0.009). Conversely, the PD-L1+/CD8+ status was a good prognostic factor in patients treated with ICIs (P = 0.022), whereas was significantly associated with poor prognosis in patients treated with non-ICIs (P = 0.014). While the expression of CD28 was not related to outcome, the Ki67 expression was significantly associated with poor OS in the subgroup CD8+ TIL+/PD-L1- (P = 0.02). CONCLUSIONS The pretreatment combination of PD-L1 expression with the level of CD8+ TILs could better assess OS and predict therapeutic response of patients with metastatic melanoma treated by either immunotherapy or other treatment regimens.
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Affiliation(s)
- C Bence
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - V Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - E Chamorey
- Biostatistics Unit, Antoine Lacassagne Comprehensive Cancer Center, Nice, France
| | - E Long-Mira
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - S Lassalle
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | | | | | - K Zahaf
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - A Picard
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Nice, France
| | - H Montaudié
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Nice, France
| | - J P Lacour
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Nice, France
| | - T Passeron
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Nice, France
| | - A A Andea
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - M Ilie
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - P Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
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Ilie M, Benzaquen J, Hofman V, Lassalle S, Yazbeck N, Leroy S, Heeke S, Bence C, Mograbi B, Glaichenhaus N, Marquette CH, Hofman P. Immunotherapy in Non-Small Cell Lung Cancer: Biological Principles and Future Opportunities. Curr Mol Med 2019; 17:527-540. [PMID: 29473504 DOI: 10.2174/1566524018666180222114038] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 02/04/2018] [Accepted: 02/15/2018] [Indexed: 11/22/2022]
Abstract
Immunotherapy aims to amplify the anticancer immune response through reactivation of the lymphocytic response raised against several tumor neo-antigens. To obtain an effective immune response, this therapeutic approach requires that a number of immunological checkpoints be passed, such as the activation of excitatory costimulatory signals or the avoidance of coinhibitory molecules. Among the immune checkpoints, the interaction of the membrane-bound ligand PD-1 and its receptor PD-L1 has received much attention because of remarkable efficacy in numerous clinical trials for various cancer types, including non-small cell lung cancer (NSCLC). However, several limitations exist with these therapeutic agents when used as monotherapy, with objective responses observed in only 30-40% of patients, with the majority of patients demonstrating innate resistance, and approximately 25% of responders later demonstrating disease progression. Recent developments in the understanding of cancer immunology have the potential to identify mechanisms of innate and acquired resistance to immune checkpoint inhibitors through translational research in human samples. This review focuses on the biological basic principles for immunological checkpoint blockade, and highlights the current status and the perspectives of this therapeutic approach in NSCLC patients.
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Affiliation(s)
- M Ilie
- University Cote d'Azur, Nice Hospital, FHU OncoAge, Laboratory of Clinical and Experimental Pathology and Hospital-related Biobank (BB-0033-00025), 06001 Nice, France.,University Cote d'Azur, Inserm U1081/CNRS UMR 7284, Institute for Research on Cancer and Aging, Comprehensive Cancer Center Antoine Lacassagne, Nice, France
| | - J Benzaquen
- University Cote d'Azur, Inserm U1081/CNRS UMR 7284, Institute for Research on Cancer and Aging, Comprehensive Cancer Center Antoine Lacassagne, Nice, France.,University Cote d'Azur, Nice Hospital, FHU OncoAge, Pneumology Department, 06000 Nice, France
| | - V Hofman
- University Cote d'Azur, Nice Hospital, FHU OncoAge, Laboratory of Clinical and Experimental Pathology and Hospital-related Biobank (BB-0033-00025), 06001 Nice, France.,University Cote d'Azur, Inserm U1081/CNRS UMR 7284, Institute for Research on Cancer and Aging, Comprehensive Cancer Center Antoine Lacassagne, Nice, France
| | - S Lassalle
- University Cote d'Azur, Nice Hospital, FHU OncoAge, Laboratory of Clinical and Experimental Pathology and Hospital-related Biobank (BB-0033-00025), 06001 Nice, France.,University Cote d'Azur, Inserm U1081/CNRS UMR 7284, Institute for Research on Cancer and Aging, Comprehensive Cancer Center Antoine Lacassagne, Nice, France
| | - N Yazbeck
- University Cote d'Azur, Inserm U1081/CNRS UMR 7284, Institute for Research on Cancer and Aging, Comprehensive Cancer Center Antoine Lacassagne, Nice, France
| | - S Leroy
- University Cote d'Azur, Nice Hospital, FHU OncoAge, Pneumology Department, 06000 Nice, France
| | - S Heeke
- University Cote d'Azur, Inserm U1081/CNRS UMR 7284, Institute for Research on Cancer and Aging, Comprehensive Cancer Center Antoine Lacassagne, Nice, France
| | - C Bence
- University Cote d'Azur, Nice Hospital, FHU OncoAge, Laboratory of Clinical and Experimental Pathology and Hospital-related Biobank (BB-0033-00025), 06001 Nice, France
| | - B Mograbi
- University Cote d'Azur, Inserm U1081/CNRS UMR 7284, Institute for Research on Cancer and Aging, Comprehensive Cancer Center Antoine Lacassagne, Nice, France
| | - N Glaichenhaus
- University Cote d'Azur, FHU OncoAge, Cellular and Molecular Pharmacology Institute CNRS, INSERM, Valbonne, France
| | - C-H Marquette
- University Cote d'Azur, Inserm U1081/CNRS UMR 7284, Institute for Research on Cancer and Aging, Comprehensive Cancer Center Antoine Lacassagne, Nice, France.,University Cote d'Azur, Nice Hospital, FHU OncoAge, Pneumology Department, 06000 Nice, France
| | - P Hofman
- University Cote d'Azur, Nice Hospital, FHU OncoAge, Laboratory of Clinical and Experimental Pathology and Hospital-related Biobank (BB-0033-00025), 06001 Nice, France.,University Cote d'Azur, Inserm U1081/CNRS UMR 7284, Institute for Research on Cancer and Aging, Comprehensive Cancer Center Antoine Lacassagne, Nice, France
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Ilie MI, Bence C, Hofman V, Long-Mira E, Butori C, Bouhlel L, Lalvée S, Mouroux J, Poudenx M, Otto J, Marquette CH, Hofman P. Discrepancies between FISH and immunohistochemistry for assessment of the ALK status are associated with ALK 'borderline'-positive rearrangements or a high copy number: a potential major issue for anti-ALK therapeutic strategies. Ann Oncol 2015; 26:238-244. [PMID: 25344360 DOI: 10.1093/annonc/mdu484] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Patients with advanced lung adenocarcinomas expressing ALK rearrangements are highly responsive to crizotinib, a dual ALK/c-MET inhibitor. Immunohistochemistry (IHC) is an easy clinically and routinely applicable cost-effective assay for ALK, c-MET and ROS1 protein expression for potential treatment with crizotinib. The purpose of this study was to evaluate the percentage and the pattern of ALK-rearranged cells, the variation in the native ALK copy number, as well as ALK, c-MET and ROS1 protein expression, and their significance on outcome of crizotinib-treated lung adenocarcinoma patients. PATIENTS AND METHODS Consecutive lung adenocarcinoma specimens (n = 176) 'double-negative' (wild-type EGFR and KRAS) were tested for ALK rearrangements/copy number alterations and for ALK, c-MET and ROS1 protein expression using automated standardized protocols. Preliminary data on the outcome of crizotinib-treated patients were recorded. RESULTS FISH analysis identified 26/176 (15%) cases with ALK rearrangements. Seven cases had discordant results between the ALK FISH and IHC. Five cases with discordant FISH-positive/IHC-negative revealed FISH 'borderline' positivity (15%-20%). Three cases overexpressed c-MET and responded to crizotinib, and two cases with ALK-'borderline' rearranged cells only, not associated with c-MET expression, progressed under crizotinib. Two cases with discordant FISH-negative/IHC-positive revealed ALK gene amplification without associated c-MET or ROS1 protein expression. CONCLUSIONS The discrepancies observed between the IHC and FISH data revealed unexpected biological events, rather than technical issues, which potentially can have a strong impact on the therapeutic strategy with crizotinib.
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Affiliation(s)
- M I Ilie
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice; IRCAN Team 3, INSERM U1081/UMR CNRS 7284, Faculty of Medicine of Nice, University of Nice Sophia Antipolis, Nice
| | - C Bence
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice
| | - V Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice; IRCAN Team 3, INSERM U1081/UMR CNRS 7284, Faculty of Medicine of Nice, University of Nice Sophia Antipolis, Nice; Hospital Integrated Biobank
| | - E Long-Mira
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice; IRCAN Team 3, INSERM U1081/UMR CNRS 7284, Faculty of Medicine of Nice, University of Nice Sophia Antipolis, Nice
| | - C Butori
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice
| | | | - S Lalvée
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice
| | - J Mouroux
- IRCAN Team 3, INSERM U1081/UMR CNRS 7284, Faculty of Medicine of Nice, University of Nice Sophia Antipolis, Nice; Department of Thoracic Surgery, Pasteur Hospital, Nice
| | | | - J Otto
- Department of Pneumology, Centre Antoine Lacassagne, Nice, France
| | - C H Marquette
- IRCAN Team 3, INSERM U1081/UMR CNRS 7284, Faculty of Medicine of Nice, University of Nice Sophia Antipolis, Nice; Department of Pneumology
| | - P Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice; IRCAN Team 3, INSERM U1081/UMR CNRS 7284, Faculty of Medicine of Nice, University of Nice Sophia Antipolis, Nice; Hospital Integrated Biobank.
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