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Da Gama Duarte J, Woods K, Quigley LT, Deceneux C, Tutuka C, Witkowski T, Ostrouska S, Hudson C, Tsao SCH, Pasam A, Dobrovic A, Blackburn JM, Cebon J, Behren A. Ropporin-1 and 1B Are Widely Expressed in Human Melanoma and Evoke Strong Humoral Immune Responses. Cancers (Basel) 2021; 13:1805. [PMID: 33918976 PMCID: PMC8069442 DOI: 10.3390/cancers13081805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022] Open
Abstract
Antibodies that block immune regulatory checkpoints (programmed cell death 1, PD-1 and cytotoxic T-lymphocyte-associated antigen 4, CTLA-4) to mobilise immunity have shown unprecedented clinical efficacy against cancer, demonstrating the importance of antigen-specific tumour recognition. Despite this, many patients still fail to benefit from these treatments and additional approaches are being sought. These include mechanisms that boost antigen-specific immunity either by vaccination or adoptive transfer of effector cells. Other than neoantigens, epigenetically regulated and shared antigens such as NY-ESO-1 are attractive targets; however, tissue expression is often heterogeneous and weak. Therefore, peptide-specific therapies combining multiple antigens rationally selected to give additive anti-cancer benefits are necessary to achieve optimal outcomes. Here, we show that Ropporin-1 (ROPN1) and 1B (ROPN1B), cancer restricted antigens, are highly expressed and immunogenic, inducing humoral immunity in patients with advanced metastatic melanoma. By multispectral immunohistochemistry, 88.5% of melanoma patients tested (n = 54/61) showed ROPN1B expression in at least 1 of 2/3 tumour cores in tissue microarrays. Antibody responses against ROPN1A and ROPN1B were detected in 71.2% of melanoma patients tested (n = 74/104), with increased reactivity seen with more advanced disease stages. Thus, ROPN1A and ROPN1B may indeed be viable targets for cancer immunotherapy, alone or in combination with other cancer antigens, and could be combined with additional therapies such as immune checkpoint blockade.
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Affiliation(s)
- Jessica Da Gama Duarte
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Katherine Woods
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Luke T. Quigley
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Cyril Deceneux
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Candani Tutuka
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Tom Witkowski
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Simone Ostrouska
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Chris Hudson
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Simon Chang-Hao Tsao
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Anupama Pasam
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Alexander Dobrovic
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
- Department of Clinical Pathology, Melbourne Medical School, University of Melbourne, Parkville, VIC 3010, Australia
| | - Jonathan M. Blackburn
- Department of Integrative Biomedical Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa;
- Institute for Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
- Medical Oncology Unit, Austin Health, Heidelberg, VIC 3084, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; (J.D.G.D.); (K.W.); (L.T.Q.); (C.D.); (C.T.); (T.W.); (S.O.); (C.H.); (S.C.-H.T.); (A.P.); (A.D.); (J.C.)
- School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
- Department of Medicine—Austin, Melbourne Medical School, University of Melbourne, Parkville, VIC 3010, Australia
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Rigau M, Ostrouska S, Fulford T, Johnson DN, Woods K, Ruan Z, McWilliam H, Hudson C, Tutuka C, Wheatley AK, Kent SJ, Villadangos JA, Pal B, Kurts C, Simmonds J, Pelzing M, Hammet AD, Verhagen AM, Vairo G, Maraskovsky E, Panousis C, Gherardin NA, Cebon J, Godfrey DI, Behren A, Uldrich AP. Butyrophilin molecules govern γδ T cell reactivity against phosphoantigens. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.140.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Humans have a minor lymphocyte population of gamma-delta (γδ) T cells. The majority of these express a recombined Vγ9Vδ2 T cell receptor (TCR) attractive to immunotherapy. This distinct TCR conveys reactivity to phosphorylated antigens (pAg) that derive from pathogens or accumulate inside tumour cells. Such T cell responses are regulated by butyrophilin (BTN) 3A1 and other membrane-related proteins present on antigen-presenting cells. However, the activation mechanism and direct molecular ligand recognised by the γδ TCR remain a crucial unresolved question. Herein, we used pAg-reactive TCR probes in a whole-genome screen to identify BTN2A1 as an essential ligand. In further investigation, we elucidated its functionality working in cis with BTN3A1. Also, a mutational analysis unveiled critical regions of the γδ TCR are positioned at opposite sides. We locate germ-line encoded residues of the Vγ9 chain were responsible for BTN2A1 binding, whereas two amino-acids of the Vδ2 chain were necessary for a complete response to pAg. In conclusion, we propose a dual-ligand complex model that senses pAg to evoke immune responses, wherein BTN2A1 sets the framework to develop new opportunities on γδ T cell-based immunotherapies.
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Affiliation(s)
- Marc Rigau
- 1Univ. of Melbourne, Australia
- 2Univ. of Bonn, Germany
- 3Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Australia
| | - Simone Ostrouska
- 4Olivia Newton-John Cancer Research Institute, Australia
- 5La Trobe University, Sch. of Cancer Medicine, Australia
| | | | | | - Katherine Woods
- 4Olivia Newton-John Cancer Research Institute, Australia
- 5La Trobe University, Sch. of Cancer Medicine, Australia
- 6Ludwig Institute for Cancer Research, Australia
| | | | | | | | - Candani Tutuka
- 4Olivia Newton-John Cancer Research Institute, Australia
- 5La Trobe University, Sch. of Cancer Medicine, Australia
| | - Adam K Wheatley
- 1Univ. of Melbourne, Australia
- 7Australian Research Council Centre of Excellence for Convergent Bio-Nano Science and Technology at the Univ. of Melbourne, Australia
| | - Stephen J Kent
- 1Univ. of Melbourne, Australia
- 7Australian Research Council Centre of Excellence for Convergent Bio-Nano Science and Technology at the Univ. of Melbourne, Australia
| | | | - Bhupinder Pal
- 4Olivia Newton-John Cancer Research Institute, Australia
- 5La Trobe University, Sch. of Cancer Medicine, Australia
| | | | | | | | | | | | | | | | | | | | - Jonathan Cebon
- 4Olivia Newton-John Cancer Research Institute, Australia
- 5La Trobe University, Sch. of Cancer Medicine, Australia
| | - Dale Ian Godfrey
- 1Univ. of Melbourne, Australia
- 3Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Australia
| | - Andreas Behren
- 4Olivia Newton-John Cancer Research Institute, Australia
- 5La Trobe University, Sch. of Cancer Medicine, Australia
- 6Ludwig Institute for Cancer Research, Australia
| | - Adam Peter Uldrich
- 1Univ. of Melbourne, Australia
- 3Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Australia
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3
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Rigau M, Ostrouska S, Fulford TS, Johnson DN, Woods K, Ruan Z, McWilliam HEG, Hudson C, Tutuka C, Wheatley AK, Kent SJ, Villadangos JA, Pal B, Kurts C, Simmonds J, Pelzing M, Nash AD, Hammet A, Verhagen AM, Vairo G, Maraskovsky E, Panousis C, Gherardin NA, Cebon J, Godfrey DI, Behren A, Uldrich AP. Butyrophilin 2A1 is essential for phosphoantigen reactivity by γδ T cells. Science 2020; 367:science.aay5516. [PMID: 31919129 DOI: 10.1126/science.aay5516] [Citation(s) in RCA: 232] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/14/2019] [Accepted: 12/23/2019] [Indexed: 12/21/2022]
Abstract
Gamma delta (γδ) T cells are essential to protective immunity. In humans, most γδ T cells express Vγ9Vδ2+ T cell receptors (TCRs) that respond to phosphoantigens (pAgs) produced by cellular pathogens and overexpressed by cancers. However, the molecular targets recognized by these γδTCRs are unknown. Here, we identify butyrophilin 2A1 (BTN2A1) as a key ligand that binds to the Vγ9+ TCR γ chain. BTN2A1 associates with another butyrophilin, BTN3A1, and these act together to initiate responses to pAg. Furthermore, binding of a second ligand, possibly BTN3A1, to a separate TCR domain incorporating Vδ2 is also required. This distinctive mode of Ag-dependent T cell activation advances our understanding of diseases involving pAg recognition and creates opportunities for the development of γδ T cell-based immunotherapies.
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Affiliation(s)
- Marc Rigau
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,University of Bonn, Bonn, Germany.,Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Victoria 3010, Australia
| | - Simone Ostrouska
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, Victoria 3084, Australia
| | - Thomas S Fulford
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Darryl N Johnson
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Victoria 3010, Australia
| | - Katherine Woods
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, Victoria 3084, Australia.,Ludwig Institute for Cancer Research, Melbourne -Austin Branch, Victoria 3084, Australia
| | - Zheng Ruan
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Victoria 3010, Australia
| | - Hamish E G McWilliam
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,Department of Biochemistry and Molecular Biology at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Christopher Hudson
- Ludwig Institute for Cancer Research, Melbourne -Austin Branch, Victoria 3084, Australia
| | - Candani Tutuka
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, Victoria 3084, Australia
| | - Adam K Wheatley
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,Australian Research Council Centre of Excellence for Convergent Bio-Nano Science and Technology at the University of Melbourne, Victoria 3010, Australia
| | - Stephen J Kent
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,Australian Research Council Centre of Excellence for Convergent Bio-Nano Science and Technology at the University of Melbourne, Victoria 3010, Australia
| | - Jose A Villadangos
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia.,Department of Biochemistry and Molecular Biology at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Bhupinder Pal
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, Victoria 3084, Australia
| | | | - Jason Simmonds
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Matthias Pelzing
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Andrew D Nash
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Andrew Hammet
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Anne M Verhagen
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Gino Vairo
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Eugene Maraskovsky
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Con Panousis
- CSL Limited at the Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Nicholas A Gherardin
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, Victoria 3084, Australia.,Ludwig Institute for Cancer Research, Melbourne -Austin Branch, Victoria 3084, Australia.,Department of Medicine, The University of Melbourne, Melbourne, Victoria 3010, Australia.,Austin Health, Heidelberg, Victoria 3084, Australia
| | - Dale I Godfrey
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia. .,Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Victoria 3010, Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria 3084, Australia. .,School of Cancer Medicine, La Trobe University, Heidelberg, Victoria 3084, Australia.,Ludwig Institute for Cancer Research, Melbourne -Austin Branch, Victoria 3084, Australia.,Department of Medicine, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Adam P Uldrich
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria 3010, Australia. .,Australian Research Council Centre of Excellence for Advanced Molecular Imaging at the University of Melbourne, Victoria 3010, Australia
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4
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Hochheiser K, Aw Yeang HX, Wagner T, Tutuka C, Behren A, Waithman J, Angel C, Neeson PJ, Gebhardt T, Gyorki DE. Accumulation of CD103 + CD8 + T cells in a cutaneous melanoma micrometastasis. Clin Transl Immunology 2019; 8:e1100. [PMID: 31885869 PMCID: PMC6931001 DOI: 10.1002/cti2.1100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/05/2019] [Accepted: 12/05/2019] [Indexed: 12/22/2022] Open
Abstract
Objective The immune system can halt cancer progression by suppressing outgrowth of clinically occult micrometastases in a state of cancer-immune equilibrium. Cutaneous melanoma provides a unique opportunity to study the immune contexture of such lesions, as miniscule skin metastases are accessible to clinical inspection and diagnostic biopsy. Methods Here, we analysed by multiplex immunofluorescence microscopy samples from a melanoma patient presenting with an overt and an occult in-transit metastasis (ITM), the latter of which appeared as a small erythematous papule. Results Microarchitecture and immune composition in the two lesions were vastly different. CD4+ and CD8+ T cells accumulated around the margin of the overt SOX10+ Melan A+ ITM but were largely excluded from the tumor centre. By contrast, the occult micrometastasis contained only few SOX10+ Melan A- melanoma cells which were scattered within a dense infiltrate of T cells, including a prominent population of CD103+ CD8+ T cells resembling tissue-resident memory T (TRM) cells. Notably, almost every single melanoma cell in the micrometastasis was in close proximity to these TRM-like cells. Conclusion Such results support the emerging concept that CD103+ CD8+ TRM cells are key mediators of cancer surveillance and imply an important function of these cells in controlling clinically occult micrometastases in humans.
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Affiliation(s)
- Katharina Hochheiser
- Peter MacCallum Cancer Centre Melbourne VIC Australia.,Department of Microbiology & Immunology The University of Melbourne at the Peter Doherty Institute for Infection & Immunity Melbourne VIC Australia
| | - Han Xian Aw Yeang
- Peter MacCallum Cancer Centre Melbourne VIC Australia.,Sir Peter MacCallum Department of Oncology The University of Melbourne Parkville VIC Australia
| | - Teagan Wagner
- Department of Microbiology & Immunology The University of Melbourne at the Peter Doherty Institute for Infection & Immunity Melbourne VIC Australia.,Telethon Kids Institute University of Western Australia Perth WA Australia
| | - Candani Tutuka
- Olivia Newton-John Cancer Research Institute Heidelberg VIC Australia
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute Heidelberg VIC Australia
| | - Jason Waithman
- Telethon Kids Institute University of Western Australia Perth WA Australia
| | | | - Paul J Neeson
- Peter MacCallum Cancer Centre Melbourne VIC Australia.,Sir Peter MacCallum Department of Oncology The University of Melbourne Parkville VIC Australia
| | - Thomas Gebhardt
- Department of Microbiology & Immunology The University of Melbourne at the Peter Doherty Institute for Infection & Immunity Melbourne VIC Australia
| | - David E Gyorki
- Peter MacCallum Cancer Centre Melbourne VIC Australia.,Department of Surgery University of Melbourne Melbourne VIC Australia
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5
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Da Gama Duarte J, Parakh S, Andrews MC, Woods K, Pasam A, Tutuka C, Ostrouska S, Blackburn JM, Behren A, Cebon J. Autoantibodies May Predict Immune-Related Toxicity: Results from a Phase I Study of Intralesional Bacillus Calmette-Guérin followed by Ipilimumab in Patients with Advanced Metastatic Melanoma. Front Immunol 2018; 9:411. [PMID: 29552014 PMCID: PMC5840202 DOI: 10.3389/fimmu.2018.00411] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 02/14/2018] [Indexed: 11/13/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced melanoma. The first ICI to demonstrate clinical benefit, ipilimumab, targets cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4); however, the long-term overall survival is just 22%. More than 40 years ago intralesional (IL) bacillus Calmette-Guérin (BCG), a living attenuated strain of Mycobacterium bovis, was found to induce tumor regression by stimulating cell-mediated immunity following a localized and self-limiting infection. We evaluated these two immune stimulants in combination with melanoma with the aim of developing a more effective immunotherapy and to assess toxicity. In this phase I study, patients with histologically confirmed stage III/IV metastatic melanoma received IL BCG injection followed by up to four cycles of intravenous ipilimumab (anti-CTLA-4) (ClinicalTrials.gov number NCT01838200). The trial was discontinued following treatment of the first five patients as the two patients receiving the escalation dose of BCG developed high-grade immune-related adverse events (irAEs) typical of ipilimumab monotherapy. These irAEs were characterized in both patients by profound increases in the repertoire of autoantibodies directed against both self- and cancer antigens. Interestingly, the induced autoantibodies were detected at time points that preceded the development of symptomatic toxicity. There was no overlap in the antigen specificity between patients and no evidence of clinical responses. Efforts to increase response rates through the use of novel immunotherapeutic combinations may be associated with higher rates of irAEs, thus the imperative to identify biomarkers of toxicity remains strong. While the small patient numbers in this trial do not allow for any conclusive evidence of predictive biomarkers, the observed changes warrant further examination of autoantibody repertoires in larger patient cohorts at risk of developing irAEs during their course of treatment. In summary, dose escalation of IL BCG followed by ipilimumab therapy was not well tolerated in advanced melanoma patients and showed no evidence of clinical benefit. Measuring autoantibody responses may provide early means for identifying patients at risk from developing severe irAEs during cancer immunotherapy.
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Affiliation(s)
- Jessica Da Gama Duarte
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
| | - Sagun Parakh
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
| | - Miles C Andrews
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia.,MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Katherine Woods
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
| | - Anupama Pasam
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
| | - Candani Tutuka
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
| | - Simone Ostrouska
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia
| | - Jonathan M Blackburn
- Department of Integrative Biomedical Sciences and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.,Sengenics Corporation, Singapore, Singapore
| | - Andreas Behren
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
| | - Jonathan Cebon
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia.,School of Cancer Medicine, La Trobe University, Heidelberg, VIC, Australia.,Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Melbourne, VIC, Australia
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6
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Wen Q, Tutuka C, Keegan A, Jin B. Fate of pathogenic microorganisms and indicators in secondary activated sludge wastewater treatment plants. J Environ Manage 2009; 90:1442-7. [PMID: 18977580 DOI: 10.1016/j.jenvman.2008.09.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2008] [Revised: 08/07/2008] [Accepted: 09/18/2008] [Indexed: 05/10/2023]
Abstract
This study was undertaken to investigate the removal of pathogenic microorganisms and their indicators in a laboratory scale biological treatment system that simulated the secondary treatment process of a wastewater treatment plant (WWTP). Four groups of microorganisms including bacteria, viruses, protozoa and helminths as well as the selected indicators were employed in the investigation. The results demonstrated that approximately 2-3 log10 removal of the microbial indicators was achieved in the treatment process. The log removal of Clostridium perfringens spores was low due to their irreversible adsorption to sludge flocs. The laboratory treatment system demonstrated a similar removal capability for Escherichia coli and the bacterial indicators (total coliforms, enterococci and particles <2.73 microm/L). The MS-2 bacteriophage, measured as a viral indicator, showed a lower removal than poliovirus, which may be considered as a worst case scenario for virus removal. The results of using particle profiling as an indicator for protozoa and helminths appeared to be inaccurate. The removal performance for bacterial and protozoan pathogens and their indicators in a full scale WWTP and the laboratory treatment system was compared.
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Affiliation(s)
- Qinxue Wen
- School of Natural and Built Environments, University of South Australia, Adelaide, SA 5095, Australia.
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Abstract
As climate change and increasing population sizes continue to place stress on water resources, communities are increasingly looking to recycled water as a supplementary water source, whether for drinking water, domestic irrigation, industrial or agricultural use. Protecting public health by ensuring the safety of water supplies is a key concern for the water industry and health authorities.
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