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Lim DWT, Kao HF, Suteja L, Li CH, Quah HS, Tan DSW, Tan SH, Tan EH, Tan WL, Lee JN, Wee FYT, Jain A, Goh BC, Chua MLK, Liao BC, Ng QS, Hong RL, Ang MK, Yeong JPS, Iyer NG. Clinical efficacy and biomarker analysis of dual PD-1/CTLA-4 blockade in recurrent/metastatic EBV-associated nasopharyngeal carcinoma. Nat Commun 2023; 14:2781. [PMID: 37188668 PMCID: PMC10184620 DOI: 10.1038/s41467-023-38407-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 05/02/2023] [Indexed: 05/17/2023] Open
Abstract
Single-agent checkpoint inhibitor (CPI) activity in Epstein-Barr Virus (EBV) related nasopharyngeal carcinoma (NPC) is limited. Dual CPI shows increased activity in solid cancers. In this single-arm phase II trial (NCT03097939), 40 patients with recurrent/metastatic EBV-positive NPC who failed prior chemotherapy receive nivolumab 3 mg/kg every 2 weeks and ipilimumab 1 mg/kg every 6 weeks. Primary outcome of best overall response rate (BOR) and secondary outcomes (progression-free survival [PFS], clinical benefit rate, adverse events, duration of response, time to progression, overall survival [OS]) are reported. The BOR is 38% with median PFS and OS of 5.3 and 19.5 months, respectively. This regimen is well-tolerated and treatment-related adverse events requiring discontinuation are low. Biomarker analysis shows no correlation of outcomes to PD-L1 expression or tumor mutation burden. While the BOR does not meet pre-planned estimates, patients with low plasma EBV-DNA titre (<7800 IU/ml) trend to better response and PFS. Deep immunophenotyping of pre- and on-treatment tumor biopsies demonstrate early activation of the adaptive immune response, with T-cell cytotoxicity seen in responders prior to any clinically evident response. Immune-subpopulation profiling also identifies specific PD-1 and CTLA-4 expressing CD8 subpopulations that predict for response to combined immune checkpoint blockade in NPC.
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Affiliation(s)
- Darren Wan-Teck Lim
- National Cancer Centre Singapore, Singapore, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
- Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore.
| | - Hsiang-Fong Kao
- National Taiwan University Hospital, Taipei, Taiwan
- National Taiwan University Cancer Center, Taipei, Taiwan
| | - Lisda Suteja
- National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Constance H Li
- National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Hong Sheng Quah
- National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Daniel Shao-Weng Tan
- National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Genome Institute of Singapore, A*STAR, Singapore, Singapore
| | - Sze-Huey Tan
- National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Eng-Huat Tan
- National Cancer Centre Singapore, Singapore, Singapore
| | - Wan-Ling Tan
- National Cancer Centre Singapore, Singapore, Singapore
| | - Justina Nadia Lee
- Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore
| | | | - Amit Jain
- National Cancer Centre Singapore, Singapore, Singapore
| | - Boon-Cher Goh
- National University Health System, Singapore, Singapore
| | - Melvin L K Chua
- National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Bin-Chi Liao
- National Taiwan University Hospital, Taipei, Taiwan
- National Taiwan University Cancer Center, Taipei, Taiwan
| | - Quan Sing Ng
- National Cancer Centre Singapore, Singapore, Singapore
| | - Ruey-Long Hong
- National Taiwan University Hospital, Taipei, Taiwan
- National Taiwan University Cancer Center, Taipei, Taiwan
| | - Mei-Kim Ang
- National Cancer Centre Singapore, Singapore, Singapore
| | - Joe Poh-Sheng Yeong
- Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore
- Singapore General Hospital, Singapore, Singapore
| | - N Gopalakrishna Iyer
- National Cancer Centre Singapore, Singapore, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
- Singapore General Hospital, Singapore, Singapore.
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Sin WX, Yeong JPS, Lim TJF, Su IH, Connolly JE, Chin KC. IRF-7 Mediates Type I IFN Responses in Endotoxin-Challenged Mice. Front Immunol 2020; 11:640. [PMID: 32373120 PMCID: PMC7176903 DOI: 10.3389/fimmu.2020.00640] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 09/11/2019] [Accepted: 03/20/2020] [Indexed: 01/23/2023] Open
Abstract
IRF-7 mediates robust production of type I IFN via MyD88 of the TLR9 pathway in plasmacytoid dendritic cells (pDCs). Previous in vitro studies using bone marrow-derived dendritic cells lacking either Irf7 or Irf3 have demonstrated that only IRF-3 is required for IFN-β production in the TLR4 pathway. Here, we show that IRF-7 is essential for both type I IFN induction and IL-1β responses via TLR4 in mice. Mice lacking Irf7 were defective in production of both IFN-β and IL-1β, an IFN-β-induced pro-inflammatory cytokine, after LPS challenge. IFN-β production in response to LPS was impaired in IRF-7-deficient macrophages, but not dendritic cells. Unlike pDCs, IRF-7 is activated by the TRIF-, but not MyD88-, dependent pathway via TBK-1 in macrophages after LPS stimulation. Like pDCs, resting macrophages constitutively expressed IRF-7 protein. This basal IRF-7 protein was completely abolished in either Ifnar1 -/- or Stat1 -/- macrophages, which corresponded with the loss of LPS-stimulated IFN-β induction in these macrophages. These findings demonstrate that macrophage IRF-7 is critical for LPS-induced type I IFN responses, which in turn facilitate IL-1β production in mice.
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Affiliation(s)
- Wei-Xiang Sin
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research, Singapore, Singapore
| | - Joe Poh-Sheng Yeong
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research, Singapore, Singapore.,Division of Pathology, Singapore General Hospital, Singapore, Singapore
| | - Thomas Jun Feng Lim
- School of Biological Sciences, College of Science, Nanyang Technological University, Singapore, Singapore
| | - I-Hsin Su
- School of Biological Sciences, College of Science, Nanyang Technological University, Singapore, Singapore
| | - John E Connolly
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research, Singapore, Singapore.,Institute of Biomedical Studies, Baylor University, Waco, TX, United States
| | - Keh-Chuang Chin
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Physiology, NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Lim TS, Chew V, Sieow JL, Goh S, Yeong JPS, Soon AL, Ricciardi-Castagnoli P. PD-1 expression on dendritic cells suppresses CD8 + T cell function and antitumor immunity. Oncoimmunology 2015; 5:e1085146. [PMID: 27141339 DOI: 10.1080/2162402x.2015.1085146] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [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: 04/14/2015] [Revised: 07/31/2015] [Accepted: 08/14/2015] [Indexed: 12/31/2022] Open
Abstract
Programmed death one (PD-1) is a well-established co-inhibitory regulator that suppresses proliferation and cytokine production of T cells. Despite remarkable progress in delineating the functional roles of PD-1 on T lymphocytes, little is known about the regulatory role of PD-1 expressed on myeloid cells such as dendritic cells (DCs). Here, we show that CD8+ T cells can be more potently activated to secrete IL-2 and IFNγ by PD-1-deficient DCs compared to wild-type DCs. Adoptive transfer of PD-1-deficient DCs demonstrated their superior capabilities in inducing antigen-specific CD8+ T cell proliferation in vivo. In addition, we provide first evidence demonstrating the existence of peripheral blood DCs and CD11c+ tumor-infiltrating myeloid cells that co-express PD-1 in patients with hepatocellular carcinoma (HCC). The existence of PD-1-expressing HCC-infiltrating DCs (HIDCs) was further supported in a mouse model of HCC. Intratumoral transfer of PD-1-deficient DCs rendered recipient mice resistant to the growth of HCC by promoting tumor-infiltrating CD8+ effector T cells to secrete perforin and granzyme B. This novel finding provides a deeper understanding of the role of PD-1 in immune regulation and has significant implications for cancer immunotherapies targeting PD-1.
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Affiliation(s)
- Tong Seng Lim
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 8A Biomedical Grove, IMMUNOS Building #4, BIOPOLIS, Singapore; A. Menarini Biomarkers Singapore Pte Ltd, 30 Pasir Panjang Road, #08-32, Mapletree Business City, Singapore
| | - Valerie Chew
- SingHealth Translational Immunology and Inflammation Center (STIIC), Duke-NUS Medical School, The Academia , 20 College Road, Discovery Tower Level 8 , Singapore
| | - Je Lin Sieow
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR) , 8A Biomedical Grove, IMMUNOS Building #4, BIOPOLIS , Singapore
| | - Siting Goh
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR) , 8A Biomedical Grove, IMMUNOS Building #4, BIOPOLIS , Singapore
| | - Joe Poh-Sheng Yeong
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR), 8A Biomedical Grove, IMMUNOS Building #4, BIOPOLIS, Singapore; Department of Pathology, Singapore General Hospital, 20 College Road, Academia, Diagnostics Tower, Singapore
| | - Ai Ling Soon
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (ASTAR) , 8A Biomedical Grove, IMMUNOS Building #4, BIOPOLIS , Singapore
| | - Paola Ricciardi-Castagnoli
- Genomics, Genetics and Biology Innovation Pole (PoloGGB), Piazza Gambuli, Edificio D, 3° Piano, Perugia, Italy; A. Menarini Biomarkers Singapore Pte Ltd, 30 Pasir Panjang Road, #08-32, Mapletree Business City, Singapore
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Abstract
Interferons (IFNs) were discovered more than half a century ago, and extensive research has since identified multifarious roles for type I IFN in human immune responses. Here, we review the functions of IFN-β in innate and adaptive immunity. We also discuss the activation and influence of IFN-β on myeloid cell types, including monocytes and dendritic cells, as well as address the effects of IFN-β on T cells and B cells. Findings from our own laboratory, which explores the molecular mechanisms of IFN-β activation by LPS and viruses, as well as from other groups investigating the regulation of IFN-β by viral proteins and endogenous factors are described. The effects of post-translational modifications of the interferon regulatory factor (IRF)-3 on IFN-β induction are also highlighted. Many unanswered questions remain concerning the regulation of the type I IFN response in inflammation, especially the role of transcription factors in the modulation of inflammatory gene expression, and these questions will form the basis for exciting avenues of future research.
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Affiliation(s)
- Wei-Xiang Sin
- Laboratory of Gene Regulation and Inflammation, Singapore Immunology Network, Agency for Science, Technology and Research (A*STAR), 8A Biomedical Grove, #04 Immunos, Biopolis, Singapore
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