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TLR 激动剂与树突状细胞疫苗联合在恶性胶质瘤中极化干扰素反应:一项随机 II 期试验

英文原题:TLR agonists polarize interferon responses in conjunction with dendritic cell vaccination in malignant glioma: a randomized phase II Trial.

PubMed 2024/05/08(内容时间) Nat Commun Q1 · IF 18.1(JCR 2025)

研究概要

这些发现表明,将 ATL-DC 与 poly-ICLC 联合使用可在循环单核细胞和 CD8+ T 细胞中诱导极化的干扰素反应,这可能代表该患者群体免疫治疗的一个重要血液生物标志物。试验注册:ClinicalTrials.gov 标识符:NCT01204684。

中文摘要

在这项随机II期临床试验中,我们评估了在新诊断或复发的WHO III-IV级恶性胶质瘤患者中,将TLR激动剂poly-ICLC或resiquimod加入自体肿瘤裂解物脉冲树突状细胞(ATL-DC)疫苗的有效性。主要终点是评估疫苗和佐剂的最有效组合,以增强免疫效力,同时评估安全性。ATL-DC疫苗与TLR激动剂的联合应用是安全的,并发现可增强全身免疫反应,表现为干扰素基因表达增加和免疫细胞活化变化。具体而言,PD-1在CD4+ T细胞上的表达增加,而CD38和CD39在CD8+ T细胞上的表达减少,同时单核细胞增加。Poly-ICLC治疗增强了单核细胞和T淋巴细胞中干扰素诱导基因的诱导。表现出较高干扰素反应基因表达的患者显示出更长的生存期和延迟的疾病进展。这些发现表明,将ATL-DC与poly-ICLC联合使用可在循环单核细胞和CD8+ T细胞中诱导极化干扰素反应,这可能代表该患者群体免疫治疗的重要血液生物标志物。试验注册:ClinicalTrials.gov标识符:NCT01204684。

展开英文摘要原文

In this randomized phase II clinical trial, we evaluated the effectiveness of adding the TLR agonists, poly-ICLC or resiquimod, to autologous tumor lysate-pulsed dendritic cell (ATL-DC) vaccination in patients with newly-diagnosed or recurrent WHO Grade III-IV malignant gliomas. The primary endpoints were to assess the most effective combination of vaccine and adjuvant in order to enhance the immune potency, along with safety. The combination of ATL-DC vaccination and TLR agonist was safe and found to enhance systemic immune responses, as indicated by increased interferon gene expression and changes in immune cell activation. Specifically, PD-1 expression increases on CD4+ T-cells, while CD38 and CD39 expression are reduced on CD8+ T cells, alongside an increase in monocytes. Poly-ICLC treatment amplifies the induction of interferon-induced genes in monocytes and T lymphocytes. Patients that exhibit higher interferon response gene expression demonstrate prolonged survival and delayed disease progression. These findings suggest that combining ATL-DC with poly-ICLC can induce a polarized interferon response in circulating monocytes and CD8+ T cells, which may represent an important blood biomarker for immunotherapy in this patient population.Trial Registration: ClinicalTrials.gov Identifier: NCT01204684.

论文信息

作者
Everson RG、Hugo W、Sun L、Antonios J、Lee A、Ding L、Bu M、Khattab S
第一作者单位
Department of Neurosurgery, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA, 90095, USA.United States
通讯作者单位
Department of Neurosurgery, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA, 90095, USA. RPrins@mednet.ucla.edu.United States
文献类型
II 期临床试验 · 随机对照试验 · 非美国政府资助研究 · 美国 NIH 资助研究
期刊
Nature communications2024 May 8
原文标识
PubMed 38719809 · DOI 10.1038/s41467-024-48073-y