帕博利珠单抗联合二甲双胍治疗转移性头颈部癌的 II 期可行性研究
A Phase II Feasibility Study Combining Pembrolizumab and Metformin in Patients with Metastatic Head and Neck Cancer.
二甲双胍联合帕博利珠单抗耐受性良好,仅出现轻度胃肠道不良事件,并展现出有前景的活性,值得在随机试验中进一步研究。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Distinct CD8(+) T cell dynamics associate with response to neoadjuvant cancer immunotherapies.
Distinct CD8(+) T cell dynamics associate with response to neoadjuvant cancer immunotherapies.
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我们利用一项临床试验(NCT04080804),该试验在头颈部鳞状细胞癌患者中比较了新辅助抗PD-1、抗PD-1+CTLA-4和抗PD-1+LAG-3治疗。联合治疗相比单药治疗可促进更高的病理缓解率,并且主要病理缓解与更好的生存相关。为了探讨成功的免疫检查点抑制剂(ICI)方案是否通过相似或不同的通路发挥作用,我们以克隆方式稳健且纵向地表征了CD8+TIL(肿瘤浸润淋巴细胞)的转录组和蛋白质组动态。抗PD-1+LAG-3将具有I型干扰素应答和耗竭基因程序的CD8+TIL重编程为效应记忆和驻留记忆(T EM/T RM)。相比之下,抗PD-1+CTLA-4激活并扩增预先存在的T EM/T RM CD8+TIL,但不会使耗竭表型 rejuvenate 为T效应细胞。抗PD-1+LAG-3,而非抗PD-1+CTLA-4,在不同转录状态之间诱导广泛的TCR共享,并在应答患者中增加TCR多样性。
我们的数据表明,肿瘤反应性CD8+T细胞具有双药方案特异性的转录和克隆动态。
We leverage a clinical trial (NCT04080804) that compared neoadjuvant anti-PD-1, anti-PD-1+CTLA-4, and anti-PD-1+LAG-3 therapies in head and neck squamous cell carcinoma patients. Combination therapies promote higher pathologic response rates versus monotherapy, and major pathologic response is associated with better survival. To address whether successful immune checkpoint inhibitor (ICI) regimens act through similar or distinct pathways, we robustly and longitudinally characterize transcriptional and proteomic dynamics of CD8 + tumor-infiltrating lymphocytes (TILs) in a clonal manner.
Anti-PD-1+LAG-3 reprograms CD8 + TIL with type-I interferon response and exhaustion gene programs into effector memory and resident memory (T EM /T RM ). In contrast, anti-PD-1+CTLA-4 activates and expands pre-existing T EM /T RM CD8 + TIL, but does not rejuvenate exhausted phenotypes into T effector cells. Anti-PD-1+LAG-3, but not anti-PD-1+CTLA-4, induces widespread TCR sharing among the different transcriptional states, as well as increased TCR diversity in responding patients.
Our data suggest doublet regimen-specific transcriptional and clonal dynamics of tumor-reactive CD8 + T cells.
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