单细胞追踪揭示黑色素瘤 TIL 治疗过程中肿瘤反应性 T 细胞的可塑性
Single-cell tracking reveals tumor-reactive T cell plasticity during melanoma TIL therapy.
TIL(肿瘤浸润淋巴细胞)过继细胞治疗可在转移性黑色素瘤中诱导持久缓解,然而在体外扩增过程中及回输后,调控肿瘤反应性T细胞命运的克隆和转录动态仍知之甚少。
英文原题:Immunologic determinants of infusion products and the tumor microenvironment govern response to TIL therapy in advanced melanoma.
这些发现定义了一个整合框架,将 TIL 组成和肿瘤微环境与治疗反应联系起来,并确定了可能指导患者选择和优化 TIL 治疗的潜在生物标志物和生物学特征。
背景:晚期黑色素瘤患者中,TIL(肿瘤浸润淋巴细胞)输注产品的免疫学特征及其与肿瘤微环境的相互作用如何决定临床应答,尚未得到充分阐明。方法:我们对早期临床试验中接受治疗的患者,整合分析了 TIL 输注产品及其匹配肿瘤微环境的免疫表型和空间转录组特征。结果:接受 TIL 治疗(无论是否联合其他疗法)患者的持久客观缓解率为36%,中位无进展生存期为8个月。应答者的输注产品中 CD8 阳性 T 细胞、干细胞样记忆亚群和表达 LAG-3 的 CD8 阳性 T 细胞富集,且外周 TIL 持续存在的程度更高。输注的 LAG-3 阳性 TIL 丰度与肿瘤反应性及更长的无进展生存期相关。既往接受免疫检查点抑制剂与 CD8 阳性干细胞记忆 T 细胞频率降低及共刺激受体表达减少相关,提示 TIL 适能受损。富含三级淋巴结构、且空间免疫程序呈现抗原呈递、干扰素信号和 B 细胞活化特征的肿瘤,与临床获益独立相关。结论:这些发现构建了一个将 TIL 组成及肿瘤微环境与治疗应答相联系的综合框架,并确定了可能指导患者选择及 TIL 治疗优化的潜在生物标志物和生物学特征。经费来源:本研究由 Iovance Biotherapeutics、Miriam 和 Sheldon G. Adelson 医学研究基金会、黑色素瘤研究联盟、Donald A. Adam 黑色素瘤与皮肤癌卓越中心、美国癌症协会 Leo 和 Anne Albert 慈善基金会研究学者资助项目以及黑色素瘤 SPORE(P50CA168536)资助。
BACKGROUND: The immunologic features of tumor-infiltrating lymphocyte (TIL) infusion products and their interactions with the tumor microenvironment that govern clinical responses in metastatic melanoma remain incompletely characterized. METHODS: We performed integrated immunophenotypic and spatial transcriptomic profiling of TIL infusion products and matched tumor microenvironments from patients treated on early-phase clinical trials. RESULTS: The durable objective response rate was 36%, with a median progression-free survival of 8 months among patients treated with TIL therapy with or without additional therapies. Responders exhibited infusion products enriched for CD8 + T cells, stem-like memory subsets, and LAG-3-expressing CD8 + T cells, together with enhanced peripheral TIL persistence. The abundance of infused LAG-3+ TILs correlated with tumor reactivity and prolonged progression-free survival. Prior immune checkpoint inhibitor exposure was associated with reduced CD8 + stem cell memory T cell frequency and diminished co-stimulatory receptor expression, suggesting impaired TIL fitness. Tumors enriched for tertiary lymphoid structures and spatial immune programs characterized by antigen presentation, interferon signaling, and B cell activation were independently associated with clinical benefit. CONCLUSIONS: These findings define an integrated framework linking TIL composition and the tumor microenvironment to therapeutic response and identify potential biomarkers and biological features that may guide patient selection and optimization of TIL therapy. FUNDING: This work was funded by Iovance Biotherapeutics, the Dr. Miriam and Sheldon G. Adelson Medical Research Foundation, the Melanoma Research Alliance, the Donald A. Adam Melanoma & Skin Cancer Center of Excellence, American Cancer Society-Leo and Anne Albert Charitable Foundation Research Scholar Grant, and Melanoma SPORE (P50CA168536).
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