Biologic and immunomodulatory events after CTLA-4 blockade with ticilimumab in patients with advanced malignant melanoma

James M. Reuben, Bang Ning Lee, Changping Li, Jesus Gomez-Navarro, Viviana A. Bozon, Charla A. Parker, Ingrid M. Hernandez, Carolina Gutierrez, Gabriel Lopez-Berestein, Luis H. Camacho

Research output: Contribution to journalArticle

112 Scopus citations

Abstract

BACKGROUND. T-regulatory (TR) cells expressing cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) maintain peripheral immune tolerance and negatively affect host immune responses against cancer. The immunobiologic effects of ticilimumab, a human monoclonal antibody against CTLA-4, was administered to patients with metastatic melanoma who participated in a Phase I/II clinical trial. METHODS. Thirty patients who received ticilimumab at a dose of 10 mg/kg monthly (n = 20) or 15 mg/kg every 3 months (n = 10) were studied at study entry and at 14-day intervals thereafter to assess lymphocyte immunophenotypes, interleukin (IL)-2 and IL-10 production, and the expression of TR-related genes in peripheral blood mononuclear cells (PBMC) from a subset of patients was studied by real-time polymerase chain reaction. RESULTS. Four of 12 patients with immune-related adverse events (IRAE) attained objective antitumor responses (ATR), whereas only 1 of 18 patients without IRAE attained ATR (χ2 = 4.0; P = .0455). Patients with ATR had significant reductions in TR cells and constitutive IL-10 production accompanied by a significant increase in IL-2 production by activated T cells. Although IRAE+/ATR+ patients demonstrated a positive correlation between CTLA-4 and glucocorticoid-induced tumor necrosis factor receptor (GITR) transcripts (Spearman rho = .522; P = .015), IRAE -/ATR- patients had a positive correlation between the transcripts of CTLA-4 and program death-1 (PD-1) receptor (Spearman rho = .891; P = .000). CONCLUSIONS. Antitumor responses in patients with metastatic melanoma who were treated with ticilimumab were found to be correlated with reductions in TR cells and constitutive secretion of IL-10, an increase in IL-2 production, and a positive correlation between transcripts of CTLA-4 and GITR. Conversely, a lack of ATR was found to be correlated with steady levels of TR cells and constitutive IL-10 secretion, and a positive correlation between the transcripts of CTLA-4 and PD-1.

Original languageEnglish (US)
Pages (from-to)2437-2444
Number of pages8
JournalCancer
Volume106
Issue number11
DOIs
StatePublished - Jun 1 2006

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Keywords

  • CTLA-4
  • Immune tolerance
  • Melanoma
  • Regulatory T cells

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Reuben, J. M., Lee, B. N., Li, C., Gomez-Navarro, J., Bozon, V. A., Parker, C. A., Hernandez, I. M., Gutierrez, C., Lopez-Berestein, G., & Camacho, L. H. (2006). Biologic and immunomodulatory events after CTLA-4 blockade with ticilimumab in patients with advanced malignant melanoma. Cancer, 106(11), 2437-2444. https://doi.org/10.1002/cncr.21854