Immunologic Predictors for Clinical Responses during Immune Checkpoint Blockade in Patients with Myelodysplastic Syndromes

Sung Eun Lee, Feng Wang, Maison Grefe, Abel Trujillo-Ocampo, Wilfredo Ruiz-Vasquez, Koichi Takahashi, Hussein A. Abbas, Pamella Borges, Dinler Amaral Antunes, Gheath Al-Atrash, Naval Daver, Jeffrey J. Molldrem, Andrew Futreal, Guillermo Garcia-Manero, Jin S. Im

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Purpose: The aim of this study is to determine immune-related biomarkers to predict effective antitumor immunity in myelodysplastic syndrome (MDS) during immunotherapy (IMT, αCTLA-4, and/or αPD-1 antibodies) and/or hypomethylating agent (HMA). Experimental Design: Peripheral blood samples from 55 patients with MDS were assessed for immune subsets, T-cell receptor (TCR) repertoire, mutations in 295 acute myeloid leukemia (AML)/MDS-related genes, and immune-related gene expression profiling before and after the first treatment. Results: Clinical responders treated with IMT ± HMA but not HMA alone showed a significant expansion of central memory (CM) CD8+ T cells, diverse TCRβ repertoire pretreatment with increased clonality and emergence of novel clones after the initial treatment, and a higher mutation burden pretreatment with subsequent reduction posttreatment. Autophagy, TGFβ, and Th1 differentiation pathways were the most downregulated in nonresponders after treatment, while upregulated in responders. Finally, CTLA-4 but not PD-1 blockade attributed to favorable changes in immune landscape. Conclusions: Analysis of tumor–immune landscape in MDS during immunotherapy provides clinical response biomarkers.

Original languageEnglish (US)
Pages (from-to)1938-1951
Number of pages14
JournalClinical Cancer Research
Volume29
Issue number10
DOIs
StatePublished - May 15 2023

ASJC Scopus subject areas

  • General Medicine

MD Anderson CCSG core facilities

  • Flow Cytometry and Cellular Imaging Facility

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