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Regulatory B cell repertoire defects predispose lung cancer patients to immune-related toxicity following checkpoint blockade.


ABSTRACT: Checkpoint blockade with Pembrolizumab, has demonstrated durable clinical responses in advanced non-small cell lung cancer, however, treatment is offset by the development of high-grade immune related adverse events (irAEs) in some patients. Here, we show that in these patients a deficient Breg checkpoint fails to limit self-reactive T cell enhanced activity and auto-antibody formation enabled by PD-1/PD-L1 blockade, leading to severe auto-inflammatory sequelae. Principally a failure of IL-10 producing regulatory B cells as demonstrated through functional ex vivo assays and deep phenotyping mass cytometric analysis, is a major and significant finding in patients who develop high-grade irAEs when undergoing treatment with anti-PD1/PD-L1 checkpoint blockade. There is currently a lack of biomarkers to identify a priori those patients at greatest risk of developing severe auto-inflammatory syndrome. Pre-therapy B cell profiling could provide an important tool to identify lung cancer patients at high risk of developing severe irAEs on checkpoint blockade.

SUBMITTER: Patel AJ 

PROVIDER: S-EPMC9174492 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Regulatory B cell repertoire defects predispose lung cancer patients to immune-related toxicity following checkpoint blockade.

Patel Akshay J AJ   Willsmore Zena N ZN   Khan Naeem N   Richter Alex A   Naidu Babu B   Drayson Mark T MT   Papa Sophie S   Cope Andrew A   Karagiannis Sophia N SN   Perucha Esperanza E   Middleton Gary W GW  

Nature communications 20220607 1


Checkpoint blockade with Pembrolizumab, has demonstrated durable clinical responses in advanced non-small cell lung cancer, however, treatment is offset by the development of high-grade immune related adverse events (irAEs) in some patients. Here, we show that in these patients a deficient Breg checkpoint fails to limit self-reactive T cell enhanced activity and auto-antibody formation enabled by PD-1/PD-L1 blockade, leading to severe auto-inflammatory sequelae. Principally a failure of IL-10 pr  ...[more]

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