2017
Tumor and Microenvironment Evolution during Immunotherapy with Nivolumab
Abstract: SUMMARY The mechanisms by which immune checkpoint blockade modulates tumor evolution during therapy are unclear. We assessed genomic changes in tumors from 68 patients with advanced melanoma, who progressed on ipilimumab or were ipilimumab-naive, before and after nivolumab initiation (CA209-038 study). Tumors were analyzed by whole-exome, transcriptome, and/or T-cell receptor (TCR) sequencing. In responding patients, mutation and neoantigen load were reduced from baseline, and analysis of intratumoral heteroge…
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“…We next examined the association of TMB, purity, ploidy, and heterogeneity with response stratified by prior ipilimumab therapy (Extended Data Fig 6a). Unlike prior studies 44,45 , we found no specific association of higher TMB with response in the ipilimumab-naive vs. -treated subgroup (MWW p=0.15, both). However, higher heterogeneity and lower ploidy were associated with progressors only in the ipilimumab-naive subgroup (MWW p=0.06, 0.004, respectively).…”
Section: Resultscontrasting
confidence: 99%
“…We next examined the association of TMB, purity, ploidy, and heterogeneity with response stratified by prior ipilimumab therapy (Extended Data Fig 6a). Unlike prior studies 44,45 , we found no specific association of higher TMB with response in the ipilimumab-naive vs. -treated subgroup (MWW p=0.15, both). However, higher heterogeneity and lower ploidy were associated with progressors only in the ipilimumab-naive subgroup (MWW p=0.06, 0.004, respectively).…”
Section: Resultscontrasting
confidence: 99%
“…These trends are visualized in the patient-level melanogenesis gene expression profiles shown in Figure S14. Despite previous reports suggesting that active melanogenesis may contribute to immune evasion and therapy resistance through immunosuppressive microenvironments [ [40] , [41] , [42] ], our data does not show a consistent association between melanogenesis activation and clinical outcomes. For example, patient P4 exhibited higher melanogenesis activity and longer survival than P2, despite both receiving immunotherapy; however, this may also be influenced by BRAF V600E mutation status.…”
Section: Discussioncontrasting
confidence: 99%
“…Our finding that clonal spreading were enhanced after anti-PD-L1 and anti-CD4 treatments seems to contradict with many previous studies on the repertoire analysis of TILs reporting an association between oligoclonal expansion and objective antitumor effects following ICIs (Dovedi et al, 2017; Riaz et al, 2017; Yusko et al, 2019; Zhang et al, 2020). However, these studies did not separate CD4 + and CD8 + TILs prior to TCR sequencing.…”
Section: Discussioncontrasting
confidence: 99%
