title: Skin-test infiltrating lymphocytes early predict clinical outcome of dendritic cell-based vaccination in metastatic melanoma.
abstract: The identification of responding patients early during treatment would improve the capability to develop effective new immunotherapies more rapidly. Here, we describe a bioassay that may link early T-cell-mediated immune responses to later clinical benefits. This bioassay rests upon the tenet of immunotherapy that tumor-specific effector T cells capable of invading peripheral tissue can recognize tumor antigens and exert cytotoxic functions there. To show its utility, we conducted a retrospective study of a large cohort of metastatic melanoma patients (n = 91) enrolled in dendritic cell (DC)-based vaccination protocols to examine a hypothesized correlation of posttreatment skin-infiltrating lymphocytes (SKIL) with overall survival (OS). Stringent immunologic criteria were defined to identify long-term survivors. The presence of tumor-associated antigen (TAA)-specific CD8(+) T cell populations within SKILs (criterion I) was highly predictive for long-term survival. Further restriction by selecting for the presence of TAA-specific CD8(+) T cells specifically recognizing tumor peptide (criterion II) was also associated with improved OS. Recognition of naturally processed antigen (criterion III) maximized the accuracy of the test, with a median OS of 24.1 versus 9.9 months (P = 0.001). Our results show that detailed characterization of SKILs can permit an accurate selection of metastatic melanoma patients who benefit most from DC-based vaccination. This simple and robust bioassay integrates multiple aspects of cellular functions that mediate effective immune responses, thereby offering an effective tool to rapidly identify patients who are responding to immunotherapy at an early stage of treatment.
authors.affiliation: Department of Tumor Immunology, Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Erik H J G
authors.initials: EH
authors.lastname: Aarntzen
authors.forename: Kalijn
authors.initials: K
authors.lastname: Bol
authors.forename: Gerty
authors.initials: G
authors.lastname: Schreibelt
authors.forename: Joannes F M
authors.initials: JF
authors.lastname: Jacobs
authors.forename: W Joost
authors.initials: WJ
authors.lastname: Lesterhuis
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Van Rossum
authors.forename: Gosse J
authors.initials: GJ
authors.lastname: Adema
authors.forename: Carl G
authors.initials: CG
authors.lastname: Figdor
authors.forename: Cornelis J A
authors.initials: CJ
authors.lastname: Punt
authors.forename: I Jolanda M
authors.initials: IJ
authors.lastname: De Vries
mesh_terms: D019496:Cancer Vaccines / Q000276:immunology / Q000627:therapeutic use*; D015331:Cohort Studies; D003713:Dendritic Cells / Q000276:immunology*; D018984:Epitopes, T-Lymphocyte / Q000276:immunology; D006433:Hemocyanins / Q000276:immunology; D006801:Humans; D016219:Immunotherapy, Adoptive; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology*; D008545:Melanoma / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D014442:Monophenol Monooxygenase / Q000096:biosynthesis / Q000235:genetics / Q000276:immunology; D009362:Neoplasm Metastasis; D012333:RNA, Messenger / Q000096:biosynthesis / Q000235:genetics; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D012882:Skin Tests; D013601:T-Lymphocytes / Q000276:immunology*; D014162:Transfection; D058951:gp100 Melanoma Antigen / Q000096:biosynthesis / Q000235:genetics / Q000276:immunology
chemical_list: D019496:Cancer Vaccines; D018984:Epitopes, T-Lymphocyte; D012333:RNA, Messenger; D058951:gp100 Melanoma Antigen; D006433:Hemocyanins; D014442:Monophenol Monooxygenase; C032808:keyhole-limpet hemocyanin