{"id":4423,"date":"2017-05-24T11:05:24","date_gmt":"2017-05-24T15:05:24","guid":{"rendered":"http:\/\/blogs.shu.edu\/cancer\/?p=4423"},"modified":"2021-07-02T08:51:41","modified_gmt":"2021-07-02T12:51:41","slug":"peripheral-white-blood-cell-profiles-may-predict-response-to-checkpoint-blockade","status":"publish","type":"post","link":"https:\/\/blogs.shu.edu\/cancer\/2017\/05\/24\/peripheral-white-blood-cell-profiles-may-predict-response-to-checkpoint-blockade\/","title":{"rendered":"Peripheral white blood cell profiles may predict response to checkpoint blockade"},"content":{"rendered":"

While some patients enjoy excellent and durable responses<\/a> to treatment with checkpoint inhibits, most do not, and some even hyper-progress<\/a>. Selecting patients who will benefit most has been challenging.<\/p>\n

Researchers from Italy reported on a series of 54 patients with non-small cell lung cancer<\/a> (52% squamous and 48% adenocarcinoma) who received nivolumab (Opdivo), most of whom (89%) had Stage IV disease. Twenty patients had a complete or partial response or stable disease and 34 progressed. Assessments were made at baseline (T0) and after two (T1) and four (T2) treatment cycles.<\/p>\n

The following peripheral blood<\/em><\/strong> immune profiles were examined:<\/p>\n

    \n
  1. CD3 – expressed on all T-cells<\/li>\n
  2. CD4 – T helper cells<\/li>\n
  3. CD8 \u2013 cytotoxic T-cells<\/li>\n
  4. CD56 \u2013 NK cells<\/li>\n
  5. FOXP3 \u2013 Treg cells<\/li>\n
  6. MDSC \u2013 myeloid-derived suppressor cells<\/a>, which suppress T cell responses<\/li>\n<\/ol>\n

    The characteristics of those who had good responses versus<\/em> those who did not included:<\/p>\n

      \n
    1. ECOG performance status of 0 – 76.9% vs 23.1% (P<\/em>< .001)<\/li>\n
    2. At least four months since prior chemotherapy – 61.9% vs 38.1% (P<\/em>< .004)<\/li>\n
    3. Higher baseline CD3+ count (P<\/em>= .046) and higher NK cell count (P<\/em>\u00a0< .001)<\/li>\n
    4. Lower neutrophil count (P<\/em>= .002)<\/li>\n
    5. Lower neutrophil-to-lymphocyte ratio (P<\/em>< .001)<\/li>\n<\/ol>\n

      An analysis of 31 patients who underwent all three assessments revealed that \u00a0significant increases in NK cells and a significant decrease in the proportion of CD4 cells from T0 to T2 were associated with treatment response. Responders also had a greater number and concentration of CD8+ expressing PD-1.<\/p>\n

      This study was exploratory in nature and a larger, prospective, randomized study with multivariate analyses needs to be conducted to better determine the value of these (and other) potentially predictive markers.<\/p>\n

      The ability to predict response to checkpoint blockade from baseline and on-treatment peripheral blood analyses is very appealing and could benefit many patients, and improve therapeutic selection and efficiency.<\/p>\n","protected":false},"excerpt":{"rendered":"

      While some patients enjoy excellent and durable responses to treatment with checkpoint inhibits, most do not, and some even hyper-progress. Selecting patients who will benefit most has been challenging.<\/p>\n","protected":false},"author":2252,"featured_media":3979,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[1],"tags":[183,1076,240,508,1047,457,664,89],"class_list":["post-4423","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-cd3","tag-cd4","tag-cd8","tag-checkpoint","tag-foxp3","tag-mdsc","tag-myeloid-derived-suppressor-cells","tag-nivolumab"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/posts\/4423","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/users\/2252"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/comments?post=4423"}],"version-history":[{"count":2,"href":"https:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/posts\/4423\/revisions"}],"predecessor-version":[{"id":4425,"href":"https:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/posts\/4423\/revisions\/4425"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/media\/3979"}],"wp:attachment":[{"href":"https:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/media?parent=4423"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/categories?post=4423"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.shu.edu\/cancer\/wp-json\/wp\/v2\/tags?post=4423"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}