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      Combination of chemotherapy and PD-1 blockade induces T cell responses to tumor non-mutated neoantigens

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          Abstract

          Here, we developed an unbiased, functional target-discovery platform to identify immunogenic proteins from primary non-small cell lung cancer (NSCLC) cells that had been induced to apoptosis by cisplatin (CDDP) treatment in vitro, as compared with their live counterparts. Among the multitude of proteins identified, some of them were represented as fragmented proteins in apoptotic tumor cells, and acted as non-mutated neoantigens (NM-neoAgs). Indeed, only the fragmented proteins elicited effective multi-specific CD4 + and CD8 + T cell responses, upon a chemotherapy protocol including CDDP. Importantly, these responses further increased upon anti-PD-1 therapy, and correlated with patients’ survival and decreased PD-1 expression. Cross-presentation assays showed that NM-neoAgs were unveiled in apoptotic tumor cells as the result of caspase-dependent proteolytic activity of cellular proteins. Our study demonstrates that apoptotic tumor cells generate a repertoire of immunogenic NM-neoAgs that could be potentially used for developing effective T cell-based immunotherapy across multiple cancer patients.

          Abstract

          Grimaldi and Cammarata et al. develop a proteomics-based, target discovery platform to identify immunogenic proteins specific to apoptotic tumor cells. This study highlights the importance of protein modifications in apoptotic tumor cells as a mechanism of generating immunogenic neoantigens that can be targeted for T cell-based immunotherapy.

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          Most cited references41

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          Neoantigen vaccine generates intratumoral T cell responses in phase Ib glioblastoma trial

          Neoantigens, which are derived from tumour-specific protein-coding mutations, are exempt from central tolerance, can generate robust immune responses1,2 and can function as bona fide antigens that facilitate tumour rejection3. Here we demonstrate that a strategy that uses multi-epitope, personalized neoantigen vaccination, which has previously been tested in patients with high-risk melanoma4-6, is feasible for tumours such as glioblastoma, which typically have a relatively low mutation load1,7 and an immunologically 'cold' tumour microenvironment8. We used personalized neoantigen-targeting vaccines to immunize patients newly diagnosed with glioblastoma following surgical resection and conventional radiotherapy in a phase I/Ib study. Patients who did not receive dexamethasone-a highly potent corticosteroid that is frequently prescribed to treat cerebral oedema in patients with glioblastoma-generated circulating polyfunctional neoantigen-specific CD4+ and CD8+ T cell responses that were enriched in a memory phenotype and showed an increase in the number of tumour-infiltrating T cells. Using single-cell T cell receptor analysis, we provide evidence that neoantigen-specific T cells from the peripheral blood can migrate into an intracranial glioblastoma tumour. Neoantigen-targeting vaccines thus have the potential to favourably alter the immune milieu of glioblastoma.
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            Immunogenic Chemotherapy Sensitizes Tumors to Checkpoint Blockade Therapy.

            Checkpoint blockade immunotherapies can be extraordinarily effective, but might benefit only the minority of patients whose tumors are pre-infiltrated by T cells. Here, using lung adenocarcinoma mouse models, including genetic models, we show that autochthonous tumors that lacked T cell infiltration and resisted current treatment options could be successfully sensitized to host antitumor T cell immunity when appropriately selected immunogenic drugs (e.g., oxaliplatin combined with cyclophosphamide for treatment against tumors expressing oncogenic Kras and lacking Trp53) were used. The antitumor response was triggered by direct drug actions on tumor cells, relied on innate immune sensing through toll-like receptor 4 signaling, and ultimately depended on CD8(+) T cell antitumor immunity. Furthermore, instigating tumor infiltration by T cells sensitized tumors to checkpoint inhibition and controlled cancer durably. These findings indicate that the proportion of cancers responding to checkpoint therapy can be feasibly and substantially expanded by combining checkpoint blockade with immunogenic drugs.
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              Neoantigen-directed immune escape in lung cancer evolution

              The interplay between an evolving cancer and the dynamic immune-microenvironment remains unclear. Here, we analyze 258 regions from 88 early-stage untreated non-small cell lung cancers (NSCLCs) using RNAseq and pathology tumor infiltrating lymphocyte estimates. The immune-microenvironment was variable both between and within patients’ tumors. Diverse immune selection pressures were associated with different mechanisms of neoantigen presentation dysfunction restricted to distinct microenvironments. Sparsely infiltrated tumors exhibited evidence for historical immunoediting, with a waning of neoantigen-editing during tumor evolution, or copy number loss of historically clonal neoantigens. Immune-infiltrated tumor regions exhibited ongoing immunoediting, with either HLA LOH or depletion of expressed neoantigens. Promoter hypermethylation of genes harboring neoantigens was identified as an epigenetic mechanism of immunoediting. Our results suggest the immune-microenvironment exerts a strong selection pressure in early stage, untreated NSCLCs, producing multiple routes to immune evasion, which are clinically relevant, forecasting poor disease-free survival in multivariate analysis.
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                Author and article information

                Contributors
                vincenzo.barnaba@uniroma1.it
                Journal
                Commun Biol
                Commun Biol
                Communications Biology
                Nature Publishing Group UK (London )
                2399-3642
                25 February 2020
                25 February 2020
                2020
                : 3
                : 85
                Affiliations
                [1 ]GRID grid.7841.a, Dipartimento di Medicina Interna e Specialità Mediche, , Sapienza Università di Roma, ; 00161 Rome, Italy
                [2 ]GRID grid.7841.a, Dipartimento di Medicina Molecolare, , Sapienza Università di Roma, ; 00161 Rome, Italy
                [3 ]GRID grid.7841.a, Dipartimento di Scienze Radiologiche, Oncologiche e Anatomo Patologiche, Oncologia Medica, , Università di Roma, ; 00161 Rome, Italy
                [4 ]GRID grid.7841.a, Department of Radiological, Oncological and Pathological Sciences, , Sapienza University of Rome, ; Rome, Italy
                [5 ]ISNI 0000 0004 1760 3561, GRID grid.419543.e, IRCCS Neuromed, ; Pozzilli, Isernia Italy
                [6 ]GRID grid.7841.a, Dipartimento di Scienze e Biotecnologie Medico-Chirurgiche, , Sapienza Università di Roma - Polo Pontino, ; 04100 Latina, Italy
                [7 ]GRID grid.7841.a, UOC Oncologia Universitaria, ASL Latina (distretto Aprilia), , Sapienza Università di Roma, ; Via Giustiniano snc, 04011 Aprilia, Latina Italy
                [8 ]ISNI 0000 0004 1764 2907, GRID grid.25786.3e, Center for Life Nano Science@Sapienza, , Istituto Italiano di Tecnologia, ; 00161 Rome, Italy
                [9 ]ISNI 0000 0004 1760 5276, GRID grid.417520.5, Tumor Immunology and Immunotherapy Unit, , IRCCS-Regina Elena National Cancer Institute, ; Rome, Italy
                [10 ]ISNI 0000 0004 1760 5276, GRID grid.417520.5, Medical Oncology 1, , IRCCS-Regina Elena National Cancer Institute, ; Rome, Italy
                [11 ]ISNI 0000 0004 1760 5276, GRID grid.417520.5, Unit of Pathology, , IRCCS-Regina Elena National Cancer Institute, ; Rome, Italy
                [12 ]ISNI 0000 0004 1760 5276, GRID grid.417520.5, Thoracic Surgery Unit, , IRCCS-Regina Elena National Cancer Institute, ; Rome, Italy
                [13 ]ISNI 0000 0004 1764 2528, GRID grid.452606.3, Istituto Pasteur - Fondazione Cenci Bolognetti, ; 00185 Rome, Italy
                Author information
                http://orcid.org/0000-0002-7334-3966
                http://orcid.org/0000-0002-6517-9107
                http://orcid.org/0000-0003-4409-2261
                Article
                811
                10.1038/s42003-020-0811-x
                7042341
                32099064
                1a8c64b4-aac1-433a-ad2f-ceeabbd3f002
                © The Author(s) 2020

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 14 August 2019
                : 6 February 2020
                Funding
                Funded by: FundRef https://doi.org/10.13039/501100003196, Ministero della Salute (Ministry of Health, Italy);
                Award ID: RF-2010-2310438
                Award ID: RF-2010-2318269
                Award Recipient :
                Funded by: FundRef https://doi.org/10.13039/100007366, Fondazione Italiana Sclerosi Multipla (Italian Multiple Sclerosis Foundation);
                Award ID: 2015/R/04
                Award Recipient :
                Funded by: FundRef https://doi.org/10.13039/501100004588, Istituto Pasteur-Fondazione Cenci Bolognetti (Pasteur Institute-Cenci Bolognetti Foundation);
                Award ID: 2014-2016
                Award Recipient :
                Funded by: Fondo per gli investimenti di ricerca di base (FIRB) cod. RBAP10TPXK International Network Institut Pasteur, Paris - Programmes Transversaux de Recherche PTR n. 20-16 The accelerated award 2018 Id. 22794
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                © The Author(s) 2020

                immunoediting,immune cell death
                immunoediting, immune cell death

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