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  • Valpione, Sara; Galvani, Elena; Tweedy, Joshua; Mundra, Piyushkumar A; Banyard, Antonia; Middlehurst, Philippa; Barry, Jeff; Mills, Sarah; Salih, Zena; Weightman, John; Gupta, Avinash; Gremel, Gabriela; Baenke, Franziska; Dhomen, Nathalie; Lorigan, Paul C; Marais, Richard

    Nature cancer, 02/2020, Volume: 1, Issue: 2
    Journal Article

    Our understanding of how checkpoint inhibitors (CPI) affect T cell evolution is incomplete, limiting our ability to achieve full clinical benefit from these drugs. Here we analyzed peripheral T cell populations after one cycle of CPI and identified a dynamic awakening of the immune system revealed by T cell evolution in response to treatment. We sequenced T cell receptors (TCR) in plasma cell-free DNA (cfDNA) and peripheral blood mononuclear cells (PBMC) and performed phenotypic analysis of peripheral T cell subsets from metastatic melanoma patients treated with CPI. We found that early peripheral T cell turnover and TCR repertoire dynamics identified which patients would respond to treatment. Additionally, the expansion of a subset of immune-effector peripheral T cells we call T cells correlated with response. These events are prognostic and occur within 3 weeks of starting immunotherapy, raising the potential for monitoring patients responses using minimally invasive liquid biopsies."