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  • Quantitative Spatial Profil...
    Johnson, Douglas B; Bordeaux, Jennifer; Kim, Ju Young; Vaupel, Christine; Rimm, David L; Ho, Thai H; Joseph, Richard W; Daud, Adil I; Conry, Robert M; Gaughan, Elizabeth M; Hernandez-Aya, Leonel F; Dimou, Anastasios; Funchain, Pauline; Smithy, James; Witte, John S; McKee, Svetlana B; Ko, Jennifer; Wrangle, John M; Dabbas, Bashar; Tangri, Shabnam; Lameh, Jelveh; Hall, Jeffrey; Markowitz, Joseph; Balko, Justin M; Dakappagari, Naveen

    Clinical cancer research, 11/2018, Letnik: 24, Številka: 21
    Journal Article

    PD-1/L1 axis-directed therapies produce clinical responses in a subset of patients; therefore, biomarkers of response are needed. We hypothesized that quantifying key immunosuppression mechanisms within the tumor microenvironment by multiparameter algorithms would identify strong predictors of anti-PD-1 response. Pretreatment tumor biopsies from 166 patients treated with anti-PD-1 across 10 academic cancer centers were fluorescently stained with multiple markers in discovery ( = 24) and validation ( = 142) cohorts. Biomarker-positive cells and their colocalization were spatially profiled in pathologist-selected tumor regions using novel Automated Quantitative Analysis algorithms. Selected biomarker signatures, PD-1/PD-L1 interaction score, and IDO-1/HLA-DR coexpression were evaluated for anti-PD-1 treatment outcomes. In the discovery cohort, PD-1/PD-L1 interaction score and/or IDO-1/HLA-DR coexpression was strongly associated with anti-PD-1 response ( = 0.0005). In contrast, individual biomarkers (PD-1, PD-L1, IDO-1, HLA-DR) were not associated with response or survival. This finding was replicated in an independent validation cohort: patients with high PD-1/PD-L1 and/or IDO-1/HLA-DR were more likely to respond ( = 0.0096). These patients also experienced significantly improved progression-free survival (HR = 0.36; = 0.0004) and overall survival (HR = 0.39; = 0.0011). In the combined cohort, 80% of patients exhibiting higher levels of PD-1/PD-L1 interaction scores and IDO-1/HLA-DR responded to PD-1 blockers ( = 0.000004). In contrast, PD-L1 expression was not predictive of survival. Quantitative spatial profiling of key tumor-immune suppression pathways by novel digital pathology algorithms could help more reliably select melanoma patients for PD-1 monotherapy. .