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  • Major Histocompatibility Co...
    Roemer, Margaretha G M; Redd, Robert A; Cader, Fathima Zumla; Pak, Christine J; Abdelrahman, Sara; Ouyang, Jing; Sasse, Stephanie; Younes, Anas; Fanale, Michelle; Santoro, Armando; Zinzani, Pier Luigi; Timmerman, John; Collins, Graham P; Ramchandren, Radhakrishnan; Cohen, Jonathon B; De Boer, Jan Paul; Kuruvilla, John; Savage, Kerry J; Trneny, Marek; Ansell, Stephen; Kato, Kazunobu; Farsaci, Benedetto; Sumbul, Anne; Armand, Philippe; Neuberg, Donna S; Pinkus, Geraldine S; Ligon, Azra H; Rodig, Scott J; Shipp, Margaret A

    Journal of clinical oncology, 04/2018, Letnik: 36, Številka: 10
    Journal Article

    Purpose Hodgkin Reed-Sternberg (HRS) cells evade antitumor immunity by multiple means, including gains of 9p24.1/ CD274(PD-L1)/ PDCD1LG2(PD-L2) and perturbed antigen presentation. Programmed death 1 (PD-1) receptor blockade is active in classic Hodgkin lymphoma (cHL) despite reported deficiencies of major histocompatibility complex (MHC) class I expression on HRS cells. Herein, we assess bases of sensitivity to PD-1 blockade in patients with relapsed/refractory cHL who were treated with nivolumab (anti-PD-1) in the CheckMate 205 trial. Methods HRS cells from archival tumor biopsies were evaluated for 9p24.1 alterations by fluorescence in situ hybridization and for expression of PD ligand 1 (PD-L1) and the antigen presentation pathway components-β2-microglobulin, MHC class I, and MHC class II-by immunohistochemistry. These parameters were correlated with clinical responses and progression-free survival (PFS) after PD-1 blockade. Results Patients with higher-level 9p24.1 copy gain and increased PD-L1 expression on HRS cells had superior PFS. HRS cell expression of β2-microglobulin/MHC class I was not predictive for complete remission or PFS after nivolumab therapy. In contrast, HRS cell expression of MHC class II was predictive for complete remission. In patients with a > 12-month interval between myeloablative autologous stem-cell transplantation and nivolumab therapy, HRS cell expression of MHC class II was associated with prolonged PFS. Conclusion Genetically driven PD-L1 expression and MHC class II positivity on HRS cells are potential predictors of favorable outcome after PD-1 blockade. In cHL, clinical responses to nivolumab were not dependent on HRS cell expression of MHC class I.