Dexamethasone Differentially Depletes Tumour and Peripheral Blood Lymphocytes and Can Impact the Efficacy of Chemotherapy/checkpoint Blockade Combination Treatment

Overview

Journal Oncoimmunology

Specialty Allergy & Immunology

Date 2019 Oct 25

PMID 31646089

Citations 15

Authors

Wayne J Aston

Danika E Hope

Alistair M Cook

Louis Boon

Ian Dick

Anna K Nowak

Richard A Lake

W Joost Lesterhuis

Affiliations

Soon will be listed here.

Abstract

Dexamethasone is a synthetic glucocorticoid commonly used for the prevention and management of side effects in cancer patients undergoing chemotherapy. While it is effective as an anti-emetic and in preventing hypersensitivity reactions, dexamethasone depletes peripheral blood lymphocytes and impacts immune responses. The effect of dexamethasone on the number and quality of tumour-infiltrating leukocytes has not been reported. To address this, we calibrated the dose in two different strains of mice to achieve the same extent of peripheral blood lymphocyte depletion observed in patients with cancer. Doses that caused analogous depletion of T and B lymphocytes and NK cells from the peripheral blood, elicited no change in these populations within the tumour. The expression of immune checkpoint molecules PD-1, OX40, GITR and TIM3 on tumour-infiltrating lymphocytes was not altered. We found that dexamethasone had a small but significant deleterious impact on weakly efficacious chemoimmunotherapy but had no effect when the protocol was highly efficacious. Based on these results, we predict that dexamethasone will have a modest negative influence on the overall effectiveness of chemoimmunotherapy treatment.

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