Regulatory B Cell Repertoire Defects Predispose Lung Cancer Patients to Immune-related Toxicity Following Checkpoint Blockade

Overview

Journal Nat Commun

Specialty Biology

Date 2022 Jun 7

PMID 35672305

Authors

Akshay J Patel

Zena N Willsmore

Naeem Khan

Alex Richter

Babu Naidu

Mark T Drayson

Sophie Papa

Andrew Cope

Sophia N Karagiannis

Esperanza Perucha

Gary W Middleton

Affiliations

Soon will be listed here.

Abstract

Checkpoint blockade with Pembrolizumab, has demonstrated durable clinical responses in advanced non-small cell lung cancer, however, treatment is offset by the development of high-grade immune related adverse events (irAEs) in some patients. Here, we show that in these patients a deficient Breg checkpoint fails to limit self-reactive T cell enhanced activity and auto-antibody formation enabled by PD-1/PD-L1 blockade, leading to severe auto-inflammatory sequelae. Principally a failure of IL-10 producing regulatory B cells as demonstrated through functional ex vivo assays and deep phenotyping mass cytometric analysis, is a major and significant finding in patients who develop high-grade irAEs when undergoing treatment with anti-PD1/PD-L1 checkpoint blockade. There is currently a lack of biomarkers to identify a priori those patients at greatest risk of developing severe auto-inflammatory syndrome. Pre-therapy B cell profiling could provide an important tool to identify lung cancer patients at high risk of developing severe irAEs on checkpoint blockade.

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