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         headline:T cell profiling reveals high CD4+CTLA-4+ T cell frequency as dominant predictor for survival after Prostate GVAX/ipilimumab treatment
         description:Immune checkpoint blockade enhances antitumor responses, but can also lead to severe immune-related adverse events (IRAE). To avoid unnecessary exposure to these potentially hazardous agents, it is important to identify biomarkers that correlate with clinical activity and can be used to select patients that will benefit from immune checkpoint blockade. To understand the consequences of CTLA-4 blockade and identify biomarkers for clinical efficacy and/or survival, an exploratory T cell monitoring study was performed in a phase I/II dose escalation/expansion trial (n = 28) of combined Prostate GVAX/ipilimumab immunotherapy. Phenotypic T cell monitoring in peripheral blood before and after Prostate GVAX/ipilimumab treatment revealed striking differences between patients who benefited from therapy and patients that did not. Treatment-induced rises in absolute lymphocyte counts, CD4+ T cell differentiation, and CD4+ and CD8+ T cell activation were all associated with clinical benefit. Moreover, significantly prolonged overall survival (OS) was observed for patients with high pre-treatment frequencies of CD4+CTLA-4+, CD4+PD-1+, or differentiated (i.e., non-naive) CD8+ T cells or low pre-treatment frequencies of differentiated CD4+ or regulatory T cells. Unsupervised clustering of these immune biomarkers revealed cancer-related expression of CTLA-4+ in CD4+ T cells to be a dominant predictor for survival after Prostate GVAX/ipilimumab therapy and to thus provide a putative and much-needed biomarker for patient selection prior to therapeutic CTLA4 blockade.
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            address:
               name:Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
               type:PostalAddress
            type:Organization
      name:Winald R. Gerritsen
      affiliation:
            name:VU University Medical Center
            address:
               name:Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
               type:PostalAddress
            type:Organization
      name:Tanja D. de Gruijl
      affiliation:
            name:VU University Medical Center
            address:
               name:Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
               type:PostalAddress
            type:Organization
      email:[email protected]
PostalAddress:
      name:Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
      name:Department of Pathology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
      name:Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
      name:Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
      name:Department of Pathology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
      name:Department of Pathology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
      name:Cell Genesys Inc., South San Francisco, USA
      name:Cell Genesys Inc., South San Francisco, USA
      name:Cell Genesys Inc., South San Francisco, USA
      name:Medarex, Bloomsbury, NJ/Bristol-Myers Squibb Company, Wallingford, USA
      name:Medarex, Bloomsbury, NJ/Bristol-Myers Squibb Company, Wallingford, USA
      name:Department of Pathology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
      name:Department of Pathology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
      name:Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
      name:Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
      name:Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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