Abstract |
BACKGROUNDCurrent clinical biomarkers for the programmed cell death 1 (PD-1) blockade therapy are insufficient because they rely only on the tumor properties, such as programmed cell death ligand 1 expression frequency and tumor mutation burden. Identifying reliable, responsive biomarkers based on the host immunity is necessary to improve the predictive values.METHODSWe investigated levels of plasma metabolites and T cell properties, including energy metabolism markers, in the blood of patients with non-small cell lung cancer before and after treatment with nivolumab (n = 55). Predictive values of combination markers statistically selected were evaluated by cross-validation and linear discriminant analysis on discovery and validation cohorts, respectively. Correlation between plasma metabolites and T cell markers was investigated.RESULTSThe 4 metabolites derived from the microbiome ( hippuric acid), fatty acid oxidation ( butyrylcarnitine), and redox ( cystine and glutathione disulfide) provided high response probability (AUC = 0.91). Similarly, a combination of 4 T cell markers, those related to mitochondrial activation (PPARĪ³ coactivator 1 expression and ROS), and the frequencies of CD8+PD-1hi and CD4+ T cells demonstrated even higher prediction value (AUC = 0.96). Among the pool of selected markers, the 4 T cell markers were exclusively selected as the highest predictive combination, probably because of their linkage to the abovementioned metabolite markers. In a prospective validation set (n = 24), these 4 cellular markers showed a high accuracy rate for clinical responses of patients (AUC = 0.92).CONCLUSIONCombination of biomarkers reflecting host immune activity is quite valuable for responder prediction.FUNDINGAMED under grant numbers 18cm0106302h0003, 18gm0710012h0105, and 18lk1403006h0002; the Tang Prize Foundation; and JSPS KAKENHI grant numbers JP16H06149, 17K19593, and 19K17673.
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Authors | Ryusuke Hatae, Kenji Chamoto, Young Hak Kim, Kazuhiro Sonomura, Kei Taneishi, Shuji Kawaguchi, Hironori Yoshida, Hiroaki Ozasa, Yuichi Sakamori, Maryam Akrami, Sidonia Fagarasan, Izuru Masuda, Yasushi Okuno, Fumihiko Matsuda, Toyohiro Hirai, Tasuku Honjo |
Journal | JCI insight
(JCI Insight)
Vol. 5
Issue 2
(01 30 2020)
ISSN: 2379-3708 [Electronic] United States |
PMID | 31855576
(Publication Type: Journal Article)
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Chemical References |
- Antineoplastic Agents, Immunological
- Biomarkers, Tumor
- Hippurates
- PDCD1 protein, human
- Programmed Cell Death 1 Receptor
- butyrylcarnitine
- Nivolumab
- Carnitine
- hippuric acid
- Glutathione Disulfide
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents, Immunological
(pharmacology, therapeutic use)
- Biomarkers, Tumor
(immunology)
- Carcinoma, Non-Small-Cell Lung
- Carnitine
(analogs & derivatives)
- Drug Therapy, Combination
- Energy Metabolism
- Female
- Glutathione Disulfide
- Hippurates
- Humans
- Immunotherapy
(methods)
- Lung Neoplasms
- Male
- Microbiota
- Middle Aged
- Nivolumab
(pharmacology, therapeutic use)
- Programmed Cell Death 1 Receptor
(drug effects, immunology, metabolism)
- Prospective Studies
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