Prognostic impact of circulating Her-2-reactive T-cells producing pro- and/or anti-inflammatory cytokines in elderly breast cancer patients

Journal for ImmunoTherapy of Cancer

Graham Pawelec³  Brigitte Gueckel⁴  Evelyna Derhovanessian²  Jithendra Kini Bailur¹ 

[1] Present Address: Yale Cancer Center, Yale University School of Medicine, New Haven, CT, USA;Present Address: BioNTech AG, Mainz, Germany;School of Science and Technology, College of Arts and Science, Nottingham Trent University, Nottingham, UK;Radiology Clinic, Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany

关键词: Immunosenescence;    Cytokines;    Tumour-associated antigens;    Elderly;    Her-2;    Breast cancer;    T-cells;   

Others  :  1229108
DOI  :  10.1186/s40425-015-0090-0

 received in 2015-06-07, accepted in 2015-08-28,  发布年份 2015

【 摘 要 】

Background

Treating elderly breast cancer patients remains a challenge but the increasing availability of immunotherapeutic approaches instills optimism that these tumours may also be susceptible to immune control. Because aging leads to a number of alterations in the immune system (“immunosenescence”) reflecting potential exhaustion which could compromise immunomodulatory antibody therapy, here we have assessed the immunocompetence of elderly breast cancer patients compared with a group of younger patients, and related this to the 5-year survival of the former.

Methods

T-cell responses to Her-2 peptide pools in vitro were assessed by analyzing pro- and anti-inflammatory cytokine production by CD4+ and CD8+ T-cells in 40 elderly and 35 younger breast cancer patients.

Results

The proportions of older and younger patients whose peripheral T-cells responded to Her-2 peptides in vitro were found to be similar, although a significantly higher fraction of younger patients possessed IL-2-producing CD4+ Her-2-reactive T-cells than in the elderly (p = 0.03). However, IL-2 production did not impart a survival benefit to the latter. In contrast, there was a survival benefit of possessing Her-2-reactive CD8+ T-cells, but this was abrogated in patients if they also had CD4+ Her-2-responsive T-cells that producedIL-5 and/or IL-17 (p = 0.01). This resulted in a 5-yr survival rate of only 29 % compared to 76 % for patients whose her-2-reactive CD4+ T-cells did not produceIL-5 and/or IL-17. Additionally, patients whose CD8+ T-cells produced TNF had a significantly better survival than those that did not (93 % compared to 52 %, p = 0.01), whereas no survival benefit was attributable to possessing IFN-γ-producing cells.

Conclusions

Elderly breast cancer patients appear perfectly immunocompetent to respond to Her-2 peptide pools in vitro, with response patterns very similar to younger patients. The nature of this response is associated with 5-year survival of these elderly patients, suggesting that boosting anti-tumor responses and modulating the nature of the T-cell response is likely to be effective even in potentially immunosenescent elderly breast cancer patients, and might be useful for predicting which patients are most likely to benefit from such treatments.

【 授权许可】

   
2015 Bailur et al.

【 图 表 】

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