Abstract

BackgroundPD-1 inhibitors are approved for multiple malignancies and function by stimulating T cells. However, the role of B cells in the anti-tumor activity of these drugs is unknown, as is their activity in patients who have received B cell depleting drugs or with immunoglobulin deficiencies.MethodsWe studied B cell content in 40 melanomas from patients treated with pembrolizumab or nivolumab and assessed the association with response to therapy. Murine MC38 colon cancer and YUMMER1.7 melanoma models were used to determine whether concomitant anti-CD20 antibody injections diminish the anti-tumor effects of anti-PD-1. Results were validated in muMT mice, which lack B cells.ResultsB cells were sparse in most melanomas and B cell content was not associated with response to anti-PD-1 or overall survival. Employing MC38 and YUMMER1.7 models, we demonstrated that anti-CD20 antibodies reduce tumor-infiltrating B cells yet had no effect on tumor growth, response to PD-1 inhibition, or survival. In muMT mice, T-cell dependent tumor rejection and anti-PD-1 responses were no different than in wildtype C57BL/6 J mice.ConclusionsThe degree of tumor infiltrating B cell content is not associated with response to anti-PD-1 inhibitors in melanoma. PD-1 inhibitors cause tumor shrinkage in murine cancer models even when B cells are absent or are depleted. PD-1 inhibitors are likely to be active in patients with impaired B cell function, such as patients undergoing B cell depletion with drugs including rituximab for conditions such as B cell malignancies or autoimmune disorders.

Highlights

  • Immune checkpoint inhibitors (CPIs) that block PD-1/ PD-L1 or CTLA-4 have transformed the treatment of many cancers and their use continues to expand

  • We studied B cell content in melanoma tumors from 40 patients treated with PD-1 inhibitors

  • Seeing that B cell content can vary within a tumor, we used the highest B cell density in the three histospots to evaluate associations with outcome

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Summary

Introduction

Immune checkpoint inhibitors (CPIs) that block PD-1/ PD-L1 or CTLA-4 have transformed the treatment of many cancers and their use continues to expand. Anti-CTLA-4 was approved for treatment of melanoma followed by inhibitors of PD-1 or PD-L1, which have been approved to treat, in addition to melanoma, multiple tumor types [1]. In addition to use as single agents, The anti-tumor mechanisms of action of CPIs involve relief of negative T cell costimulatory signals [2]. This effect is not specific to anti-tumor T cells, and the role of B cells, which express PD-1, in anti-tumor immune response during CPI therapy has not been well established. The role of B cells in the anti-tumor activity of these drugs is unknown, as is their activity in patients who have received B cell depleting drugs or with immunoglobulin deficiencies

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