Primate Monocytes - CD14, CD16 - Ziegler-Heitbrock

Improved T cell immunity following neoadjuvant chemotherapy in ovarian cancer.

Abstract

PURPOSE: Although local tissue-based immune responses are critical for elucidating direct tumor-immune cell interactions, peripheral immune responses are increasingly recognized as occupying an important role in anti-cancer immunity. We evaluated serial blood samples from patients with epithelial ovarian cancer(EOC) undergoing standard-of-care neoadjuvant carboplatin and paclitaxel chemotherapy (including dexamethasone for prophylaxis of paclitaxel-associated hypersensitivity reactions) to characterize the evolution of the peripheral immune cell function and composition during therapy. EXPERIMENTAL DESIGN: Serial blood samples from ten patients with advanced high-grade serous ovarian cancer treated with neoadjuvant chemotherapy(NACT) were collected before initiation of chemotherapy, after third and sixth cycles, and ~2 months after completion of chemotherapy. T-cell function was evaluated using ex vivo IFN-gamma ELISpot assays, and the dynamics of T-cell repertoire and immune cell composition were assessed using bulk and single-cell RNA sequencing. RESULTS: T-cells exhibited an improved response to viral antigens after NACT, which paralleled the decrease in CA125 levels. Single-cell analysis revealed increased numbers of memory T-cell receptor(TCR) clonotypes and increased central memory CD8+ and regulatory T-cells throughout chemotherapy. Finally, administration of NACT was associated with increased monocyte frequency and expression of HLA class II and antigen presentation genes; single cell RNAseq analyses showed that while driven largely by classical monocytes, increased class II gene expression was observed across monocyte subpopulations after chemotherapy. CONCLUSIONS: NACT may alleviate tumor-associated immunosuppression by reducing tumor burden and may enhance antigen processing and presentation. These findings have implications for the successful combinatorial applications of immune checkpoint blockade and therapeutic vaccine approaches in EOC.