Differential effects of corticosteroids and anti-TNF on tumor-specific immune responses: implications for the management of irAEs
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Differential effects of corticosteroids and anti-TNF on tumor-specific immune responses : implications for the management of irAEs. / Draghi, Arianna; Borch, Troels Holz; Radic, Haja Dominike; Chamberlain, Christopher Aled; Gokuldass, Aishwarya; Svane, Inge Marie; Donia, Marco.
I: International Journal of Cancer, Bind 145, Nr. 5, 2019, s. 1408-1413.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Differential effects of corticosteroids and anti-TNF on tumor-specific immune responses
T2 - implications for the management of irAEs
AU - Draghi, Arianna
AU - Borch, Troels Holz
AU - Radic, Haja Dominike
AU - Chamberlain, Christopher Aled
AU - Gokuldass, Aishwarya
AU - Svane, Inge Marie
AU - Donia, Marco
PY - 2019
Y1 - 2019
N2 - Up to 60% of patients treated with cancer immunotherapy develop severe or life threatening immune-related adverse events (irAEs). Immunosuppression with high dose corticosteroids, or tumor necrosis factor (TNF) antagonists in refractory cases, is the mainstay of treatment for irAEs. It is currently unknown what impact corticosteroids and anti-TNF have on the activity of antitumor T cells. In our study, the influence of clinically relevant doses of dexamethasone (corresponding to an oral dose of 10–125 mg prednisolone) and infliximab (anti-TNF) on the activation and killing ability of tumor-infiltrating lymphocytes (TILs) was tested in vitro. Overall, dexamethasone at low or intermediate/high doses impaired the activation (−46 and −62%, respectively) and tumor-killing ability (−48 and −53%, respectively) of tumor-specific TILs. In contrast, a standard clinical dose of infliximab only had a minor effect on T cell activation (−20%) and tumor killing (−10%). A 72-hr resting period after withdrawal of dexamethasone was sufficient to rescue the in vitro activity of TILs, while a short withdrawal did not result in a full rescue. In conclusion, clinically relevant doses of infliximab only had a minor influence on the activity of tumor-specific TILs in vitro, whereas even low doses of corticosteroids markedly impaired the antitumor activity of TILs. However, the activity of TILs could be restored after withdrawal of steroids. These data indirectly support steroid-sparing strategies and early initiation of anti-TNF therapy for the treatment of irAEs in immuno-oncology.
AB - Up to 60% of patients treated with cancer immunotherapy develop severe or life threatening immune-related adverse events (irAEs). Immunosuppression with high dose corticosteroids, or tumor necrosis factor (TNF) antagonists in refractory cases, is the mainstay of treatment for irAEs. It is currently unknown what impact corticosteroids and anti-TNF have on the activity of antitumor T cells. In our study, the influence of clinically relevant doses of dexamethasone (corresponding to an oral dose of 10–125 mg prednisolone) and infliximab (anti-TNF) on the activation and killing ability of tumor-infiltrating lymphocytes (TILs) was tested in vitro. Overall, dexamethasone at low or intermediate/high doses impaired the activation (−46 and −62%, respectively) and tumor-killing ability (−48 and −53%, respectively) of tumor-specific TILs. In contrast, a standard clinical dose of infliximab only had a minor effect on T cell activation (−20%) and tumor killing (−10%). A 72-hr resting period after withdrawal of dexamethasone was sufficient to rescue the in vitro activity of TILs, while a short withdrawal did not result in a full rescue. In conclusion, clinically relevant doses of infliximab only had a minor influence on the activity of tumor-specific TILs in vitro, whereas even low doses of corticosteroids markedly impaired the antitumor activity of TILs. However, the activity of TILs could be restored after withdrawal of steroids. These data indirectly support steroid-sparing strategies and early initiation of anti-TNF therapy for the treatment of irAEs in immuno-oncology.
KW - anti-TNF
KW - cancer immunotherapy
KW - corticosteroids
KW - immune-related adverse events
KW - in vitro tumor-killing
U2 - 10.1002/ijc.32080
DO - 10.1002/ijc.32080
M3 - Journal article
C2 - 30575963
AN - SCOPUS:85059557153
VL - 145
SP - 1408
EP - 1413
JO - International Journal of Cancer
JF - International Journal of Cancer
SN - 0020-7136
IS - 5
ER -
ID: 218769354