Integrated molecular analysis of tumor biopsies on sequential CTLA-4 and PD-1 blockade reveals markers of response and resistance.
| Author | :  | 
|---|---|
| Abstract | :  Immune checkpoint blockade produces clinical benefit in many patients. However, better biomarkers of response are still needed, and mechanisms of resistance remain incompletely understood. To address this, we recently studied a cohort of melanoma patients treated with sequential checkpoint blockade against cytotoxic T lymphocyte antigen-4 (CTLA-4) followed by programmed death receptor-1 (PD-1) and identified immune markers of response and resistance. Building on these studies, we performed deep molecular profiling including T cell receptor sequencing and whole-exome sequencing within the same cohort and demonstrated that a more clonal T cell repertoire was predictive of response to PD-1 but not CTLA-4 blockade. Analysis of CNAs identified a higher burden of copy number loss in nonresponders to CTLA-4 and PD-1 blockade and found that it was associated with decreased expression of genes in immune-related pathways. The effect of mutational load and burden of copy number loss on response was nonredundant, suggesting the potential utility of a combinatorial biomarker to optimize patient care with checkpoint blockade therapy. | 
| Year of Publication | :  2017 | 
| Journal | :  Science translational medicine | 
| Volume | :  9 | 
| Issue | :  379 | 
| Date Published | :  2017 | 
| ISSN Number | :  1946-6234 | 
| URL | :  http://stm.sciencemag.org/cgi/pmidlookup?view=short&pmid=28251903 | 
| DOI | :  10.1126/scitranslmed.aah3560 | 
| Short Title | :  Sci Transl Med | 
| Download citation |