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2014 ; 2
(9
): 878-89
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CALGB 150905 (Alliance): rituximab broadens the antilymphoma response by
activating unlicensed NK cells
#MMPMID24958280
Du J
; Lopez-Verges S
; Pitcher BN
; Johnson J
; Jung SH
; Zhou L
; Hsu K
; Czuczman MS
; Cheson B
; Kaplan L
; Lanier LL
; Venstrom JM
Cancer Immunol Res
2014[Sep]; 2
(9
): 878-89
PMID24958280
show ga
Natural killer (NK) cells contribute to clinical responses in patients treated
with rituximab, but the rules determining NK-cell responsiveness to mAb therapies
are poorly defined. A deeper understanding of the mechanisms responsible for
antibody-dependent cellular cytotoxicity (ADCC) could yield useful biomarkers for
predicting clinical responses in patients. Unlicensed NK cells, defined as NK
cells lacking expression of an inhibitory KIR for self-HLA class I ligands, are
hyporesponsive in steady state, but are potent effectors in inflammatory
conditions. We hypothesized that antitumor antibodies such as rituximab can
overcome NK-cell dependence on licensing, making unlicensed NK cells important
for clinical responses. Here, we examined the influences of variations in KIR and
HLA class I alleles on in vitro responses to rituximab. We tested the clinical
significance in a cohort of patients with follicular lymphoma treated with
rituximab-containing mAb combinations, and show that rituximab triggers responses
from all NK-cell populations regardless of licensing. Neither IL2 nor accessory
cells are required for activating unlicensed NK cells, but both can augment
rituximab-mediated ADCC. Moreover, in 101 patients with follicular lymphoma
treated with rituximab-containing mAb combinations, a "missing ligand" genotype
(predictive of unlicensed NK cells) is associated with a higher rate of
progression-free survival. Our data suggest that the clinical efficacy of
rituximab may be driven, in part, by its ability to broaden the NK-cell
repertoire to include previously hyporesponsive, unlicensed NK cells. A "missing
ligand" KIR and HLA class I genotype may be predictive of this benefit and useful
for personalizing treatment decisions in lymphomas and other tumors.
|Adult
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Antibodies, Monoclonal, Murine-Derived/*therapeutic use
[MESH]