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2016 ; 22
(7
): 1572-82
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Disruption of in vivo Chronic Lymphocytic Leukemia Tumor-Microenvironment
Interactions by Ibrutinib--Findings from an Investigator-Initiated Phase II
Study
#MMPMID26660519
Niemann CU
; Herman SE
; Maric I
; Gomez-Rodriguez J
; Biancotto A
; Chang BY
; Martyr S
; Stetler-Stevenson M
; Yuan CM
; Calvo KR
; Braylan RC
; Valdez J
; Lee YS
; Wong DH
; Jones J
; Sun C
; Marti GE
; Farooqui MZ
; Wiestner A
Clin Cancer Res
2016[Apr]; 22
(7
): 1572-82
PMID26660519
show ga
PURPOSE: Chronic lymphocytic leukemia (CLL) cells depend on microenvironmental
interactions for proliferation and survival that are at least partially mediated
through B-cell receptor (BCR) signaling. Ibrutinib, a Bruton tyrosine kinase
inhibitor, disrupts BCR signaling and leads to the egress of tumor cells from the
microenvironment. Although the on-target effects on CLL cells are well defined,
the impact on the microenvironment is less well studied. We therefore sought to
characterize the in vivo effects of ibrutinib on the tumor microenvironment.
EXPERIMENTAL DESIGN: Patients received single-agent ibrutinib on an
investigator-initiated phase II trial. Serial blood and tissue samples were
collected pretreatment and during treatment. Changes in cytokine levels, cellular
subsets, and microenvironmental interactions were assessed. RESULTS: Serum levels
of key chemokines and inflammatory cytokines decreased significantly in patients
on ibrutinib. Furthermore, ibrutinib treatment decreased circulating tumor cells
and overall T-cell numbers. Most notably, a reduced frequency of the Th17 subset
of CD4(+)T cells was observed concurrent with reduced expression of activation
markers and PD-1 on T cells. Consistent with direct inhibition of T cells,
ibrutinib inhibited Th17 differentiation of murine CD4(+)T cells in vitro
Finally, in the bone marrow microenvironment, we found that ibrutinib
disaggregated the interactions of macrophages and CLL cells, inhibited secretion
of CXCL13, and decreased the chemoattraction of CLL cells. CONCLUSIONS: In
conjunction with inhibition of BCR signaling, these changes in the tumor
microenvironment likely contribute to the antitumor activity of ibrutinib and may
impact the efficacy of immunotherapeutic strategies in patients with CLL. See
related commentary by Bachireddy and Wu, p. 1547.
|Adenine/analogs & derivatives
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Animals
[MESH]
|Antineoplastic Agents/pharmacology/*therapeutic use
[MESH]