Monitoring and functional characterization of the lymphocytic compartment in pancreatic ductal adenocarcinoma patients

Pancreatology. 2016 Nov-Dec;16(6):1069-1079. doi: 10.1016/j.pan.2016.07.008. Epub 2016 Jul 11.

Abstract

Background/objectives: Pancreatic ductal adenocarcinoma (PDAC) still has a poor prognosis and current treatments including immunotherapy often fail. This might be due to the pronounced immunosuppressive milieu impairing infiltration and function of immune effector cells. This study aimed at a comprehensive analysis of immune cells in PDAC patients by determining absolute and relative peripheral blood cell numbers of immune cell subsets along with their functional capacity.

Methods: Whole blood cells or isolated peripheral blood mononuclear cells were characterized by flow cytometry. PDAC tissues were analyzed by immunohistochemistry. Anti-tumor activity of immune effector cells was determined by RTCA system.

Results: Our data demonstrate that relative CD4+ memory- and regulatory T cell numbers were enhanced, whereas determination of absolute cell numbers revealed generally lower immune cell numbers in PDAC patients compared to healthy controls. γδ T cells accumulated at higher numbers compared to αβ T cells in the malignant ductal epithelium of PDAC tissues indicating that γδ T cells infiltrate into the tumor. Cytotoxicity against tumor cells of even small numbers of T- and NK cells could be induced by a bispecific antibody targeting CD3+ T cells to human epidermal growth factor receptor (HER)2 expressing PDAC cells or Trastuzumab. Importantly, a critical number of γδ T cells was required for significant tumor cell killing by a bispecific antibody engaging the γδ T cell receptor on γδ T cells and HER2 on tumor cells.

Conclusion: Monitoring immune cells along with the determination of their functional capacity provides a comprehensive assessment as a prerequisite for a personalized immunotherapeutic PDAC treatment.

Keywords: Immune escape; Immune status; Immune therapy; Pancreatic cancer; γδ T cells.

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • CD4-Positive T-Lymphocytes / immunology
  • Carcinoma, Pancreatic Ductal / drug therapy
  • Carcinoma, Pancreatic Ductal / immunology*
  • Carcinoma, Pancreatic Ductal / pathology
  • Epithelium / pathology
  • Female
  • Flow Cytometry
  • Humans
  • Immunohistochemistry
  • Immunotherapy
  • Leukocyte Count
  • Lymphocytes / immunology*
  • Male
  • Middle Aged
  • Monitoring, Physiologic
  • Pancreatic Ducts / pathology
  • Pancreatic Neoplasms / drug therapy
  • Pancreatic Neoplasms / immunology*
  • Pancreatic Neoplasms / pathology
  • Receptor, ErbB-2 / genetics
  • Receptor, ErbB-2 / metabolism
  • T-Lymphocytes, Regulatory / immunology
  • Trastuzumab / therapeutic use

Substances

  • Antineoplastic Agents
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Trastuzumab