Durable response in a patient with recurrent respiratory papillomatosis treated with immune checkpoint blockade

Head Neck. 2022 Oct;44(10):E31-E37. doi: 10.1002/hed.27144. Epub 2022 Jul 11.

Abstract

Background: Immune checkpoint blockade can provide clinical benefit for patients with advanced cancer. Here, we report durable disease control over many years following PD-L1 blockade through induction of a viral antigen-specific T cell response in an adult patient with recurrent respiratory papillomatosis.

Methods: Antigen-specific T cell response assays, single cell RNA-sequencing, and RNA-scope was used to study clinical tissues.

Results: An HPV6 E2-specific T cell clone restricted to HLA-B*55, present at low frequency in the pre-treatment papilloma, significantly expanded after six doses of PD-L1 blockade and remained present and functional at the site of initial response in the larynx as a tissue resident memory T cell for 4 years. An associated reduction in E2 target gene was observed following treatment.

Conclusions: Although demonstrated in a single exceptional responder, these results highlight that immune checkpoint blockade may induce durable, viral antigen-specific immunity of sufficient magnitude to control disease in patients with nonmalignant disorders.

Keywords: PD-L1; human papillomavirus type 6; immune checkpoint blockade; recurrent respiratory papillomatosis; resident memory T cell.

Publication types

  • Case Reports
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Antigens, Viral
  • B7-H1 Antigen*
  • Humans
  • Immune Checkpoint Inhibitors
  • Papilloma*
  • Papillomavirus Infections
  • RNA
  • Respiratory Tract Infections

Substances

  • Antigens, Viral
  • B7-H1 Antigen
  • Immune Checkpoint Inhibitors
  • RNA

Supplementary concepts

  • Recurrent respiratory papillomatosis