Interleukin 17 signaling supports clinical benefit of dual CTLA-4 and PD-1 checkpoint inhibition in melanoma

Nat Cancer. 2023 Sep;4(9):1292-1308. doi: 10.1038/s43018-023-00610-2. Epub 2023 Jul 31.

Abstract

Recent studies suggest that BRAFV600-mutated melanomas in particular respond to dual anti-programmed cell death protein 1 (PD-1) and anti-cytotoxic T lymphocyte-associated protein 4 (CTLA-4) immune checkpoint inhibition (ICI). Here we identified an over-representation of interleukin (IL)-17-type 17 helper T (TH17) gene expression signatures (GES) in BRAFV600-mutated tumors. Moreover, high baseline IL-17 GES consistently predicted clinical responses in dual-ICI-treated patient cohorts but not in mono anti-CTLA-4 or anti-PD-1 ICI cohorts. High IL-17 GES corresponded to tumor infiltration with T cells and neutrophils. Accordingly, high neutrophil infiltration correlated with clinical response specifically to dual ICI, and tumor-associated neutrophils also showed strong IL-17-TH17 pathway activity and T cell activation capacity. Both the blockade of IL-17A and the depletion of neutrophils impaired dual-ICI response and decreased T cell activation. Finally, high IL-17A levels in the blood of patients with melanoma indicated a higher global TH17 cytokine profile preceding clinical response to dual ICI but not to anti-PD-1 monotherapy, suggesting a future role as a biomarker for patient stratification.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • CTLA-4 Antigen / metabolism
  • Humans
  • Interleukin-17* / genetics
  • Interleukin-17* / therapeutic use
  • Melanoma* / drug therapy
  • Melanoma* / genetics
  • Programmed Cell Death 1 Receptor / metabolism
  • Proto-Oncogene Proteins B-raf / therapeutic use

Substances

  • Interleukin-17
  • CTLA-4 Antigen
  • Programmed Cell Death 1 Receptor
  • Proto-Oncogene Proteins B-raf