Oral Presentation Melbourne Immunotherapy Network Winter Retreat 2018

Impact of tumour inherent interferons on immune reactivity and personalised therapy in TNBC (#20)

Natasha K Brockwell 1 , Jai Rautela 2 , Katie L Owen 1 , Tim Molloy 3 , Vinod Ganju 4 5 , Sandra O'Toole 6 , Belinda S Parker 1
  1. La Trobe University, Bundoora, VIC, Australia
  2. Walter and Eliza Hall institute , Melbourne, VIC, Australia
  3. St Vincents Centre for Applied Medical Research , Darlinghurst , Sydney , Australia
  4. Clinical Translational Research , Hudson Institute for Medical Research, Melbourne , Victoria, Australia
  5. Monash Cancer centre , Melbourne , Victoria, Australia
  6. Garvan Institute of Medical Research , Sydney , NSW, Australia

Triple negative breast cancer (TNBC) accounts for 15-20% of all breast cancers and has an increased risk of rapid metastasis within the first two years compared to other subtypes. A feature of TNBC is the high accumulation of tumour infiltrating lymphocytes (TILs) in some patients that predict a favourable prognosis and response to chemotherapy. This, along with the lack of targeted therapeutic options for TNBC, has triggered interest in trialling checkpoint-targeted immunotherapy. However, responses to date have been underwhelming are very difficult to predict, leading to an inability to accurately weigh up the benefit-to-risk ratio for their implementation. In agreement with clinical responses, our recent studies in preclinical TNBC models have demonstrated a lack of efficacy of the checkpoint inhibitor, anti-PD-1, in aggressive, immune cold TNBC tumours. Increasing the heat of the tumour via poly (I:C), a potent type I interferon inducer, sensitised mice to anti-PD-1 and induced a tumour specific T-cell response that extended metastasis-free survival. We have now built on these findings to profile the immune landscape of TNBC in a neoadjuvant sequential biopsy cohort in order to develop immune markers that predict poor chemotherapeutic response, a poor prognosis, and patients that may benefit from immunotherapeutic intervention.  Utilizing multiplexed immunohistochemistry we have demonstrated that immune cell characterisation and activation status is a superior prognostic for chemotherapeutic response and risk of relapse than standard TIL score. Furthermore, we identified a novel prognostic marker that indicates presence of an intact tumour-intrinsic type I IFN signalling pathway which is superior to TIL characterisation and predicts survival in 3 independent TNBC cohorts. Our work supports preclinical and clinical trials of immunoactivating therapies in patients with IFN and immune cell cold tumours.

  1. N. K. Brockwell, K. L. Owen, D. Zanker, A. Spurling, J. Rautela, H. M. Duivenvoorden, N. Baschuk, F. Caramia, S. Loi, P. K. Darcy, E. Lim, and B. S. Parker, “Neoadjuvant Interferons: Critical for effective PD-1 based immunotherapy in TNBC,” Cancer Immunol. Res., Aug. 2017.
  2. N. K. Brockwell and B. S. Parker, “Tumor inherent interferons: Impact on immune reactivity and immunotherapy,” Cytokine, 2018.