Tumor-Specific CD8+ T Cell Reactivity in the Sentinel Lymph Node of GM-CSF–Treated Stage I Melanoma Patients is Associated with High Myeloid Dendritic Cell Content

• Published in: Clinical cancer research 2006-05, Vol.12 (9), p.2826-2833
• Main Authors: VUYLSTEKE, Ronald J. C. L. M, MOLENKAMP, Barbara G, VAN LEEUWEN, Paul A. M, MEIJER, Sybren, WIJNANDS, Pepijn G. J. T. B, HAANEN, John B. A. G, SCHEPER, Rik J, DE GRUIJL, Tanja D
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic agents; Biological and medical sciences; CD8+ T cell; CD8-Positive T-Lymphocytes - immunology; Cell Count; Dendritic Cells - immunology; Dermatology; Female; GM-CSF; Granulocyte-Macrophage Colony-Stimulating Factor - therapeutic use; HLA-A Antigens - analysis; Humans; Lymph Nodes - immunology; Lymph Nodes - pathology; Male; Medical sciences; Melanoma; Melanoma - immunology; Melanoma - pathology; Melanoma - surgery; Middle Aged; Myeloid DC; Neoplasm Staging; Pharmacology. Drug treatments; Recombinant Proteins; Sentinel lymph node; Sentinel Lymph Node Biopsy; Tumors of the skin and soft tissue. Premalignant lesions
• ISSN: 1078-0432; 1557-3265
• DOI: 10.1158/1078-0432.CCR-05-2431

Purpose: Impaired immune functions in the sentinel lymph node (SLN) may facilitate early metastatic events during melanoma development. Local potentiation of tumor-specific T cell reactivity may be a valuable adjuvant treatment option. Experimental Design: We examined the effect of locally administered granulocyte/macrophage-colony stimulating factor (GM-CSF) on the frequency of tumor-specific CD8+ T cells in the SLN and blood of patients with stage I melanoma. Twelve patients were randomly assigned to preoperative local administration of either recombinant human GM-CSF or NaCl 0.9%. CD8+ T cells from SLN and peripheral blood were tested for reactivity in an IFNγ ELISPOT assay against the full-length MART-1 antigen and a number of HLA-A1, HLA-A2, and HLA-A3–restricted epitopes derived from a range of melanoma-associated antigens. Results: Melanoma-specific CD8+ T cell response rates in the SLN were one of six for the control group and four of six for the GM-CSF-administered group. Only one patient had detectable tumor-specific CD8+ T cells in the blood, but at lower frequencies than in the SLN. All patients with detectable tumor-specific CD8+ T cells had a percentage of CD1a+ SLN-dendritic cells (DC) above the median (i.e., 0.33%). This association between above median CD1a+ SLN-DC frequencies and tumor antigen–specific CD8+ T cell reactivity was significant in a two-sided Fisher's exact test ( P = 0.015). Conclusions: Locally primed antitumor T cell responses in the SLN are detectable as early as stage I of melanoma development and may be enhanced by GM-CSF-induced increases in SLN-DC frequencies.