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Table 2 Immunodynamic endpoint assessment

From: Immunodynamics: a cancer immunotherapy trials network review of immune monitoring in immuno-oncology clinical trials

Immuno-prognostic Immunotherapeutic Area

Immunodynamic Endpoint

Method of Assessment

Site of Assessment

Prognostic

Immunoscore

T-cell infiltrate

IHC: 1. CD8 2. CD45RO

Tumor

Therapeutic

Conventional Therapies

   

Chemotherapy

Immunogenic Cell Death

IHC: 1. phosphorylated eIF2α 2. nuclear HMGB1 (late apoptosis-related marker) 3. LC3-B (autophagosome-related marker) 4. Mx1 and TLR3 (IFN signature) 5. CD8/Foxp3 or CD8/CD68 ratios

Tumor

  

Gene expression analyses: 1. Cxcl10 2. IFNb 3. TLR3

Tumor

Radiation therapy

Tumor immunogenicity

Gene expression analysis: 1. Immunologic constant region (ICR)

Tumor

 

Radiation induced T and NK activation

IHC: 1. MICA

Tumor

  

ELISPOT: 1. sMICA 2. anti-sMICA antibodies

Peripheral Blood - Serum

 

Memory T cell response

T cell receptor (TCR) repertoire analysis

PBMCs

ITAs - Passive

   

Cellular Therapy

   

Adoptive T and NK cells

Quantification of adoptive cell population

Flow cytometry–based or PCR-based assessment of unique label in adoptive cell population

PBMCs

Chimeric Antigen

Receptor (CAR) T cells

Phenotype of adoptive cell population

Flow cytometry based or PCR based assessment of phenotype of adoptive cell population (see Tables 3 and 4; activation and inhibitory markers including ICOS, 4-1BB, PD-1, PD-L1, OX-40, LAG-3, GITR, VISTA, LIGHT)

PBMCs

 

Function of adoptive cell population

Flow cytometry based (perforin, granzyme, intracellular cytokine expression including IFN-γ), ELISPOT, in-vitro cytotoxicity (ie chromium release) or PCR based assessment of phenotype of adoptive cell population after antigen-specific (preferred, ie autologous tumor cells or tumor peptide pulsed T2 cells) or nonspecific stimulation (ie CD3/CD28, PMA, or ionomycin)

PBMCs

 

Toxicity

Comprehensive cytokine assessment, CRP

Peripheral Blood - Serum or plasma

ITAs - Active & Specific

   

Monoclonal Antibodies

   

Tumor-targeting

Target antigen expression in tumor

IHC, multicolor IF, and/or in-situ gene expression of target antigen of mAb on tumor (CD20, HER2, EGFR)

Tumor (primary, metastatic and circulating disease)

 

FcR polymorphism

FcR genotype (FcgRIIIA, FcgRIIA)

Peripheral blood – Mononuclear cells (genomic DNA)

 

Phenotype and function of immune (T and NK cell) response

T cell receptor (TCR) repertoire analysis Flow cytometry based or PCR based assessment of phenotype of T and NK cells (see Tables 3 and 4) and flow cytometry based (perforin, granzyme, intracellular cytokine expression including IFN-γ), ELISPOT, in-vitro cytotoxicity (ie chromium release) or PCR based assessment of phenotype T and NK cells after antigen-specific (preferred, ie autologous tumor cells or tumor peptide pulsed T2 cells) or nonspecific stimulation (ie CD3/CD28, PMA, or ionomycin)

PBMCs

 

Systemic cytokine response

Comprehensive cytokine assessment (IL-6, IFN-γ, IL-10) and serologic assessment (sIL-2Rα, MCP)

Peripheral Blood - Serum or plasma

Immune-targeting, including checkpoint inhibitors

Target expression in tumor microenvironment

IHC, multicolor IF, and/or in-situ gene expression of target on tumor and stroma (CTLA-4, PD-1, PD-L1, OX-40, 4-1BB, LAG-3, GITR, CD40)

Tumor

 

Tumor infiltrating immune response

IHC: 1. Quantity and phenotype of tumor-infiltrating lymphocytes (TILs) 2. CD8 effector: CD4 regulatory T cell ratio

Tumor

 

Memory T cell response

T cell receptor (TCR) repertoire analysis

PBMCs

 

Clinical response

CRP, LDH, WBC, ALC, MDSCs

Peripheral Blood - Serum or plasma

 

Toxicity

Comprehensive cytokine assessment

Peripheral Blood - Serum or plasma

Vaccines

   

In-situ Vaccines

Cell-based Vaccines

Target antigen expression in tumor

IHC, multicolor IF, and/or in-situ gene expression of target vaccination antigen on tumor (gp100, MART, Mucin)

Tumor

 Dendritic Cell-based

 Vaccines Non–cell-based Vaccines

T cell response postvaccination in tumor

IHC, multicolor IF (pre/post assessment of ratio of Treg to Teffectors and CD1a, CD8, CD94; CD207 and HLA-DR), and/or in-situ gene expression of intratumoral T cell population

Tumor

 

Quantification of T cell response

T cell receptor (TCR) repertoire analysis Flow cytometry based or PCR based assessment of tumor-specific T cells (dimer, tetramer, dextramer)

PBMCs)

 

Phenotype of T cell response

T cell receptor (TCR) repertoire analysis Flow cytometry based or PCR based assessment of phenotype of tumor-specific T cells (see Table 3)

PBMCs)

 

Function of T cell response

Flow cytometry based (perforin, granzyme, intracellular cytokine expression including IFN-γ), ELISPOT, in-vitro cytotoxicity (ie chromium release) or PCR based assessment of phenotype of tumor-specific T cells after antigen-specific (preferred, ie autologous tumor cells or tumor peptide pulsed T2 cells) or nonspecific stimulation (ie CD3/CD28, PMA, or ionomycin)

PBMCs

 

Humoral response Systemic cytokine response

ELISPOT tumor/antigen antibody response Comprehensive cytokine assessment (GM-CSF)

Peripheral Blood - Serum or plasma

ITargeted Agents

Active & Nonspecific

   

Cytokines

Intratumoral immune response

IHC, multicolor IF, and/or in-situ gene expression of intratumoral lymphocyte (T, B, and NK cell) population

Tumor

 

Phenotype and function of immune(T and NK) response

T cell receptor (TCR) repertoire analysis Flow cytometry based or PCR based assessment of phenotype of T and NK cells (see Tables 3 and 4) and flow cytometry based (perforin, granzyme, intracellular cytokine expression including IFN-γ), ELISPOT, in-vitro cytotoxicity (ie chromium release) or PCR based assessment of phenotype T and NK cells after antigen-specific (preferred, ie autologous tumor cells or tumor peptide pulsed T2 cells) or nonspecific stimulation (ie CD3/CD28, PMA, or ionomycin)

PBMCs

 

Systemic serologic and cytokine response

Comprehensive cytokine assessment (IL-6, IFNγ, IL-10) and serologic assessment (sIL-2Rα, MCP)

Peripheral Blood - Serum or plasma

IDO Inhibitors

IDO expression in tumor

IHC and/or in-situ gene expression of IDO1

Tumor

 

Inhibition of IDO1 based on Kyn/Trp ratio

Kyn/Trp level and IHC of DC maturation status (CD80, CD86)

Tumor & Peripheral Blood - Serum or plasma

 

Phenotype and function of immune (T and NK cell) response

T cell receptor (TCR) repertoire analysis Flow cytometry based or PCR based assessment of phenotype of T and NK cells (see Tables 3 and 4) and flow cytometry based (perforin, granzyme, intracellular cytokine expression including IFN-γ), ELISPOT, in-vitro cytotoxicity (ie chromium release) or PCR based assessment of phenotype T and NK cells after antigen-specific (preferred, ie autologous tumor cells or tumor peptide pulsed T2 cells) or nonspecific stimulation (ie CD3/CD28, PMA, or ionomycin)

PBMCs

  1. ALC absolute lymphocyte count, CRP C-reactive protein, DC dendritic cell, IDO indoleamine-2,3-dioxygenase; IFN-γ interferon gamma, LDH lactate dehydrogenase, MCP Monocyte Chemotactic Protein-1; MDSC myeloid-derived suppressor cells, PBMC peripheral blood mononuclear cells, sIL-2Rα, soluble IL-2 receptor-alpha, WBC white blood cell count