Exploring the Dynamics of B Cell Subpopulations in Response to Immune Checkpoint Inhibitors: A Prospective Study

Author:

Pouliasi Foteini1,Salamaliki Christina1,Kanaloupitis Stavros1,Verigou Evgenia2,Liolis Elias3,Koutras Angelos3ORCID,Makatsoris Thomas3,Kalofonos Charalambos3,Liossis Stamatis-Nick4ORCID,Solomou Elena E.1

Affiliation:

1. Department of Internal Medicine, University of Patras Medical School, 26504 Rion, Greece

2. Department of Internal Medicine, Division of Hematology, University of Patras Medical School, 26504 Rion, Greece

3. Department of Internal Medicine, Division of Oncology, University of Patras Medical School, 26504 Rion, Greece

4. Department of Internal Medicine, Division of Rheumatology, University of Patras Medical School, 26504 Rion, Greece

Abstract

Globally, the efforts to find the best cancer treatment are demanding and very intensive. Immunotherapy has gained an important role as a second or sometimes first line of treatment for various types of cancer. PD-1/PD-L1 checkpoint inhibitors are an impending category of immunotherapy, and their mechanism, as well as their interaction with T cells, are well studied. However, our knowledge about any possible effect(s) of immunotherapy on B cells is limited. In this prospective study, we asked the question of any possible alterations of circulating B cells (numbers and subsets) occurring during immunotherapy in patients with cancer and of the potential correlation of such changes with the outcomes and with development of immune-related adverse events (irAEs). We enrolled 20 cancer patients who received PD-1 checkpoint inhibitors and 8 healthy donors (HD). Patients underwent regular clinical assessment and imaging using the iRECIST criteria for 6 months following immunotherapy. Peripheral blood samples were collected before and during PD-1 checkpoint inhibitor therapy, and flow cytometry analysis of peripheral blood mononuclear cells (PBMCs) was performed, evaluating various circulating B cell subset phenotypes, including mature naïve B cells, memory B cells, regulatory B cells (Bregs), antibody-secreting cells (ASCs), and age-related B cells (ABCs). Statistical analysis was employed to compare the differences of B cells between different groups and among sequential data within the same group. Total circulating CD19+ B cell counts remained stable across both groups (responders (R), nonresponders (NR)) and timepoints. However, there was a significant rise in mature naïve B cells and decline in memory B cells at the initiation of the treatment in the R group compared to healthy donors and to the NR group. Such changes were correlated with a good response to immunotherapy. On the contrary, higher numbers of ABCs at baseline were seen in the NR group and were correlated with resistance to treatment. As far as immune-related adverse events are concerned, no significant changes were recorded among the different B cell subpopulations evaluated in both groups. Our study provides preliminary data suggesting that B cell subset changes during immunotherapy may correlate with immune checkpoint inhibitor-induced clinical responses in patients with neoplasia. Further investigations to delineate the potential role(s) of B cells in patients undergoing immunotherapy are needed.

Publisher

MDPI AG

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