NK cell activation and recovery of NK cell subsets in lymphoma patients after obinutuzumab and lenalidomide treatment

Dang-Nghiem Vo; Catherine Alexia; Nerea Allende-Vega; Franck Morschhauser; Roch Houot; Cedric Menard; Karin Tarte; Guillaume Cartron; Martin Villalba

doi:10.1080/2162402X.2017.1409322

NK cell activation and recovery of NK cell subsets in lymphoma patients after obinutuzumab and lenalidomide treatment

Oncoimmunology. 2017 Dec 20;7(4):e1409322. doi: 10.1080/2162402X.2017.1409322. eCollection 2018.

Authors

Dang-Nghiem Vo^{1

2}, Catherine Alexia¹, Nerea Allende-Vega^{1

2}, Franck Morschhauser³, Roch Houot^{4

5}, Cedric Menard^{5

6}, Karin Tarte^{5

6}, Guillaume Cartron^{7

8}, Martin Villalba^{1

2}

Affiliations

¹ INSERM U1183, Université de Montpellier 1, UFR Médecine, Montpellier, France.
² Institute for Regenerative Medicine and Biotherapy (IRMB), CHU Montpellier, Montpellier, France.
³ Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille, France.
⁴ Department of Clinical Hematology, University Hospital Rennes, Rennes, France.
⁵ UMR U1236, INSERM Université Rennes 1, Etablissement Français du Sang, Rennes, France.
⁶ SITI, Pôle de Biologie, CHU de Rennes, Rennes, France.
⁷ Département d'Hématologie Clinique, CHU Montpellier, Université Montpellier I, 80 avenue Augustin Fliche, Montpellier, France.
⁸ CNRS UMR5235, Université de Montpellier, Montpellier, France.

Abstract

Obinutuzumab (OBZ) shows stronger antibody-dependent cell cytotoxicity (ADCC) compared to rituximab and improved clinical activity for treating certain CD20⁺ neoplasia. However, the efficacy of monoclonal antibody (mAb) as a monotherapy is limited. Natural Killer (NK) cells are mediators of ADCC. Hematological cancer patients possess antitumor NK cells that are unable to control disease, possibly because they are dysfunctional. The immunomodulatory drug lenalidomide (LEN) could be a treatment to restore exhausted NK cell cytotoxic functions. The clinical trial GALEN is a Phase Ib/II study of OBZ combined with LEN for the treatment of relapsed/refractory follicular and aggressive (DLBCL and MCL) B-cell Lymphoma. During treatment, we analyzed specific aspects of NK cell biology. Treatment reversed the immature NK phenotype of patients and increased expression of NK activating receptors. Inhibitory receptors were either unchanged or decreased. There was a strong NK response at the end of the 1st cycle: NK number and intracellular granzyme B (GrzB) expression decreased, degranulation increased and NK responded better to allogeneic target challenge. Moreover, the interaction of NK cells with B cell targets, measured by trogocytosis, decreased during treatment. At the end of treatment, when target cells had been wiped out, the proportion of reactive NK cells (CD69⁺, CD45RARO⁺, CD107a⁺, CD19⁺) strongly decreased. Because all patients received LEN and OBZ, it was uncertain which drug was responsible of our observations, or even if a combination of both products was necessary for the described effects on this lymphocyte lineage.

Keywords: NK cell; diffuse large B-cell lymphoma (DLBCL); follicular lymphoma (FL); lenalidomide; obinutuzumab.

Publication types

Research Support, Non-U.S. Gov't

Grants and funding

This project has been conducted owing to the Bio_GALEN funding as a part of the ancillary GALEN study. DNV has received a fellowship from the Ministère de l'Enseignement Supérieur et de la Recherche (MESR).