Cited by 2,374Cancer Immunotherapy and BiomarkersT-cell and B-cell ImmunologyCutaneous Melanoma Detection and Management

Tertiary lymphoid structures improve immunotherapy and survival in melanoma

Cabrita, Rita, Lauss, Martin, Sanna, Adriana, Donia, Marco, Skaarup Larsen, Mathilde, Mitra, Shamik, Johansson, Iva, Phung, Bengt +17 more·2020·Nature

Abstract

Checkpoint blockade therapies that reactivate tumour-associated T cells can induce durable tumour control and result in the long-term survival of patients with advanced cancers 1. Current predictive biomarkers for therapy response include high levels of intratumour immunological activity, a high tumour mutational burden and specific characteristics of the gut microbiota 2,3. Although the role of T cells in antitumour responses has thoroughly been studied, other immune cells remain insufficiently explored. Here we use clinical samples of metastatic melanomas to investigate the role of B cells in antitumour responses, and find that the co-occurrence of tumour-associated CD8+ T cells and CD20+ B cells is associated with improved survival, independently of other clinical variables. Immunofluorescence staining of CXCR5 and CXCL13 in combination with CD20 reveals the formation of tertiary lymphoid structures in these CD8+CD20+ tumours. We derived a gene signature associated with tertiary lymphoid structures, which predicted clinical outcomes in cohorts of patients treated with immune checkpoint blockade. Furthermore, B-cell-rich tumours were accompanied by increased levels of TCF7+ naive and/or memory T cells. This was corroborated by digital spatial-profiling data, in which T cells in tumours without tertiary lymphoid structures had a dysfunctional molecular phenotype. Our results indicate that tertiary lymphoid structures have a key role in the immune microenvironment in melanoma, by conferring distinct T cell phenotypes. Therapeutic strategies to induce the formation of tertiary lymphoid structures should be explored to improve responses to cancer immunotherapy.

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Crossref · 10.1038/s41586-019-1914-8

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  • Tumor-associated tertiary lymphoid structures are emerging as a powerful prognostic marker in melanoma and a number of other cancer types.

    “Also, as a member of the 12-chemokine gene signature classifier33, its expression has been correlated with the presence of tumor-associated tertiary lymphoid structures50–52 which are rapidly emerging as a powerful prognostic marker in melanoma and a number of other cancer types53–55.”
  • The findings were corroborated in translational studies of separate melanoma and sarcoma cohorts treated with ICB.

    “Moreover, these findings were corroborated in translational studies of separate cohorts of patients with melanoma36 and sarcoma37 who were treated with ICB.”
  • Presence of B cells in tumor is associated with better response to neoadjuvant ICB in melanoma and renal cell carcinoma.

    “Presence of B cells in tumor was associated with a better response to neoadjuvant therapy with ICB in melanoma and renal cell carcinoma (Cabrita et al., 2020; Helmink et al., 2020).”

    From Hallmarks of response, resistance, and toxicity to immune checkpoint blockade (2021) · cites this paper as Cabrita et al., 2020

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Authors
Cabrita, R., Lauss, M., Sanna, A., Donia, M., Skaarup Larsen, M., Mitra, S., Johansson, I., Phung, B., Harbst, K., Vallon-Christersson, J., van Schoiack, A., Lövgren, K., Warren, S., Jirström, K., Olsson, H., Pietras, K., Ingvar, C., Isaksson, K., Schadendorf, D., Schmidt, H., Bastholt, L., Carneiro, A., Wargo, J. A., Svane, I. M., & Jönsson, G.
Affiliations
  • Lund University (SE)
  • Herlev Hospital (DK)
  • Nanostring Technologies (United States) (US)
  • Skåne University Hospital (SE)
  • Essen University Hospital (DE)
  • Aarhus University Hospital (DK)
  • Odense University Hospital (DK)
  • The University of Texas MD Anderson Cancer Center (US)
Venue
Nature
Published
2020-01-15
Volume
577
Issue
7791
Pages
561-565
ISSN
  • 0028-0836 (ISSN-L)
  • 1476-4687
OpenAlex
W3000311037
Cited by
2,374
References
44
Citations by year
2026: 330 · 2025: 382 · 2024: 445 · 2023: 344 · 2022: 352 · 2021: 352 · 2020: 167 · 2019: 1
FWCI
110.35
Type
journal article
Language
en
Open access
closed
Locations
  • Nature (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
Funders
  • European Commission (641458, H2020-MSCA-ITN, H2020-MSCA-ITN-2014, HORIZON2020, H2020, H2020-MSCA, 247634)
  • Horizon 2020 Framework Programme (H2020MSCA‐ITN‐2014, H2020-MSCA, 247634, 641458, H2020-MSCA-ITN)
Topics
  • Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
  • Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
  • Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
Keywords
tertiary lymphoid structures, metastatic melanoma, immune checkpoint blockade, B cells, CD8+ T cells, CD20, CXCR5, CXCL13, tumor immune microenvironment, T cell phenotype, TCF1, gene expression signatures, survival prediction, cancer immunotherapy response
MeSH terms
Tertiary Lymphoid Structures, RNA-Seq, B-Lymphocytes, Humans, Immunologic Memory, Melanoma, Neoplasm Metastasis, Phenotype, Prognosis, T-Lymphocytes, Survival Rate, Treatment Outcome, CD8-Positive T-Lymphocytes, Antigens, CD20, Proteomics, T Cell Transcription Factor 1, Receptors, CXCR5, Chemokine CXCL13, Single-Cell Analysis, Tumor Microenvironment, B7-H1 Antigen, Programmed Cell Death 1 Receptor

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