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Supplementary Table 1, Figures 1-5 from Myeloid-Derived Suppressor Cells as an Immune Parameter in Patients with Concurrent Sunitinib and Stereotactic Body Radiotherapy

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posted on 2023-03-31, 18:30 authored by Hui-Ming Chen, Ge Ma, Neil Gildener-Leapman, Samuel Eisenstein, Brian A. Coakley, Junko Ozao, John Mandeli, Celia Divino, Myron Schwartz, Max Sung, Robert Ferris, Johnny Kao, Lu-Hai Wang, Ping-Ying Pan, Eric C. Ko, Shu-Hsia Chen

Supplementary Table 1. Characteristics of the enrolled patients. Supplementary Figure 1. PBMCs were obtained from patients enrolled in the clinical trials at time points A (pre-sunitinib treatment), B (7 days post-sunitinib treatment), and C (6-30 days post-SBRT). Supplementary Figure 2. The number of pSTAT1+ in CD33+CD14+CD16+ (upper panels) and CD33+CD14+CD16- (lower panels) cells in PBMC from all patients and sunitinib-responders and non-responders based on Tbet+ CD4 T cell-criteria, was determined at the indicated time points. (*p < 0.05; ***p < 0.001) Supplementary Figure 3. The percentage and cell numbers of CD33+CD11b+ Supplementary Figure 4. The percentage of Tbet-expressing CD4 and CD8 T cells in PBMC from all patients, and patients who were separated into sunitinib-responders and non-responders was determined at the indicated time points based on the myeloid cell-based classification Supplementary Figure 5.(A) Mouse monocytic MDSC were left untreated (red) or treated with sunitinib (250 nM, blue) for 48 hrs. The apoptotic cells (Annexin V+) and phosphorylated STAT3 were assessed by flow cytometry. (B) Flow cytometric histogram of CD206+ in CD33+CD14+CD16- (blue) and CD33+CD14+CD16+ (red) populations (left panel). Mean fluorescent intensity of CD206+ was shown on the right panel. (C) Human CD33+CD14+CD16- and CD33+CD14+CD16+ populations were sorted from total PBMC. The mRNA expression of iNOS, MRC1, ARG1 and ARG2 were standardized as the fold changes using CD33+CD14+CD16- population as the base line. (C) The suppressive activity of sorted human CD33+CD14+CD16+ cells against the proliferation of autologous CD4+ T cells in the presence or absence of arginase inhibitor (Nor-NOHA, 100microM) was presented. (*p < 0.05; ***p < 0.001)

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ARTICLE ABSTRACT

Purpose: The clinical effects of sunitinib on human myeloid-derived suppressor cell (MDSC) subsets and correlation of the T-cell–mediated immune responses and clinical outcomes in patients with oligometastases treated by stereotactic body radiotherapy (SBRT) have been evaluated.Experimental Design: The numbers of granulocytic and monocytic MDSC subsets, effector T cells, and regulatory T cells in the peripheral blood were evaluated pre- and post-sunitinib treatment and concurrent with SBRT. Correlations between MDSC, Treg, and T-cell responses and clinical outcomes were analyzed.Results: Patients with oligometastases of various cancer types had elevated granulocytic MDSC and certain subsets of monocytic MDSC population. Sunitinib treatment resulted in a significant reduction in monocytic MDSC, phosphorylated STAT3, and arginase levels in monocytic MDSC (CD33+CD14+CD16+), and an increase in T-cell proliferative activity in cancer patients. Interestingly, the effects of sunitinib on reducing the accumulation and immune-suppressive function of MDSC were significantly correlated with Treg reduction, in responders but not in nonresponding patients. SBRT synergized the therapeutic effects of sunitinib, especially as related to decreased numbers of monocytic MDSC, Treg, and B cells, and augmented Tbet expression in primary CD4 and CD8 T cells. These effects were not observed in patients receiving radiation therapy alone. Most interestingly, the responders, defined by sunitinib-mediated reduction in CD33+CD11b+ myeloid cell populations, tend to exhibit improved progression-free survival and cause-specific survival.Conclusions: Sunitinib treatment increased the efficacy of SBRT in patients with oligometastases by reversing MDSC and Treg-mediated immune suppression and may enhance cancer immune therapy to prevent tumor recurrence post-SBRT. Clin Cancer Res; 21(18); 4073–85. ©2015 AACR.