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Is your patient responding to their immunotherapy regimen?
"To assess whether CTLA-4 blockade promotes global T cell expansion and/or loss of T cell clonotype diversity, we used next-generation sequencing to assess the impact of CTLA-4 blockade on changes to the T cell repertoire. This method can potentially identify the millions of individual clonotypes by high-throughput sequencing of the repertoire of rearranged TCRβ chains in individual patients, using primers designed to read the variable (V), diversity (D), joining (J), and constant (C) gene segments."
To read more from the publication: Cha E, Klinger M, Hou Y, et al. Improved Survival with T Cell Clonotype Stability After Anti–CTLA-4 Treatment in Cancer Patients. Science translational medicine. 2014;6(238):238ra70. doi:10.1126/scitranslmed.3008211. click on the link below.
Is your patient at risk of having an IRAE?
"Because CTLA-4 blockade leads to proliferation of circulating T cells, we examined whether ipilimumab leads to clonal expansion of tissue-reactive T cells. Rather than narrowing the T cell repertoire to a limited number of clones, ipilimumab induced greater repertoire diversification in IRAE patients compared to patients without IRAEs, with increases in the numbers of clonotypes, including newly detected clones, and declines in T cell clonality overall. Initial repertoire broadening occurred within 2 weeks of treatment, preceding IRAEs."
To read more from the publication: Fong L, Oh DY, Cham J, Zhang L, Fong G, Kwek SS, Klinger M, Faham M. T cell repertoire diversification is associated with immune related toxicities following CTLA-4 blockade in cancer patients. Cancer Res. 2016 Dec 28. click on the link below.