KIR-HLA Functional Repertoire Influences Trastuzumab Efficiency in Patients With HER2-Positive Breast Cancer
- Author(s)
- Muraro, E; De Zorzi, M; Miolo, G; Lombardi, D; Scalone, S; Spazzapan, S; Massarut, S; Perin, T; Dolcetti, R; Steffan, A; De Re, V;
- Journal Title
- Frontiers in Immunology
- Publication Type
- Research article
- Abstract
- Trastuzumab induced a high rate of pathological Complete Response (pCR) in patients affected by locally advanced HER2-positive Breast Cancer (HER2-BC), by exploiting immune-mediated mechanisms as Antibody-Dependent Cell Cytotoxicity (ADCC) involving Natural Killer (NK) cells. Host's immune genetics could influence the response to therapy, through the expression of variants that characterize NK receptors involved in ADCC effectiveness. Killer cell immunoglobin-like receptors (KIRs) modulate NK cell activity through their binding to class-I Human Leukocyte Antigens (HLA). The impact of the KIR/HLA repertoire in HER2-BC is under study. We characterized KIR genotypes of 36 patients with locally advanced HER2-BC treated with neoadjuvant chemotherapy including trastuzumab. We monitored pCR achievement before surgery and Disease-Free Survival (DFS) and Overall Survival (OS) after adjuvant therapy. HLA, and Fc gamma receptor IIIa (FcgammaR3A) and IIa (FcgammaR2A) were genotyped through targeted PCR and Sanger sequencing in 35/36 patients. The KIR-HLA combinations were then described as functional haplotypes and divided in two main categories as inhibitory tel A and stimulatory tel B. Trastuzumab-dependent ADCC activity was monitored with an in vitro assay using a HER2-BC model and patients' NK cells.We observed a higher frequency of KIR activators in patients who achieved a pCR compared to partial responders. During the study of functional haplotypes, individuals carrying a tel B haplotype showed greater ADCC efficiency than tel A cases. In subjects with the tel A haplotype the presence of the favorite V allele in FcgammaR3A receptor improved their low ADCC levels. Regardless of the haplotypes detected, the presence of KIR3DL2/HLA-A03 or A11 was always associated with the FcgammaR3A V allele, and therefore correlated with greater ADCC efficiency. However, this particular KIR receptor appeared to harm DFS and OS. Indeed, patients with tel B haplotype without KIR3DL2/HLA-A03 or A11 showed a better outcome. Our data, although preliminary, suggested a potential predictive role for KIR haplotype tel B, in identifying patients who achieve a pCR after neoadjuvant treatment with trastuzumab, and supported a negative prognostic impact of KIR3DL2/HLA-A03 or A11 in the adjuvant setting.
- Keywords
- Adult; Aged; Antibodies, Monoclonal, Humanized/*therapeutic use; Antibody-Dependent Cell Cytotoxicity/drug effects; Breast Neoplasms/*drug therapy/*metabolism; Female; HLA Antigens/*metabolism; Histocompatibility Antigens Class I/metabolism; Humans; Killer Cells, Natural/drug effects/metabolism; Middle Aged; Neoadjuvant Therapy/methods; Prognosis; Receptor, ErbB-2/*metabolism; Receptors, KIR/*metabolism; Trastuzumab/*therapeutic use; Young Adult; Adcc; Hla; Kir; breast cancer; trastuzumab
- Department(s)
- Laboratory Research
- PubMed ID
- 35095867
- Publisher's Version
- https://doi.org/10.3389/fimmu.2021.791958
- Open Access at Publisher's Site
https://doi.org/10.3389/fimmu.2021.791958- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2025-02-07 05:05:38
Last Modified: 2025-02-07 05:08:50