Therapeutic plasma exchange clears circulating soluble PD-L1 and PD-L1-positive extracellular vesicles

Background Trans-acting programmed death-ligand 1 (PD-L1) derives from malignant cells in three known forms. High levels of secreted splice variant PD-L1 (sPD-L1), ADAM10/ADAM17-shed sPD-L1, and PD-L1-positive extracellular vesicles (evPD-L1) each predict poor prognosis and limited response to PD-(L...

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Main Authors: Haidong Dong, Svetomir N Markovic, Aaron S Mansfield, Jacob J Orme, Elizabeth Ann L Enninga, Fabrice Lucien-Matteoni, Heather Dale, Edwin Burgstaler, Susan M Harrington, Matthew K Ball, Sean S Park, Mathew S Block, Yiyi Yan, Roxana S Dronca, Jeffrey L Winters
Format: Article
Language:English
Published: BMJ Publishing Group 2020-10-01
Series:Journal for ImmunoTherapy of Cancer
Online Access:https://jitc.bmj.com/content/8/2/e001113.full
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author Haidong Dong
Svetomir N Markovic
Aaron S Mansfield
Jacob J Orme
Elizabeth Ann L Enninga
Fabrice Lucien-Matteoni
Heather Dale
Edwin Burgstaler
Susan M Harrington
Matthew K Ball
Sean S Park
Mathew S Block
Yiyi Yan
Roxana S Dronca
Jeffrey L Winters
author_facet Haidong Dong
Svetomir N Markovic
Aaron S Mansfield
Jacob J Orme
Elizabeth Ann L Enninga
Fabrice Lucien-Matteoni
Heather Dale
Edwin Burgstaler
Susan M Harrington
Matthew K Ball
Sean S Park
Mathew S Block
Yiyi Yan
Roxana S Dronca
Jeffrey L Winters
author_sort Haidong Dong
collection DOAJ
description Background Trans-acting programmed death-ligand 1 (PD-L1) derives from malignant cells in three known forms. High levels of secreted splice variant PD-L1 (sPD-L1), ADAM10/ADAM17-shed sPD-L1, and PD-L1-positive extracellular vesicles (evPD-L1) each predict poor prognosis and limited response to PD-(L)1 checkpoint inhibitors in cancer. To our knowledge, no clinical intervention has reduced any of these circulating forms of extracellular PD-L1. Here, we explore therapeutic plasma exchange (TPE) as a treatment to reduce circulating extracellular PD-L1.Results In patients with melanoma, sPD-L1 levels above 0.277 ng/mL predicted inferior overall survival. In patients undergoing TPE for non-malignant indications, each TPE session removed a mean 70.8% sPD-L1 and 73.1% evPD-L1 detectable in plasma. TPE also reduced total and ADAM10-positive extracellular vesicles.Conclusion Here, we report the first known clinical intervention to remove either sPD-L1 or evPD-L1 from plasma in vivo. TPE reduces plasma sPD-L1 and evPD-L1 in vivo and may have a role in treatment with immunotherapy. TPE may also prove useful in patients with other extracellular vesicle-related conditions.
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spelling doaj-art-12cda94bbdc0496a8a76193abb6aa4f32024-11-10T00:30:08ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262020-10-018210.1136/jitc-2020-001113Therapeutic plasma exchange clears circulating soluble PD-L1 and PD-L1-positive extracellular vesiclesHaidong Dong0Svetomir N Markovic1Aaron S Mansfield2Jacob J Orme3Elizabeth Ann L Enninga4Fabrice Lucien-Matteoni5Heather Dale6Edwin Burgstaler7Susan M Harrington8Matthew K Ball9Sean S Park10Mathew S Block11Yiyi Yan12Roxana S Dronca13Jeffrey L Winters14Mayo Clinic, Rochester, MN, USAMayo Clinic Rochester, Rochester, Minnesota, USAOncology, Mayo Clinic, Rochester, Minnesota, USA1 Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA2 Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA1Mayo Clinic, Rochester, MN, USA4 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA4 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA3 Department of Urology, Mayo Clinic, Rochester, Minnesota, USA4 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA5 Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA1 Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA1 Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA6 Department of Hematology and Oncology, Mayo Clinic Florida, Jacksonville, Florida, USA4 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USABackground Trans-acting programmed death-ligand 1 (PD-L1) derives from malignant cells in three known forms. High levels of secreted splice variant PD-L1 (sPD-L1), ADAM10/ADAM17-shed sPD-L1, and PD-L1-positive extracellular vesicles (evPD-L1) each predict poor prognosis and limited response to PD-(L)1 checkpoint inhibitors in cancer. To our knowledge, no clinical intervention has reduced any of these circulating forms of extracellular PD-L1. Here, we explore therapeutic plasma exchange (TPE) as a treatment to reduce circulating extracellular PD-L1.Results In patients with melanoma, sPD-L1 levels above 0.277 ng/mL predicted inferior overall survival. In patients undergoing TPE for non-malignant indications, each TPE session removed a mean 70.8% sPD-L1 and 73.1% evPD-L1 detectable in plasma. TPE also reduced total and ADAM10-positive extracellular vesicles.Conclusion Here, we report the first known clinical intervention to remove either sPD-L1 or evPD-L1 from plasma in vivo. TPE reduces plasma sPD-L1 and evPD-L1 in vivo and may have a role in treatment with immunotherapy. TPE may also prove useful in patients with other extracellular vesicle-related conditions.https://jitc.bmj.com/content/8/2/e001113.full
spellingShingle Haidong Dong
Svetomir N Markovic
Aaron S Mansfield
Jacob J Orme
Elizabeth Ann L Enninga
Fabrice Lucien-Matteoni
Heather Dale
Edwin Burgstaler
Susan M Harrington
Matthew K Ball
Sean S Park
Mathew S Block
Yiyi Yan
Roxana S Dronca
Jeffrey L Winters
Therapeutic plasma exchange clears circulating soluble PD-L1 and PD-L1-positive extracellular vesicles
Journal for ImmunoTherapy of Cancer
title Therapeutic plasma exchange clears circulating soluble PD-L1 and PD-L1-positive extracellular vesicles
title_full Therapeutic plasma exchange clears circulating soluble PD-L1 and PD-L1-positive extracellular vesicles
title_fullStr Therapeutic plasma exchange clears circulating soluble PD-L1 and PD-L1-positive extracellular vesicles
title_full_unstemmed Therapeutic plasma exchange clears circulating soluble PD-L1 and PD-L1-positive extracellular vesicles
title_short Therapeutic plasma exchange clears circulating soluble PD-L1 and PD-L1-positive extracellular vesicles
title_sort therapeutic plasma exchange clears circulating soluble pd l1 and pd l1 positive extracellular vesicles
url https://jitc.bmj.com/content/8/2/e001113.full
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