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The activation of immune cells by targeting checkpoint inhibitors showed promising results with increased patient survival in distinct primary cancers. Since only limited data exist for human brain metastases, we aimed at characterizing tumor infiltrating lymphocytes (TILs) and expression of immune checkpoints in the respective tumors. Two brain metastases cohorts, a mixed entity cohort (n = 252) and a breast carcinoma validation cohort (n = 96) were analyzed for CD3+, CD8+, FOXP3+, PD-1+ lymphocytes and PD-L1+ tumor cells by immunohistochemistry. Analyses for association with clinico-epidemiological and neuroradiological parameters such as patient survival or tumor size were performed. TILs infiltrated brain metastases in three different patterns (stromal, peritumoral, diffuse). While carcinomas often show a strong stromal infiltration, TILs in melanomas often diffusely infiltrate the tumors. Highest levels of CD3+ and CD8+ lymphocytes were seen in renal cell carcinomas (RCC) and strongest PD-1 levels on RCCs and melanomas. High amounts of TILs, high ratios of PD-1+/CD8+ cells and high levels of PD-L1 were negatively correlated with brain metastases size, indicating that in smaller brain metastases CD8+ immune response might get blocked. PD-L1 expression strongly correlated with TILs and FOXP3 expression. No significant association of patient survival with TILs was observed, while high levels of PD-L1 showed a strong trend towards better survival in melanoma brain metastases (Log-Rank p = 0.0537). In summary, melanomas and RCCs seem to be the most immunogenic entities. Differences in immunotherapeutic response between tumor entities regarding brain metastases might be attributable to this finding and need further investigation in larger patient cohorts.
The basic question which drove our whole work was to find a meaningful noncommutative gauge theory even for the time-like case ($\theta^{0 i} \neq 0$). In order to be able to tackle questions regarding unitarity, it is not sufficient to consider theories which include the noncommutative parameter only up to a finite order. The reason is that in order to investigate tree-level unitarity or the optical theorem in loops one has to know the behavior of the noncommutative theory for center-of-mass energies much greater than the noncommutative scale. Therefore an effective theory, that is by construction only valid up to the noncommutative scale, isn't sufficient for our purpose. Our model is based on two fundamental assumptions. The first assumption is given by the commutation relations \eqref{eq:ncalg}. This led to the Moyal-Weyl star-product \eqref{eq:astproduct2} which replaces all point-like products between two fields. The second assumption is to assume that the model built this way is not only invariant under the noncommutative gauge transformation but also under the commutative one. In order to obtain an action of such a model one has to replace the fields by their appropriate \swms. We chose the gauge fixed action \eqref{eq:actioncgf} as the fundamental action of our model. After having constructed the action of the NCQED including the {\swms} we were confronted with the problem of calculating the {\swms} to all orders in $\tMN$. By means of \cite{bbg} we could calculate the {\swms} order by order in the gauge field, where each order in the gauge field contains all orders in the noncommutative parameter (\cf chapter \ref{chapter:swms}). By comparing the maps with the result we obtained from an alternative ansatz \cite{bcpvz}, we realized that already the simplest {\swm} for the gauge field is not unique. In chapter \ref{chapter:ambiguities} we examined this ambiguity, which we could parametrised by an arbitrary function $\astf$. The next step was to derive the Feynman rules for our NCQED. One finds that the propagators remain unchanged so that the free theory is equal to the commutative QED. The fermion-fermion-photon vertex contains not only a phase factor coming from the Moyal-Weyl star-product but also two additional terms which have their origin in the \swms. Beside the 3-photon vertex which is already present in NCQED without {\swms} and which has also additional terms coming from the \swms, too, one has a contact vertex which couples two fermions with two photons. After having derived all the vertices we calculated the pair annihilation scattering process $e^+ e^- \rightarrow \gamma \gamma$ at Born level. By choosing the parameter $\kggg = 1$ (\cf section \ref{sec:represent}), we found that the amplitude of the pair annihilation process becomes equal to the amplitude of the NCQED without \swms. This means that, at least for this process, the NCQED excluding {\swms} is only a special case of NCQED including \swms. On the basis of the pair annihilation process, we afterwards investigated tree-level unitarity. In order to satisfy the tree-level unitarity we had to constrain the arbitrary function $\astf$. We found that the series expansion of $\astf$ has to start with unity. In addition, the even part of the function must not increase faster than $s^{-1/2} \log(s)$ for $s \rightarrow \infty$, whereas the odd part of the $\astf$-function can't be constrained, at least by the process we considered. By assuming these constrains for the $\astf$-function, we could show that tree-level unitarity is satisfied if one incorporates the uncertainties present in the energy and the momenta of the scattered particles, \ie the uncertainties of the center-of-mass energy and the scattering angles. This uncertainties are not exclusively present due to the finite experimental resolution. A delta-like center-of-mass energy as well as delta-like momenta are in general not possible because the scattered particles are never exact plane waves.
Immune checkpoint blockade therapy is beneficial and even curative for some cancer patients. However, the majority don’t respond to immune therapy. Across different tumor types, pre-existing T cell infiltrates predict response to checkpoint-based immunotherapy. Based on in vitro pharmacological studies, mouse models and analyses of human melanoma patients, we show that the cytokine GDF-15 impairs LFA-1/β2-integrin-mediated adhesion of T cells to activated endothelial cells, which is a pre-requisite of T cell extravasation. In melanoma patients, GDF-15 serum levels strongly correlate with failure of PD-1-based immune checkpoint blockade therapy. Neutralization of GDF-15 improves both T cell trafficking and therapy efficiency in murine tumor models. Thus GDF-15, beside its known role in cancer-related anorexia and cachexia, emerges as a regulator of T cell extravasation into the tumor microenvironment, which provides an even stronger rationale for therapeutic anti-GDF-15 antibody development.
While the central nervous system is considered an immunoprivileged site and brain tumors display immunosuppressive features, both innate and adaptive immune responses affect glioblastoma (GBM) growth and treatment resistance. However, the impact of the major immune cell population in gliomas, represented by glioma-associated microglia/macrophages (GAMs), on patients’ clinical course is still unclear. Thus, we aimed at assessing the immunohistochemical expression of selected microglia and macrophage markers in 344 gliomas (including gliomas from WHO grade I–IV). Furthermore, we analyzed a cohort of 241 IDH1R132H-non-mutant GBM patients for association of GAM subtypes and patient overall survival. Phenotypical properties of GAMs, isolated from high-grade astrocytomas by CD11b-based magnetic cell sorting, were analyzed by immunocytochemistry, mRNA microarray, qRT-PCR and bioinformatic analyses. A higher amount of CD68-, CD163- and CD206-positive GAMs in the vital tumor core was associated with beneficial patient survival. The mRNA expression profile of GAMs displayed an upregulation of factors that are considered as pro-inflammatory M1 (eg, CCL2, CCL3L3, CCL4, PTGS2) and anti-inflammatory M2 polarization markers (eg, MRC1, LGMN, CD163, IL10, MSR1), the latter rather being associated with phagocytic functions in the GBM microenvironment. In summary, we present evidence that human GBMs contain mixed M1/M2-like polarized GAMs and that the levels of different GAM subpopulations in the tumor core are positively associated with overall survival of patients with IDH1R132H-non-mutant GBMs.