Preexisting BCG-specific T cells improve intravesical immunotherapy for bladder cancer

Biot, Claire; Rentsch, Cyrill A; Gsponer, Joel R; Birkhäuser, Frédéric D; Jusforgues-Saklani, Hélène; Lemaître, Fabrice; Auriau, Charlotte; Bachmann, Alexander; Bousso, Philippe; Demangel, Caroline; Peduto, Lucie; Thalmann, George N; Albert, Matthew L (2012). Preexisting BCG-specific T cells improve intravesical immunotherapy for bladder cancer. Science translational medicine, 4(137), 137ra72. Washington, D.C.: American Association for the Advancement of Science 10.1126/scitranslmed.3003586

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Therapeutic intravesical instillation of bacillus Calmette-Guérin (BCG) is effective at triggering inflammation and eliciting successful tumor immunity in patients with non-muscle invasive bladder cancer, with 50 to 70% clinical response. Therapeutic success relies on repeated instillations of live BCG administered as adjuvant therapy shortly after tumor resection; however, the precise mechanisms remain unclear. Using an experimental model, we demonstrate that after a single instillation, BCG could disseminate to bladder draining lymph nodes and prime interferon-γ-producing T cells. Nonetheless, repeated instillations with live BCG were necessary for a robust T cell infiltration into the bladder. Parenteral exposure to BCG before instillation overcame this requirement; after the first intravesical instillation, BCG triggered a more robust acute inflammatory process and accelerated T cell entry into the bladder, as compared to the standard protocol. Moreover, parenteral exposure to BCG before intravesical treatment of an orthotopic tumor markedly improved response to therapy. Indeed, patients with sustained preexisting immunity to BCG showed a significant improvement in recurrence-free survival. Together, these data suggest that monitoring patients' response to purified protein derivative, and, in their absence, boosting BCG responses by parenteral exposure before intravesical treatment initiation, may be a safe and effective means of improving intravesical BCG-induced clinical responses.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Birkhäuser, Frédéric, Thalmann, George

ISSN:

1946-6234

Publisher:

American Association for the Advancement of Science

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:38

Last Modified:

05 Dec 2022 14:12

Publisher DOI:

10.1126/scitranslmed.3003586

PubMed ID:

22674550

Web of Science ID:

000305075700003

URI:

https://boris.unibe.ch/id/eprint/15428 (FactScience: 222773)

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