blood-based multiplex kinase activity profiling as a predictive … · lam_51 - lam_57 - lam_53 -...

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1. S. Folkvord et al., Int J Radiat Oncol Biol Phys, 2010 2. S. Arni et al., Oncotarget 2017 3. W. Huber et al., Bioinformatics, 2002 4. E.A. Eisenhauer et al., Eur J Cancer, 2009 Acknowledgements: R. Debets, Erasmus MC Rotterdam [email protected] Presented at the American Society of Clinical Oncology Annual Meeting • Chicago, Illinois • June 1 - 5, 2018 Blood-based multiplex kinase activity profiling as a predictive marker for clinical response to checkpoint blockade in advanced melanoma D.P. Hurkmans 1 , E.M.E. Verdegaal 2 , S.A. Schindler 3 , E.A. Basak 1 , D.M.A. van den Heuvel 4 , R. de Wijn 4 , R. Ruijtenbeek 4 , J.P. Groten 4 , R. Dummer 3 , S.L.W. Koolen 1 , M.J.P. Welters 2 , R.H.J. Mathijssen 1 , E. Kapiteijn 2 , J.G.J.V. Aerts 5 , M.P. Levesque 3 , S.H. van der Burg 2 1. Dept. of Medical Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands; 2. Dept. of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands; 3. Dept. of Dermatology, University Hospital Zurich, Zurich, Switzerland; 4. PamGene International B.V., ‘s-Hertogenbosch, The Netherlands: 5. Dept. of Pulmonology, Erasmus University Medical Center, Rotterdam, The Netherlands •There is an urgent need for response prediction to checkpoint inhibitor therapies. •A significant proportion of patients does not benefit from the treatment, agents are costly and may cause serious toxicity. •Kinase activity of peripheral blood cells (PBMCs) may reflect biological mechanisms underlying response to immunotherapy. •In a multi-center effort, data were prospectively collected from anti-CTLA4- or anti-PD1 treated advanced melanoma patients (n=143; table 1). •Kinase activity profiles were generated by analyzing phosphorylation signatures of PBMC lysates on a peptide micro-array. •The PamChip (PamGene, Netherlands) microarray comprises 144 different peptides derived from protein phosphorylation sites that are substrates for protein tyrosine kinases 1 . •Predictive models were trained using Partial Least Squares Discriminant Analysis (PLS-DA) 2 with log-transformed (anti-CTLA4) or VSN normalized (anti-PD1) 3 PamChip data. Predictive performance of the models was evaluated by estimating the Correct Classification rate (CCR) using cross-validation 2 . •Binary grouping in responder and non-responder to therapy (table 2) was based on RECIST v1.1 4 . •Kinase activity profiles of PBMC samples prior to checkpoint inhibitor therapy can predict the likelihood of response to anti-PD1 or anti-CTLA4 therapy. •This assay may serve as a rapid and fast predictive liquid biomarker to stratify patients prior to treatment. •Heparin collection tubes displays a stable kinase activity profile, whereas EDTA interferes with kinase activity over time. •Results suggest the involvement of immune receptor kinases, underlying the mechanism of response to checkpoint inhibitor therapy. Background Methods Conclusions Cohort 1 (n=10) Cohort 2 (n=29) Cohort 3 (n=33) Cohort 4 (n=33) Cohort 5 (n=38) Total (n=143) Gender Male 6 (60%) 13 (45%) 18 (55%) 22 (67%) 22 (58%) 81 (57%) Female 4 (40%) 16 (55%) 15 (45%) 11 (33%) 16 (42%) 62 (43%) Age at start (years) Mean (±SD) 59,4 (±15.2) 58,6 (±12.9) 62,7 (±10.7) 62,7 (±14.3) 60,7 (±14.2) 61,1 (±13.2) Therapy Nivolumab - - 1 (3%) 2 (6%) 14 (37%) 17 (12%) Pembrolizumab - - 30 (91%) 31 (94%) 23 (61%) 84 (59%) Ipilimumab 10 (100%) 29 (100%) - - - 39 (27%) Nivo + ipi - - 2 (6%) - 1 (3%) 3 (2%) Number of pre-treatment lines None 3 (30%) 12 (41%) 20 (61%) - 30 (79%) 65 (45%) 1 6 (60%) 8 (28%) 11 (33%) 17 (52%) 7 (18%) 49 (34%) 2 1 (10%) - 2 (6%) 9 (27%) 1 (3%) 13 (9%) 3 - - - 7 (21%) - 7 (5%) Unknown - 9 (31%) - - - 9 (6%) Pre-treatment with immunotherapy Yes - 2 (7%) 2 (6%) 33 (100%) 2 (5%) 39 (27%) No 10 (100%) 18 (62%) 29 (88%) - 36 (95%) 93 (65%) Unknown - 9 (31%) 2 (6%) - - 11 (8%) Figure 1. Kinase activity is measured in baseline PBMC samples, isolated from blood collected before immunotherapy onset, using the PamChip peptide microarray system. The PamChip consists of identical arrays, each containing 144 unique protein tyrosine kinase phosphorylation sites. Kinase activity in PBMC protein lysates is measured in time and analyzed using BioNavigator software. Responder Non-Responder Model 1: BOR CR/PR/SD PD Model 2: PFS Late/no progression Early progression (<140 d) Table 2. Responder and non-responder definitions based on BOR (model 1) and PFS (model 2). Results Treatment Patients Prediction CCR % (90%CI) Cohort 1 Anti-CTLA4 N=10 100%(90%CI 74-100%) 1 Cohort 2 Anti-CTLA4 N=29 83% (90%CI 67-93%) 1 Cohort 3 Anti-PD1 N=33 70%(90%CI 54-83%) 1 Cohort 4 Anti-PD1 N=33 70%(90%CI 54-83%) 2 Cohort 5 Anti-PD1 N=38 75%(90%CI 59-85%) 1 Table 3. Response classification based on RECIST v1.1: 1 model 1 or 2 model 2. Table 1. Descriptive characteristics of advanced melanoma patients Abstract ID: 9578 References Peptides Healthy control: Blood collection tube: Early (<4h) or late (24h) PBMC isolation: Figure 3. Late PBMC isolation from EDTA collection tubes, 24h after blood collection, results in a strong decrease in kinase activity compared to early PBMC isolation (<4h). For PBMCs isolated from Na-heparin collection tubes no effect on overall kinase activity is detected. Figure 2. Data visualization showing the correlation between kinase activity profiles and treatment response for two examples from table 3. A: protein tyrosine kinase activity profiles for cohort 2 (anti-CTLA4) shown as a heatmap with relatively high activity shown in green relatively low activity in blue. B: PLS-DA Prediction scores obtained by cross-validation showing the performance of response prediction (non-responder vs. responder) for cohort 2. C: protein tyrosine kinase activity profiles for cohort 3 (anti-PD1) shown as a heatmap with relatively high activity shown in orange and relatively low activity in blue. D: PLS-DA Prediction scores obtained by cross-validation showing the performance of response prediction (non-responder vs. responder) for cohort 3. A B C D HG14.788 - HG14.851 - HG14.904 - HG14.49 - HG14.921 - HG15.245 - HG14.297 - HG14.880 - HG14.882 - HG14.487 - HG13.1188 - HG15.1494 - HG15.1050 - HG14.574 - HG15.672 - HG15.374 - HG15.101 - HG14.984 - HG14.191 - HG13.678 - HG15.1149 - HG13.1699 - HG14.786 - HG14.626 - HG15.1428 - HG13.475 - HG13.942 - HG15.454 - HG15.792 - Patient code Prediction score -1.0 0.0 1.0 LAM_83 - LAM_75 - LAM_84 - LAM_48 - LAM_72 - LAM_45 - LAM_51 - LAM_57 - LAM_53 - LAM_86 - LAM_68 - LAM_79 - LAM_66 - LAM_56 - LAM_58 - LAM_50 - LAM_89 - LAM_90 - LAM_74 - LAM_81 - LAM_54 - LAM_64 - LAM_62 - LAM_73 - LAM_82 - LAM_55 - LAM_87 - LAM_91 - LAM_85 - LAM_63 - LAM_49 - LAM_88 - LAM_52 - Prediction score -1.0 0.0 0.5 -0.5 1.0 Patient code Response Non-responder Responder 15.0 6.0 low 2 log signal intensity high 50000 - 40000 - 30000 - 20000 - 10000 - 0 - EDTA Heparin 1 2 3 4 1 2 3 4 Early Late Early Late Early Late Early Late Early Late Early Late Early Late Early Late TK ATP ADP Kinase +Antibody -1.5 1.5 -1.5 1.5

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  • 1. S. Folkvord et al., Int J Radiat Oncol Biol Phys, 2010 2. S. Arni et al., Oncotarget 2017 3. W. Huber et al., Bioinformatics, 2002 4. E.A. Eisenhauer et al., Eur J Cancer, 2009

    Acknowledgements: R. Debets, Erasmus MC Rotterdam [email protected]

    Presented at the American Society of Clinical Oncology Annual Meeting • Chicago, Illinois • June 1 - 5, 2018

    Blood-based multiplex kinase activity profiling as a predictive marker for clinical response to checkpoint blockade in advanced melanoma

    D.P. Hurkmans1, E.M.E. Verdegaal2, S.A. Schindler3, E.A. Basak1, D.M.A. van den Heuvel4, R. de Wijn4, R. Ruijtenbeek4, J.P. Groten4, R. Dummer3, S.L.W. Koolen1, M.J.P. Welters2, R.H.J. Mathijssen1, E. Kapiteijn2, J.G.J.V. Aerts5, M.P. Levesque3, S.H. van der Burg2

    1. Dept. of Medical Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands; 2. Dept. of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands; 3. Dept. of Dermatology, University Hospital Zurich, Zurich, Switzerland; 4. PamGene International B.V., ‘s-Hertogenbosch, The Netherlands: 5. Dept. of Pulmonology, Erasmus University Medical Center, Rotterdam, The Netherlands

    •There is an urgent need for response prediction to checkpoint inhibitor therapies.

    •A significant proportion of patients does not benefit from the treatment, agents are costly

    and may cause serious toxicity.

    •Kinase activity of peripheral blood cells (PBMCs) may reflect biological mechanisms

    underlying response to immunotherapy.

    •In a multi-center effort, data were prospectively collected from anti-CTLA4- or anti-PD1

    treated advanced melanoma patients (n=143; table 1).

    •Kinase activity profiles were generated by analyzing phosphorylation signatures of PBMC

    lysates on a peptide micro-array.

    •The PamChip (PamGene, Netherlands) microarray comprises 144 different peptides derived

    from protein phosphorylation sites that are substrates for protein tyrosine kinases1.

    •Predictive models were trained using Partial Least Squares Discriminant Analysis (PLS-DA)2

    with log-transformed (anti-CTLA4) or VSN normalized (anti-PD1)3 PamChip data. Predictive

    performance of the models was evaluated by estimating the Correct Classification rate (CCR)

    using cross-validation2.

    •Binary grouping in responder and non-responder to therapy (table 2) was based on RECIST

    v1.14.

    •Kinase activity profiles of PBMC samples prior to checkpoint inhibitor therapy can predict

    the likelihood of response to anti-PD1 or anti-CTLA4 therapy.

    •This assay may serve as a rapid and fast predictive liquid biomarker to stratify patients prior

    to treatment.

    •Heparin collection tubes displays a stable kinase activity profile, whereas EDTA interferes

    with kinase activity over time.

    •Results suggest the involvement of immune receptor kinases, underlying the mechanism of

    response to checkpoint inhibitor therapy.

    Background Methods Conclusions

    Cohort 1 (n=10) Cohort 2 (n=29) Cohort 3 (n=33) Cohort 4 (n=33) Cohort 5 (n=38) Total (n=143)

    Gender

    Male 6 (60%) 13 (45%) 18 (55%) 22 (67%) 22 (58%) 81 (57%)

    Female 4 (40%) 16 (55%) 15 (45%) 11 (33%) 16 (42%) 62 (43%)

    Age at start (years)

    Mean (±SD) 59,4 (±15.2) 58,6 (±12.9) 62,7 (±10.7) 62,7 (±14.3) 60,7 (±14.2) 61,1 (±13.2)

    Therapy

    Nivolumab - - 1 (3%) 2 (6%) 14 (37%) 17 (12%)

    Pembrolizumab - - 30 (91%) 31 (94%) 23 (61%) 84 (59%)

    Ipilimumab 10 (100%) 29 (100%) - - - 39 (27%)

    Nivo + ipi - - 2 (6%) - 1 (3%) 3 (2%)

    Number of pre-treatment lines

    None 3 (30%) 12 (41%) 20 (61%) - 30 (79%) 65 (45%)

    1 6 (60%) 8 (28%) 11 (33%) 17 (52%) 7 (18%) 49 (34%)

    2 1 (10%) - 2 (6%) 9 (27%) 1 (3%) 13 (9%)

    3 - - - 7 (21%) - 7 (5%)

    Unknown - 9 (31%) - - - 9 (6%)

    Pre-treatment with immunotherapy

    Yes - 2 (7%) 2 (6%) 33 (100%) 2 (5%) 39 (27%)

    No 10 (100%) 18 (62%) 29 (88%) - 36 (95%) 93 (65%)

    Unknown - 9 (31%) 2 (6%) - - 11 (8%)

    Figure 1. Kinase activity is measured in baseline PBMC samples, isolated from blood collected before immunotherapy onset, using the PamChip peptide microarray system. The PamChip consists of identical arrays, each containing 144 unique protein tyrosine kinase phosphorylation sites. Kinase activity in PBMC protein lysates is measured in time and analyzed using BioNavigator software.

    Responder Non-Responder

    Model 1: BOR CR/PR/SD PD

    Model 2: PFS Late/no progression Early progression (