Publications by authors named "Kellie N Smith"

Article Synopsis
  • Co-mutations of KRAS and STK11 genes in advanced non-small cell lung cancer (NSCLC) are linked to resistance against immune checkpoint blockade (ICB) therapies, although their impact in patients receiving neoadjuvant chemoimmunotherapy remains unclear.
  • A study investigated how these gene mutations affect recurrence-free survival in resectable KRAS-mutated NSCLC, revealing that those with co-occurring STK11 mutations had a higher risk of recurrence compared to those without.
  • Analysis of tumor-infiltrating T cells indicated that the presence of STK11 mutations altered T cell behavior, suggesting that certain T cell characteristics might hinder effective anti-tumor immune responses in patients with KRASmut/STK11
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  • Anti-HMGCR-positive immune-mediated necrotising myopathy (IMNM) is linked to IgG autoantibodies against HMGCR and specific HLA-DR alleles, but HMGCR-specific CD4T-cells had not been previously identified in affected patients.
  • This study demonstrated that patients with anti-HMGCR+IMNM show heightened CD4T-cell responses to HMGCR compared to those with dermatomyositis, with a significant correlation between these responses and the levels of anti-HMGCR antibodies.
  • The presence of distinct HMGCR-reactive CD4T-cells in both blood and muscle tissues highlights their potential role in the disease's development.
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Background: There are increasing numbers of metabolomic studies in food allergy (FA) and asthma, which, however, are predominantly limited by cross-sectional designs, small sample size, and being conducted in European populations.

Objective: We sought to identify metabolites unique to and shared by children with FA and/or asthma in a racially diverse prospective birth cohort, the Boston Birth Cohort.

Methods: Mass spectrometry-based untargeted metabolomic profiling was performed using venous plasma collected in early childhood (n = 811).

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Gastroesophageal cancer dynamics and drivers of clinical responses with immune checkpoint inhibitors (ICI) remain poorly understood. Potential synergistic activity of dual programmed cell death protein 1 (PD-1) and lymphocyte-activation gene 3 (LAG-3) inhibition may help improve immunotherapy responses for these tumors. We report a phase Ib trial that evaluated neoadjuvant nivolumab (Arm A, n = 16) or nivolumab-relatlimab (Arm B, n = 16) in combination with chemoradiotherapy in 32 patients with resectable stage II/stage III gastroesophageal cancer together with an in-depth evaluation of pathological, molecular and functional immune responses.

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Bivalent COVID vaccines containing mRNA for ancestral and Omicron BA.5 spike proteins do not induce stronger T cell responses to Omicron BA.5 spike proteins than monovalent vaccines that contain only ancestral spike mRNA.

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Unlabelled: While tyrosine kinase inhibitors (TKI) have shown remarkable efficacy in anaplastic lymphoma kinase (ALK) fusion-positive advanced non-small cell lung cancer (NSCLC), clinical outcomes vary and acquired resistance remains a significant challenge. We conducted a retrospective study of patients with ALK-positive NSCLC who had clinico-genomic data independently collected from two academic institutions (n = 309). This was paired with a large-scale genomic cohort of patients with ALK-positive NSCLC who underwent liquid biopsies (n = 1,118).

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The latent reservoir of HIV persists for decades in people living with HIV (PWH) on antiretroviral therapy (ART). To determine if persistence arises from the natural dynamics of memory CD4+ T cells harboring HIV, we compared the clonal dynamics of HIV proviruses to that of memory CD4+ T cell receptors (TCRβ) from the same PWH and from HIV-seronegative people. We show that clonal dominance of HIV proviruses and antigen-specific CD4+ T cells are similar but that the field's understanding of the persistence of the less clonally dominant reservoir is significantly limited by undersampling.

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Understanding cancer immunobiology has been hampered by difficulty identifying cancer-specific T cells. Merkel cell polyomavirus (MCPyV) causes most Merkel cell carcinomas (MCCs). All patients with virus-driven MCC express MCPyV oncoproteins, facilitating identification of virus (cancer)-specific T cells.

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  • - Stereotactic ablative body radiation (SABR) shows promise for treating early-stage non-small cell lung cancer (NSCLC), with 83% of patients remaining alive without tumor progression at a median follow-up of 40 months.
  • - The study examined the immune and pathological effects of SABR by analyzing blood and tumor biopsies from six patients before and after treatment, focusing on immune-cell populations and T-cell receptor changes.
  • - While early post-SABR biopsies revealed viable tumors and maintained immune-cell populations, a subset of patients exhibited a temporary increase in neoantigen-specific T-cells after treatment, suggesting that SABR can provoke a delayed immune response.
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Article Synopsis
  • Regulatory T cells (T) are traditionally seen as suppressors of antitumor immunity, but their influence on immune checkpoint blockade (ICB) responses remains uncertain.
  • This study used advanced sequencing techniques to analyze over 73,000 tumor-infiltrating T cells from both anti-PD-1 treated and untreated lung cancer patients, identifying 10 distinct T cell subsets, with one subset showing high expression of activation markers linked to immune suppression.
  • The findings suggest that not all TIL-Ts are detrimental; a specific subset may help enhance responses to therapy, illustrating the complex role of TIL-Ts in cancer treatment.
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BACKGROUNDHIV-1-infected CD4+ T cells contribute to latent reservoir persistence by proliferating while avoiding immune recognition. Integration features of intact proviruses in elite controllers (ECs) and people on long-term therapy suggest that proviruses in specific chromosomal locations can evade immune surveillance. However, direct evidence of this mechanism is missing.

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Article Synopsis
  • * Unlike traditional neoadjuvant therapies that mainly aim to shrink tumors, neoadjuvant ICB works by boosting the body's immune response against the cancer, enhancing T cell activity within and beyond the tumor.
  • * This approach not only helps in understanding how ICB works and which patients might respond best, but it also opens doors for developing more effective combined therapies for better long-term results against various cancers.
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Purpose: Neoadjuvant anti-PD-1 therapy has shown promise for resectable non-small cell lung cancer (NSCLC). We reported the first phase I/II trial of neoadjuvant nivolumab in resectable NSCLC, finding it to be safe and feasible with encouraging major pathological responses (MPR). We now present 5-year clinical outcomes from this trial, representing to our knowledge, the longest follow-up data for neoadjuvant anti-PD-1 in any cancer type.

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  • A phase 1 trial was conducted to assess the safety and early effectiveness of durvalumab (D) alone and in combination with BCG or EBRT for treating patients with non-muscle-invasive bladder cancer (NMIBC) who did not respond to standard BCG therapy.
  • Patients received D every 3 weeks for eight cycles, with some also receiving BCG or EBRT, and outcomes were measured using cystoscopy, urine cytology, and bladder biopsies at 3 and 6 months.
  • Results showed that 64% of patients achieved a complete response at 3 months, with notable responses in combination therapy groups, suggesting that D combined with BCG or EBRT is safe and warrants further investigation.
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Tumor mutation burden is an imperfect proxy of tumor foreignness and has therefore failed to consistently demonstrate clinical utility in predicting responses in the context of immunotherapy. We evaluated mutations in regions of the genome that are unlikely to undergo loss in a pan-cancer analysis across 31 tumor types (n = 9,242) and eight immunotherapy-treated cohorts of patients with non-small-cell lung cancer, melanoma, mesothelioma, and head and neck cancer (n = 524). We discovered that mutations in single-copy regions and those present in multiple copies per cell constitute a persistent tumor mutation burden (pTMB) which is linked with therapeutic response to immune checkpoint blockade.

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Metastatic ovarian cancer is a significant clinical challenge due in part to its poor response to immunotherapy. In a recent issue of Cancer Cell, Anandon et al. (2022) identify a population of stem-like tissue-resident memory T cells that are responsible for the bulk of anti-tumor T cell immunity, with insights into improving therapeutic response.

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Background: Despite treatment advancements with immunotherapy, our understanding of response relies on tissue-based, static tumor features such as tumor mutation burden (TMB) and programmed death-ligand 1 (PD-L1) expression. These approaches are limited in capturing the plasticity of tumor-immune system interactions under selective pressure of immune checkpoint blockade and predicting therapeutic response and long-term outcomes. Here, we investigate the relationship between serial assessment of peripheral blood cell counts and tumor burden dynamics in the context of an evolving tumor ecosystem during immune checkpoint blockade.

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Article Synopsis
  • Transcription factors ThPOK and Runx3 dictate the development of CD4+ helper and CD8+ cytotoxic T cells, respectively, leading to single positive (SP) T cells entering the body with either CD4 or CD8 co-receptors.
  • Double positive (DP) T cells, which express both co-receptors, are found in healthy individuals and increased in diseased states, but their roles remain debated.
  • Research shows that in tumors, SP T cells can revert to DP T cells and gain traits of the opposite lineage after TCR stimulation, demonstrating their potential for enhanced tumor reactivity.
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Background: COVID-19 mRNA vaccines elicit strong T and B cell responses to the SARS-CoV-2 spike glycoprotein in both SARS-CoV-2 naïve and experienced patients. However, it is unknown whether the post-vaccine CD4+ T cell responses seen in patients with a history of COVID-19 are due to restimulation of T cell clonotypes that were first activated during natural infection or if they are the result of new clones activated by the vaccine.

Methods: To address this question, we analyzed the SARS-CoV-2 spike glycoprotein-specific CD4+ T cell receptor repertoire before and after vaccination in 10 COVID-19 convalescent patients and 4 SARS-CoV-2 naïve healthy donor vaccine recipients.

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Recent studies have shown that vaccinated individuals harbor T cells that can cross-recognize SARS-CoV-2 and endemic human common cold coronaviruses. However, it is still unknown whether CD4+ T cells from vaccinated individuals recognize peptides from bat coronaviruses that may have the potential of causing future pandemics. In this study, we identified a SARS-CoV-2 spike protein epitope (S815-827) that is conserved in coronaviruses from different genera and subgenera, including SARS-CoV, MERS-CoV, multiple bat coronaviruses, and a feline coronavirus.

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Mesothelioma is a rare and fatal cancer with limited therapeutic options until the recent approval of combination immune checkpoint blockade. Here we report the results of the phase 2 PrE0505 trial ( NCT02899195 ) of the anti-PD-L1 antibody durvalumab plus platinum-pemetrexed chemotherapy for 55 patients with previously untreated, unresectable pleural mesothelioma. The primary endpoint was overall survival compared to historical control with cisplatin and pemetrexed chemotherapy; secondary and exploratory endpoints included safety, progression-free survival and biomarkers of response.

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PD-1 blockade unleashes CD8 T cells, including those specific for mutation-associated neoantigens (MANA), but factors in the tumour microenvironment can inhibit these T cell responses. Single-cell transcriptomics have revealed global T cell dysfunction programs in tumour-infiltrating lymphocytes (TIL). However, the majority of TIL do not recognize tumour antigens, and little is known about transcriptional programs of MANA-specific TIL.

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T-cell receptor sequencing (TCRseq) enables tracking of T-cell clonotypes recognizing the same antigen over time and across biological compartments. TCRseq has been used to test if cross-reactive antitumor T cells are responsible for development of immune-related adverse events (irAEs) following immune checkpoint blockade. Prior studies have interpreted T-cell clones shared among the tumor and irAE as evidence supporting this, but interpretations of these findings are challenging, given the constraints of TCRseq.

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BACKGROUNDRecent studies have reported T cell immunity to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in unexposed donors, possibly due to crossrecognition by T cells specific for common cold coronaviruses (CCCs). True T cell crossreactivity, defined as the recognition by a single TCR of more than one distinct peptide-MHC ligand, has never been shown in the context of SARS-CoV-2.METHODSWe used the viral functional expansion of specific T cells (ViraFEST) platform to identify T cell responses crossreactive for the spike (S) glycoproteins of SARS-CoV-2 and CCCs at the T cell receptor (TCR) clonotype level in convalescent COVID-19 patients (CCPs) and SARS-CoV-2-unexposed donors.

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