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Intratumoral Cytokines and Tumor Cell Biology Determine Spontaneous Breast Cancer–Specific Immune Responses and Their Correlation to Prognosis

¹ Department of Obstetrics and Gynecology, University Hospital of Heidelberg, ² Translational Immunology Group, ³ Immunomonitoring Group, and Departments of ⁴ Theoretical Bioinformatics and ⁵ Molecular Immunology, German Cancer Research Center, and ⁶ Department of Pathology of the University Hospital of Heidelberg, Heidelberg, Germany; and ⁷ Vascular and Tumor Biology Research Center, Technion, Israel Institute of Technology, Haifa, Israel

Requests for reprints: Philipp Beckhove, Translational Immunology Group, German Cancer Research Center, Heidelberg, INF 280, 69120 Heidelberg, Germany. Phone: 0049-6221-423745; Fax: 0049-6221-423702; E-mail: p.beckhove{at}dkfz.de.

Spontaneous immune responses in cancer patients have been described. Yet their clinical relevance and the conditions for their generation remain unclear. We characterized conditions that determine immune responses in primary breast cancer patients. We used tetramer analysis, ex vivo IFN- ELISPOT, cytotoxicity assays, and ELISA in 207 untreated patients and 12 Her-2/neu–specific CD8 T-cell lines to evaluate tumor-specific T cells (TC) in the bone marrow or MUC1-specific antibodies in the blood. Multiplex analysis was performed to quantify 27 intratumoral cytokines, chemokines, and growth factors. Results were compared with multiple pathologic and clinical parameters of the patients and tumors. Forty percent of the patients showed tumor-specific TC responses. These correlated with tumors of high differentiation, estrogen receptor expression, and low proliferative activity, and with a reduced cancer mortality risk. High tumor cell differentiation correlated with increased intratumoral, but not plasma, concentrations of IFN- and reduced transforming growth factor (TGF)β1. In an in vitro priming experiment these two cytokines increased or inhibited, respectively, the capacity of dendritic cells to induce tumor-reactive TC. Tumor-specific B-cell responses, mainly of IgM isotype, were detectable in 50% of the patients and correlated with advanced tumor stage, increased TGFβ1, reduced IFN-, and absence of TC responses. We show here that different types of immune responses are linked to distinct cytokine microenvironments and correlate with prognosis-relevant differences in tumor pathobiology. These findings shed light on the relation between immune response and cancer prognosis. [Cancer Res 2009;69(21):8420–8]

Key Words: breast cancer • TC • antibodies • tumor pathology • IFN- • TGFβ1