1. KIR2DS1-HLA-C status as a predictive marker for benefit from rituximab: a post-hoc analysis of the RICOVER-60 and CLL8 trials
- Author
-
Kaddu-Mulindwa, Dominic, Altmann, Bettina, Robrecht, Sandra, Ziepert, Morita, Regitz, Evi, Tausch, Eugen, Held, Gerhard, Poeschel, Viola, Lesan, Vadim, Bittenbring, Joerg Thomas, Thurner, Lorenz, Pfreundschuht, Michael, Christofyllakis, Konstantinos, Truemper, Lorenz, Loeffler, Markus, Schmitz, Norbert, Hoth, Markus, Hallek, Michael, Fischer, Kirsten, Stilgenbauer, Stephan, Bewarder, Moritz, Rixecker, Torben Millard, Kaddu-Mulindwa, Dominic, Altmann, Bettina, Robrecht, Sandra, Ziepert, Morita, Regitz, Evi, Tausch, Eugen, Held, Gerhard, Poeschel, Viola, Lesan, Vadim, Bittenbring, Joerg Thomas, Thurner, Lorenz, Pfreundschuht, Michael, Christofyllakis, Konstantinos, Truemper, Lorenz, Loeffler, Markus, Schmitz, Norbert, Hoth, Markus, Hallek, Michael, Fischer, Kirsten, Stilgenbauer, Stephan, Bewarder, Moritz, and Rixecker, Torben Millard
- Abstract
Background The addition of rituximab to chemotherapy has substantially improved outcomes for patients with B-cell malignancies. The mechanisms of action of rituximab include activation of natural killer cells. Killer-cell immunoglobulin-like receptors (KIRs) mediate natural killer cell function through interaction with HLA. We evaluated the clinical impact of KIR-HLA genotypes on rituximab-containing therapy. Methods For this post-hoc analysis, we used data from the RICOVER-60 trial (NCT00052936) as the discovery cohort and the CLL8 trial (NCT00281918) as the validation cohort. RICOVER-60 included patients aged 61-80 years with aggressive B-cell lymphoma treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) with or without rituximab. CLL8 included patients aged 30-81 years with chronic lymphocytic leukaemia treated with chemotherapy (fludarabine and cyclophosphamide; FC) with or without rituximab. We evaluated the KIR and HLA-C status of 519 patients with available blood samples in the RICOVER-60 trial and the KIR2DS1 and HLA-C status of 549 patients with available blood samples in the CLL8 trial, and evaluated their associations with event-free survival (RICOVER-60), progression-free survival, and overall survival (RICOVER-60 and CLL8). Findings In the RICOVER-60 trial, 201 (39%) patients were positive for KIR2DS1, 79 (15%) were homozygous for HLA-C2, and 36 (7%) were positive for KIR2DS1 and homozygous for HLA-C2. In the CLL8 trial, 206 (38%) patients were positive for KIR2DS1, 75 (14%) were homozygous for HLA-C2, and 26 (5%) were positive for KIR2DS1 and homozygous for HLA-C2. In the RICOVER-60 trial, both KIR2DS1 and HLA-C status were identified as independent risk factors for survival. KIR2DS1 positivity, homozygosity for HLA-C2, and subsequent KIR2DS1-HLA-C status were associated with adverse clinical outcome in patients receiving rituximab-containing therapy (event-free survival for patients with KIR2DS1-HLA-C2/C2 vs all other patient
- Published
- 2022