We conducted in vitro studies and a clinical trial for patients with squamous cell carcinoma of the head and neck (SCCHN) to study the relationship between FcγRIIIa polymorphisms and ADCC. In vitro, FcγRIIIa genotype was correlated with ADCC and innate cytotoxicity using NK (natural killer) cells harvested from healthy donors. In the phase II study, patients with recurrent or metastatic SCCHN were treated with cetuximab (500 mg/m2 IV every 2 weeks) and lenalidomide (25 mg daily). FcγRIIIa genotype and ex vivo ADCC were correlated with clinical response, progression-free survival (PFS), and overall survival (OS). In vitro, healthy donors with a FcγRIIIa 158-V allele demonstrated more effective ADCC against 2 colon cancer cell lines HT29 and SW480, mean cytotoxicity: FF 16.1%, VF/VV 24.3% (p=0.015) and FF 11.7%, VF/VV 21.0% (p=0.008), respectively. We observed a linear relationship between ADCC response and innate cytotoxicity. In the phase II trial, 40 patients received cetuximab and lenalidomide with median PFS 7.2 and OS 16.4 weeks. Thirty-six patients had FcγRIIIa genotype: VV (2), VF (20), FF (14) and 25 patients had sufficient NK cell yield to perform ex vivo ADCC. FcγRIIIa genotype was not associated with any clinical outcomes. Patients mounting ex-vivo ADCC response had a higher likelihood of stable disease (p=0.01) and trended toward increased PFS: 14 vs 6.8 weeks, respectively (p=0.13). Enhanced ex-vivo ADCC and innate immunity responses were more predictive of clinical response than FcγRIIIa and may offer a functional assay to select patients suitable for cetuximab therapy.
- Received October 10, 2014.
- Revision received January 13, 2015.
- Accepted January 29, 2015.
- Copyright © 2015, American Association for Cancer Research.