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PD-1/PD-L1 checkpoint inhibitors in combination with olaparib display antitumor activity in ovarian cancer patient-derived three-dimensional spheroid cultures


Immune checkpoint inhibitors (ICIs) that target programmed cell death protein 1 (PD-1) and programmed death-ligand 1 (PD-L1) have shown modest activity as monotherapies for the treatment of ovarian cancer (OC). The rationale for using these therapies in combination with poly (ADP-ribose) polymerase inhibitors (PARP-Is) has been described, and their in vivo application will benefit from ex vivo platforms that aid in the prediction of patient response or resistance to therapy. This study examined the effectiveness of detecting patient-specific immune-related activity in OC using three-dimensional (3D) spheroids. Immune-related cell composition and PD-1/PD-L1 expression status were evaluated using cells dissociated from fresh OC tissue from two patients prior to and following 3D culture. The patient sample with the greatest increase in the proportion of PD-L1 + cells also possessed more activated cytotoxic T cells and mature DCs compared to the other patient sample. Upon cytokine stimulation, patient samples demonstrated increases in cytotoxic T cell activation and DC major histocompatibility complex (MHC) class-II expression. Pembrolizumab increased cytokine secretion, enhanced olaparib cytotoxicity, and reduced spheroid viability in a T cell-dependent manner. Furthermore, durvalumab and olaparib combination treatment increased cell death in a synergistic manner. This work demonstrates that immune cell activity and functional modulation can be accurately detected using our ex vivo 3D spheroid platform, and it presents evidence for their utility to demonstrate sensitivity to ICIs alone or in combination with PARP-Is in a preclinical setting.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.





Breast-related cancer antigens 1 and 2


Dendritic cells


Granulocyte–macrophage colony-stimulating factor


Immune checkpoint inhibitor


Institutional Review Board


Interferon gamma


Interleukin-2; IL-10: Interleukin-10


IFNγ-induced protein 10


Macrophage inflammatory protein


Major histocompatibility complex


Major histocompatibility complex class-II


Ovarian cancer


Peripheral blood mononuclueated cells


Poly (ADP-ribose) polymerase inhibitors


Programmed cell death protein 1


Programmed death-ligand 1


Relative luminescence units


Standard deviation

T cell CM:

T cell expansion media


Tumor-infiltrating lymphocytes


Tumor immune microenvironment


Tumor necrosis factor alpha


Regulatory T cells


Vehicle control


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The authors would like to thank the patients for their participation in this study. We would also like to extend our appreciation to the ITOR Biorepository at Prisma Health for their support.


All work for this study was funded by KIYATEC, Inc.

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Authors and Affiliations



KMA designed the study, performed the experiments and data analysis, and wrote the manuscript; AKE performed the experiments, and wrote the manuscript; KL performed flow cytometry and immunofluorescence for cytokine stimulation experiments, and provided experimental design assistance; SS provided experimental design assistance and data review; LMH provided facilities/logistics for experimental performance; TMD directed the project, provided data review, and wrote the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Teresa M. DesRochers.

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Conflict of interest

Dr. Appleton, Ms. Elrod, Ms. Lassahn, Mr. Shuford, Ms. Holmes, and Dr. DesRochers are current employees of KIYATEC, Inc.

Ethical approval

Written informed consent was obtained from patients in accordance with the Institutional Review Board (IRB)-approved biology protocols by Prisma Health, formally known as Greenville Health System, Cancer Institute (IRB-Committee C).

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Appleton, K.M., Elrod, A.K., Lassahn, K.A. et al. PD-1/PD-L1 checkpoint inhibitors in combination with olaparib display antitumor activity in ovarian cancer patient-derived three-dimensional spheroid cultures. Cancer Immunol Immunother 70, 843–856 (2021).

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  • Immune checkpoint inhibitors
  • PARP inhibitors
  • Ovarian cancer
  • Spheroid
  • 3D cultures