帕博利珠单抗联合二甲双胍治疗转移性头颈部癌的 II 期可行性研究
A Phase II Feasibility Study Combining Pembrolizumab and Metformin in Patients with Metastatic Head and Neck Cancer.
二甲双胍联合帕博利珠单抗耐受性良好,仅出现轻度胃肠道不良事件,并展现出有前景的活性,值得在随机试验中进一步研究。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Intratumoral CD103(+) CD8(+) T cells predict response to neoadjuvant chemoimmunotherapy in advanced head and neck squamous cell carcinoma.
Intratumoral CD103(+) CD8(+) T cells predict response to neoadjuvant chemoimmunotherapy in advanced head and neck squamous cell carcinoma.
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我们的研究揭示了瘤内 CD103 + CD8 + TILs 密度对不同癌症中 NACI 疗效的影响,而提升其数量的尝试尚需进一步的临床研究。
免疫细胞异质性被认为会影响癌症进展过程中的治疗应答。新辅助化学免疫治疗(NACI)已为部分晚期头颈部鳞状细胞癌(HNSCC)患者带来临床获益,但其应答背后的机制尚不清楚。要提高 NACI 疗效,需要找到能够准确预测临床应答的生物标志物。本研究旨在鉴定可预测晚期 HNSCC 患者 NACI 应答的分子。
研究对接受 NACI 的 HNSCC 患者肿瘤样本开展单细胞 RNA 测序(scRNA-seq)和多重免疫组化(mIHC),以鉴定与临床应答相关的新型肿瘤浸润细胞(TIL)亚型——CD103⁺CD8⁺ TIL;同时通过体外和体内实验评估其抗肿瘤效能。研究还利用 scRNA-seq 数据开展细胞间相互作用分析,并对 mIHC 图像进行空间分析,以考察 CD103⁺CD8⁺ TIL 群体的调节机制。
研究发现,肿瘤内 CD103⁺CD8⁺ TIL 密度可决定癌症 NACI 疗效。scRNA-seq 结果显示,NACI 应答者中的 CD103⁺CD8⁺ TIL 群体显著增加;mIHC 分析进一步证实,HNSCC 患者肿瘤内 CD103⁺CD8⁺ TIL 密度与 NACI 疗效相关。后续受试者工作特征曲线分析表明,该 TIL 亚群是预测患者 NACI 应答的有力标志物。功能实验显示,CD103⁺CD8⁺ TIL 是肿瘤反应性 T 细胞;PD-1 阻断可增强 CD103⁺CD8⁺ TIL 在体内抑制肿瘤生长的细胞毒性。从机制上看,靶向表达髓系细胞触发受体 2(TREM2⁺)的巨噬细胞,可能增加 CD103⁺CD8⁺ TIL 群体,并促进 NACI 治疗期间的抗肿瘤免疫。
本研究强调肿瘤内 CD103⁺CD8⁺ TIL 密度对不同癌症 NACI 疗效的影响,但提高该细胞群体数量的策略仍需进一步临床研究。
Immune cell heterogenicity is known to determine the therapeutic response to cancer progression. Neoadjuvant chemoimmunotherapy (NACI) has shown clinical benefits in some patients with advanced head and neck squamous cell carcinoma (HNSCC), but the underlying mechanism behind this clinical response is unknown. The efficacy of NACI needs to be potentiated by identifying accurate biomarkers to predict clinical responses. Here, we attempted to identify molecules predicting NACI response in advanced HNSCC.
We performed combined single-cell RNA sequencing (scRNA-seq) and multiplex immunofluorescence (mIHC) staining with tumor samples derived from NACI-treated HNSCC patients to identify a new tumor-infiltrating cell (TIL) subtype, CD103 + CD8 + TILs, associated with clinical response, while both in vitro and in vivo assays were carried out to determine its antitumor efficiency. The regulatory mechanism of the CD103 + CD8 + TILs population was examined by performing cell-cell interaction analysis of the scRNA-seq data and spatial analysis of the mIHC images.
We established intratumoral CD103 + CD8 + TILs density as a determinant of NACI efficacy in cancers. Our scRNA-seq results indicated that the population of CD103 + CD8 + TILs was dramatically increased in the responders of NACI-treated HNSCC patients, while mIHC analysis confirmed the correlation between intratumoral CD103 + CD8 + TILs density and NACI efficacy in HNSCC patients. Further receiver operating characteristic curve analysis defined this TIL subset as a potent marker to predict patient response to NACI. Functional assays showed that CD103 + CD8 + TILs were tumor-reactive T cells, while programmed cell death protein-1 (PD-1) blockade enhanced CD103 + CD8 + TILs cytotoxicity against tumor growth in vivo. Mechanistically, targeting the triggering receptor expressed on myeloid cells 2-positive (TREM2 + ) macrophages might enhance the population of CD103 + CD8 + TILs and facilitate antitumor immunity during NACI treatment.
Our study highlights the impact of intratumoral CD103 + CD8 + TILs density on NACI efficacy in different cancers, while the efforts to elevate its population warrant further clinical investigation.
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