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。
英文原题:Tumor-Infiltrating CD103+ Tissue-Resident Memory T Cells and CD103-CD8+ T Cells in HNSCC Are Linked to Outcome in Primary but not Metastatic Disease.
我们证实了 TIL 在原发肿瘤和复发肿瘤中的预后影响。
目的:大量TIL(肿瘤浸润淋巴细胞)与癌症患者生存改善相关。组织驻留记忆T细胞(TRM;CD8+CD103+)是抗癌免疫应答的关键参与者。为评估原发、转移和复发头颈部鳞状细胞癌(HNSCC)中的TRM,研究人员构建组织芯片(TMA),并开展多重免疫组化(MxIHC)。实验设计:收集并分析2000至2016年在南安普敦医院接受治疗的379例HNSCC原发肿瘤样本,其中105例有淋巴结转移,82例复发。每份样本制备含三个重复组织芯的TMA。采用CD8、CD103和TIM3进行染色-剥离式多重IHC;扫描切片后进行数字图像分析及质量控制。结果:质量控制后,194例原发肿瘤、76例淋巴结转移和65例复发样本可评估。饮酒与原发肿瘤TRM细胞减少显著相关(不饮酒与重度饮酒比较:P=0.0036)。已知TRM浸润可改善原发肿瘤生存,但在淋巴结转移中未发现这一关系。复发病例中,TRM细胞数量较高与12个月后结局较佳相关。与原发肿瘤相比,淋巴结转移中的检查点分子TIM3在TRM和非TRM细胞上表达均显著更高(P<0.0001);复发样本中也观察到这一现象(分别P=0.0134和P=0.0007)。结论:研究证实TIL对原发肿瘤及复发病例具有预后意义,但淋巴结转移中的TRM密度与结局无关。TIM3作为治疗靶点的作用仍待明确。
PURPOSE: High numbers of tumor-infiltrating lymphocytes (TIL) are linked to better survival in patients with cancer. Tissue-resident memory T cells (TRM; CD8+CD103+) are recognized as a key player of anticancer immune response. To assess TRM cells in primary, metastatic, and recurrent head and neck squamous cell carcinoma (HNSCC), we developed a tissue microarray (TMA) and used multiplex IHC (MxIHC). EXPERIMENTAL DESIGN: Samples from primary tumors of 379 HNSCC cases treated at Southampton Hospitals between 2000 and 2016 were collected and analyzed. Of these, 105 cases had lymph node metastases and 82 recurrences. A TMA was generated with triplicate cores for each sample. MxIHC with a stain-and-strip approach was performed using CD8, CD103, and TIM3. Scanned slides were analyzed (digital image analysis) and quality checked (QC). RESULTS: After QC, 194 primary tumors, 76 lymph node metastases, and 65 recurrences were evaluable. Alcohol consumption was statistically significantly correlated with a reduction of TRM cells in primary tumors (nondrinker vs. heavy drinker: P = 0.0036). The known survival benefit of TRM cell infiltration in primary tumors was not found for lymph node metastasis. In recurrences, a high TRM cell number led to a favorable outcome after 12 months. The checkpoint molecule TIM3, was expressed significantly higher on TRM and non-TRM cells in the lymph node compared with primary tumors (P < 0.0001), which was also seen in recurrences (P = 0.0134 and P = 0.0007, respectively). CONCLUSIONS: We confirm the prognostic impact of TIL in primary tumors and in recurrences. TRM cell density in lymph node metastases was not linked to outcome. The role of TIM3, as a therapeutic target remains to be defined.
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