单细胞追踪揭示黑色素瘤 TIL 治疗过程中肿瘤反应性 T 细胞的可塑性
Single-cell tracking reveals tumor-reactive T cell plasticity during melanoma TIL therapy.
TIL(肿瘤浸润淋巴细胞)过继细胞治疗可在转移性黑色素瘤中诱导持久缓解,然而在体外扩增过程中及回输后,调控肿瘤反应性T细胞命运的克隆和转录动态仍知之甚少。
英文原题:Tumor-infiltrating immune cell types predicting recurrence-free survival in melanoma patients receiving adjuvant PD-1 inhibitor therapy.
我们的发现表明,在“真实世界”患者队列中,免疫细胞浸润对辅助PD-1抑制剂治疗的疗效具有重要性。
基于PD-1的免疫疗法对黑色素瘤患者进行辅助治疗已改善了复发率,并成为标准治疗。然而,相当一部分患者在1-2年内复发,因此需要识别预测标志物。我们的研究旨在探讨特定免疫细胞亚群的瘤内浸润与接受辅助PD-1抑制剂治疗的黑色素瘤患者无复发生存期之间的关联。
选取48例接受辅助PD-1抑制剂治疗的黑色素瘤患者治疗前手术样本的存档石蜡块。通过免疫组化测定表达以下标志物的免疫细胞在肿瘤内的密度:CD8、FOXP3、CD20、CD103、CD134、PD-1和PD-L1,并分析其与无复发生存期的关联。
48例患者中有18例在随访期间出现复发。在该组中,显示强烈免疫细胞浸润(高于ROC曲线分析定义的截断值)的患者比例显著低于无复发患者,具体为CD8+ T细胞(2/18 vs. 16/30,p=0.0050)、CD103+组织驻留T细胞(2/18 vs. 13/30,p=0.0259)以及活化/免疫检查点标志物CD134(4/17 vs. 21/30,p=0.0029)和PD-1(2/18 vs. 14/30,p=0.0134),而FOXP3+细胞的评估则显示出接近显著的趋势(8/18 vs. 22/30,p=0.0663)。上述细胞类型的高瘤内密度伴随显著更长的无复发生存期。
BACKGROUND: Adjuvant treatment of melanoma patients with PD-1-based immunotherapy has improved recurrence rate, and became a standard treatment. However, a considerable proportion of patients recur within 1-2 years, necessitating the identification of predictive markers. Our study aimed to examine the association of intratumoral infiltration by specific immune cell subsets with the recurrence-free survival of melanoma patients receiving adjuvant PD-1 inhibitor therapy. MATERIALS AND METHODS: Archived paraffin blocks of pretreatment surgical samples from 48 melanoma patients receiving adjuvant PD-1 inhibitor therapy were selected. Intratumoral density of immune cells expressing the following markers: CD8, FOXP3, CD20, CD103, CD134, PD-1, and PD-L1 was determined by immunohistochemistry, and the associations with recurrence-free survival were analyzed. RESULTS: Eighteen of the 48 patients developed recurrence during the follow-up period. In this group the ratio of patients showing strong immune cell infiltration (higher than the cutoff values defined by ROC curve analysis) was significantly lower compared to recurrence-free patients in the case of CD8 + T cells (2/18 vs. 16/30, p=0.0050), CD103 + tissue resident T cells (2/18 vs. 13/30, p=0.0259), and the activation/immune checkpoint markers CD134 (4/17 vs. 21/30, p=0.0029) and PD-1 (2/18 vs. 14/30, p=0.0134), while the evaluation of FOXP3 + cells yielded near significant trend (8/18 vs. 22/30, p=0.0663). High intratumoral density of the above cell types was accompanied with significantly longer recurrence-free survival. CONCLUSIONS: Our findings indicate the importance of immune cell infiltration in the efficacy of adjuvant PD-1 inhibitor treatment in a "real world" patient cohort.
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