γδ T 细胞调节小细胞肺癌中的抗肿瘤免疫
γδ T cells modulate anti-tumor immunity in small cell lung cancer.
我们的发现表明,活化的γδ T细胞可能是SCLC治疗的有价值靶点。
英文原题:Early On-Treatment Expansion of Peripheral γδT Cells as a Noninvasive Biomarker of Response to Programmed Death-1 Inhibitor Therapy in Advanced Non-Small Cell Lung Cancer.
早期治疗诱导的外周γδ T细胞扩增与PD-1抑制剂治疗期间的客观临床反应、肿瘤负荷降低和有利的细胞因子重塑相关。外周γδ T细胞的动态监测可能是一种有前景的非侵入性生物标志物,用于早期评估晚期非小细胞肺癌的治疗反应。这些发现值得在更大规模的前瞻性多中心研究中验证。
预测晚期非小细胞肺癌对programmed death-1 (PD-1)抑制剂治疗反应的可靠生物标志物仍然有限。外周免疫细胞亚群,包括gamma delta (γδ) T细胞和T helper 17 (Th17)细胞,可能为监测免疫治疗期间的全身免疫反应提供一种非侵入性方法;然而,它们在晚期非小细胞肺癌患者中的临床意义仍未完全明确。
前瞻性纳入60例接受nivolumab单药治疗的晚期非小细胞肺癌患者。在基线和治疗开始后第28天采集外周血样本。通过流式细胞术定量循环γδ T细胞和Th17细胞,通过酶联免疫吸附试验检测血清肿瘤标志物和细胞因子。采用iRECIST标准评估治疗反应。进行相关性分析、多因素logistic回归分析和受试者工作特征(ROC)曲线分析。
缓解者治疗后外周γδ T细胞和Th17细胞显著增加,同时血清肿瘤标志物和免疫抑制细胞因子降低。第28天γδ T细胞比例与治疗反应独立相关,与血清肿瘤标志物水平呈负相关,同时与Th17细胞频率和白细胞介素-2浓度呈正相关。ROC分析表明,第28天γδ T细胞对识别缓解者显示出良好的区分性能(AUC = 0.915;敏感性 = 91.9%;特异性 = 82.6%),而Th17细胞也表现出良好的预测性能(AUC = 0.850)。
BACKGROUND: Reliable biomarkers for predicting the response to programmed death-1 (PD-1) inhibitor therapy in advanced non-small cell lung cancer remain limited. Peripheral immune cell subsets, including gamma delta (γδ) T cells and T helper 17 (Th17) cells, may provide a noninvasive approach for monitoring systemic immune responses during immunotherapy; however, their clinical significance in patients with advanced non-small cell lung cancer remains incompletely understood. METHODS: Sixty patients with advanced non-small cell lung cancer receiving nivolumab monotherapy were prospectively enrolled. Peripheral blood samples were collected at baseline and on day 28 after treatment initiation. Circulating γδ T cells and Th17 cells were quantified by flow cytometry, and serum tumor markers and cytokines were measured by enzyme-linked immunosorbent assay. Treatment response was evaluated using the iRECIST criteria. Correlation, multivariable logistic regression, and receiver operating characteristic (ROC) curve analyses were performed. RESULTS: Responders exhibited significant increases in peripheral γδ T cells and Th17 cells after treatment, accompanied by reductions in serum tumor markers and immunosuppressive cytokines. Day-28 γδ T cell proportions were independently associated with treatment response and correlated inversely with serum tumor marker levels while showing positive correlations with Th17 cell frequencies and interleukin-2 concentrations. ROC analysis demonstrated that day-28 γδ T cells showed good discriminative performance for identifying responders (AUC = 0.915; sensitivity = 91.9%; specificity = 82.6%), whereas Th17 cells also demonstrated favorable predictive performance (AUC = 0.850). CONCLUSION: Early treatment-induced expansion of peripheral γδ T cells was associated with objective clinical response, reduced tumor burden, and favorable cytokine remodeling during PD-1 inhibitor therapy. Dynamic monitoring of peripheral γδ T cells may represent a promising noninvasive biomarker for early assessment of treatment response in advanced non-small cell lung cancer. These findings warrant validation in larger prospective multicenter studies.
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