低表达 PD-1 的细胞毒性 CD8+肿瘤浸润淋巴细胞赋予 NSCLC 免疫特惠组织微环境并具有预后和预测价值。
Low PD-1 Expression in Cytotoxic CD8 Tumor-Infiltrating Lymphocytes Confers an Immune-Privileged Tissue Microenvironment in NSCLC with a Prognostic and Predictive Value.
机构信息
Hematology and Bone Marrow Transplantation, University Hospital of Parma, Parma, Italy.
Thoracic Surgery, University Hospital of Parma, Parma, Italy.
出版信息
Clin Cancer Res. 2018 Jan 15;24(2):407-419. doi: 10.1158/1078-0432.CCR-17-2156. Epub 2017 Oct 26.
The success of immune checkpoint inhibitors strengthens the notion that tumor growth and regression are immune regulated. To determine whether distinct tissue immune microenvironments differentially affect clinical outcome in non-small cell lung cancer (NSCLC), an extended analysis of PD-L1 and tumor-infiltrating lymphocytes (TIL) was performed. Samples from resected adenocarcinoma (ADC 42), squamous cell carcinoma (SCC 58), and 26 advanced diseases (13 ADC and 13 SCC) treated with nivolumab were analyzed. PD-L1 expression and the incidence of CD3, CD8, CD4, PD-1, CD57, FOXP3, CD25, and Granzyme B TILs were immunohistochemically assessed. PD-L1 levels inversely correlated with N involvement, although they did not show a statistically significant prognostic value in resected patients. The incidence and phenotype of TILs differed in SCC versus ADC, in which and mutations conditioned a different frequency and tissue localization of lymphocytes. NSCLC resected patients with high CD8 lymphocytes lacking PD-1 inhibitory receptor had a longer overall survival (OS: HR = 2.268; 95% CI, 1.056-4.871, = 0.03). PD-1-to-CD8 ratio resulted in a prognostic factor both on univariate (HR = 1.952; 95% CI, 1.34-3.12, = 0.001) and multivariate (HR = 1.943; 95% CI, 1.38-2.86, = 0.009) analysis. Moreover, low PD-1 incidence among CD8 cells was a distinctive feature of nivolumab-treated patients, showing clinical benefit with a prolonged progression-free survival (PFS: HR = 4.51; 95% CI, 1.45-13.94, = 0.004). In the presence of intrinsic variability in PD-L1 expression, the reservoir of PD-1-negative effector T lymphocytes provides an immune-privileged microenvironment with a positive impact on survival of patients with resected disease and response to immunotherapy in advanced NSCLC. .
免疫检查点抑制剂的成功强化了这样一种观点,即肿瘤的生长和消退受免疫调节。为了确定不同的组织免疫微环境是否会对非小细胞肺癌(NSCLC)的临床结果产生不同影响,对 PD-L1 和肿瘤浸润淋巴细胞(TIL)进行了扩展分析。对切除的腺癌(ADC 42)、鳞状细胞癌(SCC 58)和 26 例晚期疾病(13 例 ADC 和 13 例 SCC)的肿瘤样本进行了分析,这些患者接受了纳武利尤单抗治疗。采用免疫组化方法评估 PD-L1 表达和 CD3、CD8、CD4、PD-1、CD57、FOXP3、CD25 和 Granzyme B TIL 的发生率。尽管 PD-L1 水平与 N 累及呈负相关,但在切除的患者中并未显示出统计学上显著的预后价值。TIL 的发生率和表型在 SCC 与 ADC 之间存在差异,其中 和 突变调节了淋巴细胞的不同频率和组织定位。CD8 淋巴细胞高且缺乏 PD-1 抑制性受体的 NSCLC 切除患者的总生存期(OS)更长(HR=2.268;95%CI,1.056-4.871, = 0.03)。PD-1 与 CD8 比值是单因素(HR=1.952;95%CI,1.34-3.12, = 0.001)和多因素(HR=1.943;95%CI,1.38-2.86, = 0.009)分析的预后因素。此外,CD8 细胞中 PD-1 发生率低是纳武利尤单抗治疗患者的一个显著特征,其无进展生存期(PFS:HR=4.51;95%CI,1.45-13.94, = 0.004)延长显示出临床获益。在 PD-L1 表达固有变异性的情况下,PD-1 阴性效应 T 淋巴细胞库为肿瘤提供了免疫特权微环境,对切除肿瘤患者的生存和晚期 NSCLC 的免疫治疗反应产生积极影响。