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新辅助放化疗(neoCRT)上调肿瘤 PD-L1 表达可改善局部晚期直肠癌伴淋巴结转移患者的生存。

Upregulation of tumor PD-L1 by neoadjuvant chemoradiotherapy (neoCRT) confers improved survival in patients with lymph node metastasis of locally advanced rectal cancers.

机构信息

Cancer Center, China Medical University Hospital, China Medical University, 9F, Rehab Building, No. 2 Rude Rd, Taichung, 40402, Taiwan.

Translation Research Core, Medical University Hospital, China Medical University, Taichung, 40402, Taiwan.

出版信息

Cancer Immunol Immunother. 2019 Feb;68(2):283-296. doi: 10.1007/s00262-018-2275-0. Epub 2018 Nov 17.


DOI:10.1007/s00262-018-2275-0
PMID:30448924
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11028291/
Abstract

The expression of programmed cell death 1 ligand 1 (PD-L1) and interferon-γ (IFN-γ) is of great interest for the development of chemoradiotherapy and immune checkpoint inhibitor treatments. Patients with nodal metastasis (pN+) tend to have a poor prognosis, even after neoadjuvant chemoradiotherapy (neoCRT) and surgical treatment. In this study, we examined the roles of tumor PD-L1 and IFN-γ before and after neoCRT in locally advanced rectal cancer (LARC) patients. Our results demonstrate that patients with high PD-L1 expression in post-neoCRT tissues exhibit improved 5-year disease-free survival (DFS) and overall survival (OS) compared with those with low PD-L1 expression (p < 0.001). Furthermore, in the pN+ population, patients with high PD-L1 expression in post-neoCRT tissues exhibit improved 5-year DFS and OS. PD-L1 and IFN-γ upregulation increased in tumor tissues after neoCRT, and patients with high PD-L1 and high IFN-γ exhibit improved 5-year DFS and OS (p = 0.04 and p = 0.001, respectively). To the best of our knowledge, this study is the first to demonstrate that PD-L1 upregulation in a pN+ cohort correlates with improved prognosis, which is similar to that in patients without nodal metastasis. Moreover, this study verified that PD-L1 and IFN-γ were upregulated by neoCRT treatment in LARC patients and demonstrated that neoCRT may be useful not only for immune checkpoint inhibitor treatment but also for reinvigorating preexisting anti-cancer immunity.

摘要

程序性细胞死亡配体 1(PD-L1)和干扰素-γ(IFN-γ)的表达对于放化疗和免疫检查点抑制剂治疗的发展非常重要。有淋巴结转移(pN+)的患者往往预后较差,即使在新辅助放化疗(neoCRT)和手术治疗后也是如此。在这项研究中,我们检查了 neoCRT 前后局部晚期直肠癌(LARC)患者肿瘤 PD-L1 和 IFN-γ 的作用。我们的结果表明,neoCRT 后组织中高 PD-L1 表达的患者与低 PD-L1 表达的患者相比,5 年无病生存率(DFS)和总生存率(OS)得到改善(p<0.001)。此外,在 pN+人群中,neoCRT 后组织中高 PD-L1 表达的患者 5 年 DFS 和 OS 得到改善。neoCRT 后肿瘤组织中 PD-L1 和 IFN-γ 的上调增加,高 PD-L1 和高 IFN-γ 的患者 5 年 DFS 和 OS 得到改善(p=0.04 和 p=0.001)。据我们所知,这项研究首次表明,pN+患者中 PD-L1 的上调与改善的预后相关,与无淋巴结转移的患者相似。此外,这项研究证实,neoCRT 治疗可上调 LARC 患者的 PD-L1 和 IFN-γ,并表明 neoCRT 不仅对免疫检查点抑制剂治疗有用,而且对重新激活先前存在的抗癌免疫也有用。

相似文献

[1]
Upregulation of tumor PD-L1 by neoadjuvant chemoradiotherapy (neoCRT) confers improved survival in patients with lymph node metastasis of locally advanced rectal cancers.

Cancer Immunol Immunother. 2018-11-17

[2]
Prognostic relevance of programmed cell death-ligand 1 expression and CD8+ TILs in rectal cancer patients before and after neoadjuvant chemoradiotherapy.

J Cancer Res Clin Oncol. 2019-3-14

[3]
Implication of programmed cell death ligand 1 expression in tumor recurrence and prognosis in rectal cancer with neoadjuvant chemoradiotherapy.

Int J Clin Oncol. 2016-10

[4]
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BMC Cancer. 2022-12-5

[5]
Lymph node number, surface area and lymph node ratio are important prognostic indicators in neoadjuvant chemoradiotherapy treated rectal cancer.

J Clin Pathol. 2019-9-25

[6]
Can an IL13 -1112 C/T (rs1800925) polymorphism predict responsiveness to neoadjuvant chemoradiotherapy and survival of Chinese Han patients with locally advanced rectal cancer?

Oncotarget. 2016-6-7

[7]
The prognostic effect of neoadjuvant chemoradiotherapy on the change of PD-L1 expression in patients with locally advanced rectal adenocarcinoma.

J BUON. 2017

[8]
Programmed death-ligand 1 and mammalian target of rapamycin signaling pathway in locally advanced rectal cancer.

Discov Oncol. 2022-2-14

[9]
PD-L1 is upregulated by radiochemotherapy in rectal adenocarcinoma patients and associated with a favourable prognosis.

Eur J Cancer. 2016-7-25

[10]
PD-1 and PD-L1 expression in HNSCC primary cancer and related lymph node metastasis - impact on clinical outcome.

Histopathology. 2018-7-4

引用本文的文献

[1]
Neoadjuvant chemoradiotherapy up-regulates PD-L1 in radioresistant colorectal cancer.

Clin Transl Radiat Oncol. 2024-12-22

[2]
A Comprehensive Study on the Prognostic Value and Clinicopathological Significance of Different Immune Checkpoints in Patients With Colorectal Cancer: A Systematic Review and Meta-Analysis.

Curr Ther Res Clin Exp. 2024-9-12

[3]
The impact of preoperative treatments on the immune environment of rectal cancer.

APMIS. 2024-12

[4]
PD-L1 Expression in Paired Samples of Rectal Cancer.

Cancers (Basel). 2024-7-21

[5]
Immunotherapy and radiotherapy for older patients with locally advanced rectal cancer unfit for surgery or decline surgery: a practical proposal by the International Geriatric Radiotherapy Group.

Front Oncol. 2024-2-22

[6]
DNMT1 constrains IFNβ-mediated anti-tumor immunity and PD-L1 expression to reduce the efficacy of radiotherapy and immunotherapy.

Oncoimmunology. 2021-10-21

[7]
Implications of Rectal Cancer Radiotherapy on the Immune Microenvironment: Allies and Foes to Therapy Resistance and Patients' Outcome.

Cancers (Basel). 2023-10-24

[8]
Dysfunctional TLR1 reduces the therapeutic efficacy of chemotherapy by attenuating HMGB1-mediated antitumor immunity in locally advanced colorectal cancer.

Sci Rep. 2023-11-9

[9]
Preoperative chemoradiotherapy induces multiple pathways related to anti-tumour immunity in rectal cancer.

Br J Cancer. 2023-11

[10]
IMMUNOREACT 0: Biopsy-based immune biomarkers as predictors of response to neoadjuvant therapy for rectal cancer-A systematic review and meta-analysis.

Cancer Med. 2023-9

本文引用的文献

[1]
RSF-1 overexpression determines cancer progression and drug resistance in cervical cancer.

Biomedicine (Taipei). 2018-3

[2]
Cytosolic high-mobility group box protein 1 (HMGB1) and/or PD-1+ TILs in the tumor microenvironment may be contributing prognostic biomarkers for patients with locally advanced rectal cancer who have undergone neoadjuvant chemoradiotherapy.

Cancer Immunol Immunother. 2017-12-21

[3]
Immune recognition of irradiated cancer cells.

Immunol Rev. 2017-11

[4]
Cytokines in immunogenic cell death: Applications for cancer immunotherapy.

Cytokine. 2017-6-22

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Prognostic value of programmed death-ligand 1 expression in patients with stage III colorectal cancer.

Cancer Sci. 2017-5

[6]
Programmed death-ligand 1 expression in rectal cancer.

Eur Surg. 2016

[7]
Tumor Interferon Signaling Regulates a Multigenic Resistance Program to Immune Checkpoint Blockade.

Cell. 2016-12-1

[8]
PD-L1 expression in human cancers and its association with clinical outcomes.

Onco Targets Ther. 2016-8-12

[9]
Prognostic impact of programed cell death-1 (PD-1) and PD-ligand 1 (PD-L1) expression in cancer cells and tumor infiltrating lymphocytes in colorectal cancer.

Mol Cancer. 2016-8-24

[10]
PD-L1 is upregulated by radiochemotherapy in rectal adenocarcinoma patients and associated with a favourable prognosis.

Eur J Cancer. 2016-7-25

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