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