Ling Yun, Li Ning, Li Lin, Guo Changyuan, Wei Jiacong, Yuan Pei, Tan Fengwei, Tao Xiuli, Wang Shuhang, Wang Zhijie, Wu Ning, Wang Jie, Ying Jianming, Gao Shugeng, He Jie
Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Clinical Cancer Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
NPJ Precis Oncol. 2020 Dec 1;4(1):32. doi: 10.1038/s41698-020-00135-2.
Neoadjuvant immunotherapy provides a unique opportunity for understanding therapeutic responses. We analyzed pathologic responses in surgical specimens obtained from 31 squamous non-small cell lung cancer (NSCLC) patients receiving neoadjuvant anti-PD-1 treatment. Fifteen (48.4%) patients achieved pathologic complete response (pCR) or major pathologic response (MPR). Among them, seven (46.7%) were assessed as radiological partial response and eight (53.3%) as stable disease. Among 20 patients with pathologically identified tumor beds in lymph nodes (LNs), 10 and six patients achieved pCR/MPR in primary tumors and paired LNs, respectively. pCR was achieved in 6/19 N1 nodes and 1/7 N2 nodes. Residual viable tumor (RVT) cells in 8/9 MPR specimens had 100% immune-activated phenotype, while a median of 80% of RVT cells in pathologic nonresponse specimens presented immune-excluded/desert phenotype. These findings demonstrated that assessment of pathologic responses in both primary tumor and LNs may be important as a surrogate for assessing neoadjuvant immunotherapeutic efficacy.
新辅助免疫疗法为了解治疗反应提供了独特的机会。我们分析了31例接受新辅助抗程序性死亡蛋白1（PD-1）治疗的肺鳞状非小细胞肺癌（NSCLC）患者手术标本中的病理反应。15例（48.4%）患者达到病理完全缓解（pCR）或主要病理反应（MPR）。其中，7例（46.7%）被评估为放射学部分缓解，8例（53.3%）为疾病稳定。在20例病理确定有淋巴结（LN）肿瘤床的患者中，分别有10例和6例在原发性肿瘤和配对LN中达到pCR/MPR。19个N1淋巴结中有6个、7个N2淋巴结中有1个达到pCR。9个MPR标本中的残余存活肿瘤（RVT）细胞有100%的免疫激活表型，而病理无反应标本中RVT细胞的中位数为80%呈现免疫排除/免疫沙漠表型。这些发现表明，评估原发性肿瘤和LN中的病理反应作为评估新辅助免疫治疗疗效的替代指标可能很重要。
