Department of Surgery, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
Department of Anatomical Pathology, Tokyo Medical University Hospital, Tokyo, Japan.
Sci Rep. 2021 Apr 9;11(1):7830. doi: 10.1038/s41598-021-87575-3.
PD-L1 expression is the most useful predictive biomarker for immunotherapy efficacy on non-small cell lung cancer (NSCLC), and CD8+ tumor-infiltrating lymphocytes (CD8+ TILs) play an essential role in the clinical activity of immunotherapy. PD-L1 is found on the exosome's surface, and PD-L1 expressing exosomes can inhibit antitumor immune responses. This study aimed to analyze tumor PD-L1 expression, serum exosomal PD-L1, and CD8+ TILs to investigate anti-PD-1 response and clinicopathological outcomes in NSCLC. One hundred twenty patients with stage I-III NSCLC were enrolled, and serum samples collected during the initial surgery were pooled. The Human CD274/PD-L1 ELISA kit was used to quantify the exosomal PD-L1. Exosomal PD-L1 levels were significantly correlated with tumor PD-L1 levels (p < 0.001) and the number of CD8+ TILs (p = 0.001). Patients with exosomal PD-L1 ≥ 166 pg/mL tended to have a worse RFS than those with < 166 pg/mL in all stage (p = 0.163) and stage I patients (p = 0.116). Seventeen patients exhibited postoperative recurrences and received anti-PD-1 treatment. The disease control rate of patients with exosomal PD-L1 ≥ 166 pg/mL was 100%. The measurement of serum exosomal PD-L1 as a quantitative factor with tumor PD-L1 status may help predict anti-PD-1 response and clinical outcomes in patients with NSCLC.
PD-L1 表达是预测非小细胞肺癌 (NSCLC) 免疫治疗疗效的最有用的预测生物标志物,CD8+肿瘤浸润淋巴细胞 (CD8+TILs) 在免疫治疗的临床活性中发挥着重要作用。PD-L1 存在于外泌体的表面,表达 PD-L1 的外泌体可以抑制抗肿瘤免疫反应。本研究旨在分析肿瘤 PD-L1 表达、血清外泌体 PD-L1 和 CD8+TILs,以研究 NSCLC 中的抗 PD-1 反应和临床病理结局。纳入了 120 名 I-III 期 NSCLC 患者,并在初始手术期间收集了血清样本。使用 Human CD274/PD-L1 ELISA 试剂盒定量外泌体 PD-L1。外泌体 PD-L1 水平与肿瘤 PD-L1 水平呈显著相关 (p<0.001),与 CD8+TILs 的数量呈显著相关 (p=0.001)。外泌体 PD-L1≥166pg/mL 的患者与外泌体 PD-L1<166pg/mL 的患者相比,所有分期 (p=0.163) 和 I 期患者 (p=0.116) 的 RFS 较差。17 名患者术后复发并接受了抗 PD-1 治疗。外泌体 PD-L1≥166pg/mL 的患者疾病控制率为 100%。血清外泌体 PD-L1 作为一种与肿瘤 PD-L1 状态相关的定量因素的测量,可能有助于预测 NSCLC 患者的抗 PD-1 反应和临床结局。