Wei J C, Yuan P, Ling Y, Li L, Guo C Y, Guo L, Xue L Y, Ying J M
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 100021, China.
Zhonghua Bing Li Xue Za Zhi. 2021 May 8;50(5):453-457. doi: 10.3760/cma.j.cn112151-20200829-00671.
To analyze the pathologic features of responses to neoadjuvant immunotherapy of squamous cell carcinoma (SCC) of the lung. The study included 31 patients with resected lung SCC post neoadjuvant immunotherapy. All patients were recruited from the neoadjuvant anti-PD-1 (Sintilimab) phase Ⅰb clinical trial (ChiCTR-OIC-17013726). The histopathological morphology and different degrees of pathologic response to immunotherapy were evaluated basing on irPRC standard. According to the percentage of residual viable tumor (% RVT), pathologic responses of complete pathologic response (cPR), major pathologic response (MPR) and non-MPR were noted in 19% (=6), 29% (=9), and 52% (=16) of patients respectively. In addition, extensive immune activation phenomena (immune cell infiltration, including infiltration of lymphocytes, plasma cells, foamy macrophages, lymphocyte aggregation and tertiary lymphoid structures formation) and tissue repair features (giant cells, granuloma formation, proliferative fibrosis and neovascularization) were observed in tumor regression bed. Neoadjuvant immunotherapy has favorable effect on lung SCC. Pathologic assessment of resected lung cancer specimens after neoadjuvant immunotherapy shows unique histopathological features consistent with its mechanism.
分析肺鳞状细胞癌（SCC）新辅助免疫治疗反应的病理特征。该研究纳入了31例新辅助免疫治疗后接受肺SCC切除术的患者。所有患者均来自新辅助抗程序性死亡蛋白1（PD-1）（信迪利单抗）Ⅰb期临床试验（ChiCTR-OIC-17013726）。基于免疫相关疗效评价标准（irPRC）评估组织病理学形态及免疫治疗的不同程度病理反应。根据残余存活肿瘤百分比（%RVT），分别有19%（=6例）、29%（=9例）和52%（=16例）的患者出现完全病理缓解（cPR）、主要病理缓解（MPR）和非MPR的病理反应。此外，在肿瘤退缩床观察到广泛的免疫激活现象（免疫细胞浸润，包括淋巴细胞、浆细胞、泡沫巨噬细胞浸润、淋巴细胞聚集和三级淋巴结构形成）和组织修复特征（巨细胞、肉芽肿形成、增殖性纤维化和新生血管形成）。新辅助免疫治疗对肺SCC有良好疗效。新辅助免疫治疗后切除的肺癌标本的病理评估显示出与其机制一致的独特组织病理学特征。
