新辅助化疗可减轻，而手术会增加卵巢癌一线治疗中的免疫抑制。

Neo-Adjuvant Chemotherapy Reduces, and Surgery Increases Immunosuppression in First-Line Treatment for Ovarian Cancer.

作者信息

De Bruyn Christine, Ceusters Jolien, Landolfo Chiara, Baert Thaïs, Thirion Gitte, Claes Sandra, Vankerckhoven Ann, Wouters Roxanne, Schols Dominique, Timmerman Dirk, Vergote Ignace, Coosemans An

机构信息

Laboratory of Tumor Immunology and Immunotherapy, ImmunOvar Research Group, Department of Oncology, Leuven Cancer Institute, Katholieke Universiteit Leuven, 3000 Leuven, Belgium.

Department of Obstetrics and Gynecology, University Hospital Antwerp, 2650 Edegem, Belgium.

出版信息

Cancers (Basel). 2021 Nov 24;13(23):5899. doi: 10.3390/cancers13235899.

DOI:10.3390/cancers13235899

PMID:34885008

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8656504/

Abstract

UNLABELLED

In monotherapy, immunotherapy has a poor success rate in ovarian cancer. Upgrading to a successful combinatorial immunotherapy treatment implies knowledge of the immune changes that are induced by chemotherapy and surgery.

METHODOLOGY

Patients with a new d ovarian cancer diagnosis underwent longitudinal blood samples at different time points during primary treatment.

RESULTS

Ninety patients were included in the study (33% primary debulking surgery (PDS) with adjuvant chemotherapy (ACT), 61% neo-adjuvant chemotherapy (NACT) with interval debulking surgery (IDS), and 6% debulking surgery only). Reductions in immunosuppression were observed after NACT, but surgery reverted this effect. The immune-related proteins showed a pronounced decrease in immune stimulation and immunosuppression when primary treatment was completed. NACT with IDS leads to a transient amelioration of the immune microenvironment compared to PDS with ACT.

CONCLUSION

The implementation of immunotherapy in the primary treatment schedule of ovarian cancer cannot be induced blindly. Carboplatin-paclitaxel seems to ameliorate the hostile immune microenvironment in ovarian cancer, which is less pronounced at the end of primary treatment. This prospective study during primary therapy for ovarian cancer that also looks at the evolution of immune-related proteins provides us with an insight into the temporary windows of opportunity in which to introduce immunotherapy during primary treatment.

摘要

未标注

在单药治疗中，免疫疗法在卵巢癌中的成功率较低。升级为成功的联合免疫疗法需要了解化疗和手术所诱导的免疫变化。

方法

新诊断为卵巢癌的患者在初次治疗期间的不同时间点采集纵向血样。

结果

90名患者纳入研究（33%接受初次肿瘤细胞减灭术（PDS）并辅助化疗（ACT），61%接受新辅助化疗（NACT）并间隔肿瘤细胞减灭术（IDS），6%仅接受肿瘤细胞减灭术）。NACT后观察到免疫抑制减轻，但手术逆转了这种效果。当初次治疗完成时，免疫相关蛋白在免疫刺激和免疫抑制方面均显著下降。与PDS联合ACT相比，NACT联合IDS可导致免疫微环境的短暂改善。