Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Universitäts Spital Zürich (USZ), Rämistrasse 100, 8091, Zurich, Switzerland.
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Cancer Immunol Immunother. 2024 Sep 5;73(11):222. doi: 10.1007/s00262-024-03810-6.
Immunotherapy provided significant survival benefits for recurrent and metastatic patients with head and neck cancer. These improvements could not be reproduced in patients treated with curative-intent chemoradiotherapy (CRT) and the optimal radio-immunotherapy (RIT) concepts have yet to be designed. Exploration and analysis of the pre-therapeutic immune status of these patients and the changes occurring during the treatment course could be crucial in rationally designing future combined treatments.
Blood samples were collected from a cohort of 25 head and neck cancer patients treated with curative-intended (C)-RT prior to therapy, after the first week of treatment, and three months after treatment completion. Peripheral blood mononuclear cells (PBMCs) or all nucleated blood cells were isolated and analyzed via flow cytometry.
At baseline, patients showed reduced monocyte and lymphocyte counts compared to healthy individuals. Although overall CD8 T-cell frequencies were reduced, the proportion of memory subsets were increased in patients. Radiotherapy (RT) treatment led to a further increase in CD8 effector memory T-cells. Among myeloid populations, tumor-promoting subsets became less abundant after RT, in favor of pro-inflammatory cells.
The present study prospectively demonstrated a complex interplay and distinct longitudinal changes in the composition of lymphocytic and myeloid populations during curative (C)-RT of head and neck cancer. Further validation of this method in a larger cohort could allow for better treatment guidance and tailored incorporation of immunotherapies (IT) in the future.
免疫疗法为复发性和转移性头颈部癌症患者提供了显著的生存获益。然而，这些改善在接受根治性放化疗（CRT）治疗的患者中无法重现，并且尚未设计出最佳的放免联合治疗（RIT）方案。探索和分析这些患者治疗前的免疫状态以及治疗过程中发生的变化，对于合理设计未来的联合治疗方案可能至关重要。
收集了 25 例接受根治性（C）-RT 治疗的头颈部癌症患者的血液样本，分别在治疗前、治疗第一周后和治疗结束后三个月采集。分离外周血单核细胞（PBMCs）或所有有核血细胞，并通过流式细胞术进行分析。
在基线时，与健康个体相比，患者的单核细胞和淋巴细胞计数减少。尽管总体 CD8 T 细胞频率降低，但患者中记忆亚群的比例增加。放射治疗（RT）治疗导致 CD8 效应记忆 T 细胞进一步增加。在髓系群体中，RT 后促肿瘤亚群的丰度降低，有利于促炎细胞。
本研究前瞻性地展示了头颈部癌症根治性（C）-RT 过程中淋巴细胞和髓系群体组成的复杂相互作用和独特的纵向变化。在更大的队列中进一步验证这种方法，可以为更好的治疗指导和未来免疫疗法（IT）的个体化应用提供依据。
