High T-cell infiltration in tumor tissue and younger age predict the response to pembrolizumab in recurrent urothelial cancer
High T-cell infiltration in tumor tissue and younger age predict the response to pembrolizumab in recurrent urothelial cancer
复制标题
DOI：
10.1007/s00795-021-00292-8
复制
发表时间：
2021-06-16
影响因子：
1.8
通讯作者：
Kamba, Tomomi
中科院分区：
文献类型：
--
作者：
Anami, Toshiki;Komohara, Yoshihiro;Kamba, Tomomi
针对程序性细胞死亡-1 信号通路的靶向治疗已被批准用于包括尿路上皮癌在内的多种癌症的抗癌治疗。为了确定尿路上皮癌患者对派姆单抗反应的预测因素，进行了一项回顾性研究，该研究使用了从 2015 年至 2020 年间诊断为尿路上皮癌的患者获得的临床信息和石蜡包埋样本。纳入了 17 名接受原发灶全膀胱切除术或肾输尿管切除术并接受派姆单抗治疗化疗耐药性疾病的患者，并进行了免疫组织化学分析。无应答组和应答组之间特征的一个关键差异是患者的年龄（74 岁与 63 岁，p = 0.0194）。虽然无统计学差异，但肉瘤样和微乳头成分的组织学亚型仅见于无应答组，鳞状分化和淋巴结转移仅见于完全应答组。免疫组化结果显示，应答组的 CD8 阳性 T 细胞和 Tregs 密度显着高于无应答组。总之，年龄较小和肿瘤浸润淋巴细胞数量较多是对免疫检查点抑制剂产生良好反应的预测因素，尽管需要对更多入组患者进行进一步研究。
Targeting the programmed cell death-1 signaling pathway has been approved for the anti-cancer therapy in several cancers including urothelial cancer. To determine predictive factors of the responsiveness to pembrolizumab in urothelial cancer patients, a retrospective study that used clinical information and paraffin-embedded samples obtained from patients diagnosed with urothelial cancer between 2015 and 2020 were performed. Seventeen patients who underwent total cystectomy or nephroureterectomy of the primary lesion and were treated with pembrolizumab for chemo-resistant disease were enrolled, and immunohistochemical analysis was performed. A key difference in the characteristics between the non-responder group and the responder group was the age of the patients (74 vs. 63 years, p = 0.0194). Although there was no statistically significant difference, the histological subtype with sarcomatoid and micropapillary components was only seen in the non-responder group, and squamous differentiation and lymph node metastasis were only seen in cases with a complete response. In the results of immunohistochemistry, the density of CD8-positive T-cells and Tregs was significantly increased in the responder group than in the non-responder group. In conclusion, younger age and a high number of tumor-infiltrating lymphocytes were predictive factors of a good response to immune checkpoint inhibitors, although further studies with more enrolled patients are necessary.