scholarly journals Tumor‐infiltrating CD8 + T cell is prognostic and predicts adjuvant chemotherapy benefit in patients with limited‐stage small cell esophageal carcinoma

2021 ◽  
Vol 11 (6) ◽  
Author(s):  
Zhihui Zhang ◽  
Chaoqi Zhang ◽  
Guochao Zhang ◽  
Yuejun Luo ◽  
Liyan Xue ◽  
...  
BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhihui Zhang ◽  
Chaoqi Zhang ◽  
Yuejun Luo ◽  
Peng Wu ◽  
Guochao Zhang ◽  
...  

Abstract Background Small cell lung cancer (SCLC) is lethal and possesses limited therapeutic options. Platinum-based chemotherapy—with or without immune checkpoint inhibitors (anti-PDs)—is the current first-line therapy for SCLCs; however, its associated outcomes are heterogeneous. N6-methyladenosine (m6A) is a novel and decisive factor in tumour progression, chemotherapy resistance, and immunotherapy response. However, m6A modification in SCLC remains poorly understood. Methods We systematically explored the molecular features and clinical significance of m6A regulators in SCLC. We then constructed an m6A regulator-based prognostic signature (m6A score) based on our examination of 256 cases with limited-stage SCLC (LS-SCLC) from three different cohorts—including an independent cohort that contained 150 cases with qPCR data. We additionally evaluated the relationships between the m6A score and adjuvant chemotherapy (ACT) benefits and the patients’ responses to anti-PD-1 treatment. Immunohistochemical (IHC) staining and the HALO digital pathological platform were used to calculate CD8+ T cell density. Results We observed abnormal somatic mutations and expressions of m6A regulators. Using the LASSO Cox model, a five-regulator-based (G3BP1, METTL5, ALKBH5, IGF2BP3, and RBM15B) m6A score was generated from the significant regulators to classify patients into high- and low-score groups. In the training cohort, patients with high scores had shorter overall survival (HR, 5.19; 2.75–9.77; P < 0.001). The prognostic accuracy of the m6A score was well validated in two independent cohorts (HR 4.6, P = 0.006 and HR 3.07, P < 0.001). Time-dependent ROC and C-index analyses found the m6A score to possess superior predictive power than other clinicopathological parameters. A multicentre multivariate analysis revealed the m6A score to be an independent prognostic indicator. Additionally, patients with low scores received a greater survival benefit from ACT, exhibited more CD8+ T cell infiltration, and were more responsive to cancer immunotherapy. Conclusions Our results, for the first time, affirm the significance of m6A regulators in LS-SCLC. Our multicentre analysis found that the m6A score was a reliable prognostic tool for guiding chemotherapy and immunotherapy selections for patients with SCLC.


2018 ◽  
pp. canres.3297.2017 ◽  
Author(s):  
Lisanne Heim ◽  
Juliane Friedrich ◽  
Marina Engelhardt ◽  
Denis I Trufa ◽  
Carol I. Geppert ◽  
...  

Lung Cancer ◽  
2003 ◽  
Vol 41 ◽  
pp. S46-S47
Author(s):  
Luis E. Raez ◽  
Peter A. Cassileth ◽  
James Schlesselman ◽  
Swaminathan Padmanabhan ◽  
Eva Fisher ◽  
...  

2013 ◽  
Vol 106 (3) ◽  
pp. 317-322 ◽  
Author(s):  
Mao-Bin Meng ◽  
Nicholas G. Zaorsky ◽  
Chao Jiang ◽  
Li-Jun Tian ◽  
Huan-Huan Wang ◽  
...  

2003 ◽  
Vol 10 (11) ◽  
pp. 850-858 ◽  
Author(s):  
Luis E Raez ◽  
Peter A Cassileth ◽  
James J Schlesselman ◽  
Swaminathan Padmanabhan ◽  
Eva Z Fisher ◽  
...  

2015 ◽  
pp. 437 ◽  
Author(s):  
Mao-Bin Meng ◽  
Huan-Huan Wang ◽  
Nicholas Zaorsky ◽  
Chao Jiang ◽  
Zhi-Qiang Wu ◽  
...  

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. TPS9078-TPS9078
Author(s):  
Joshua E. Reuss ◽  
Boris Sepesi ◽  
Christian Diego Rolfo ◽  
Marianna Zahurak ◽  
Valsamo Anagnostou ◽  
...  

TPS9078 Background: While the role of surgery in limited-stage (stage I-III) malignant pleural mesothelioma (MPM) is controversial, many centers have adopted an aggressive tri-modality approach incorporating (neo)adjuvant chemotherapy, surgical resection and radiotherapy. Despite this, most patients relapse and die from their disease. Immune checkpoint blockade (ICB) has shown promise in advanced MPM, but the mechanisms of response and resistance remain elusive. Improving the mechanistic understanding of ICB in MPM while concurrently optimizing the treatment strategy for limited-stage MPM are two urgent unmet needs. This multicenter multi-arm phase I/II study seeks to evaluate the safety and feasibility of neoadjuvant ICB in resectable MPM, incorporating novel genomic and immunologic analyses to deliver mechanistic insight into the biology of ICB in MPM. Methods: Patients with surgically resectable stage I-III treatment-naïve epithelioid or biphasic MPM receive neoadjuvant treatment with nivolumab every 2 weeks for 3 doses with or without 1 dose of ipilimumab (arm A: nivolumab monotherapy; arm B: nivolumab + ipilimumab). After macroscopic complete resection, patients receive optional investigator-choice adjuvant chemotherapy +/- radiation. Following this, patients will receive up to 1 year of adjuvant nivolumab. Feasibility and safety are co-primary endpoints of this study with feasibility defined by a delay in surgery of ≤24 days from the preplanned surgical date and safety defined by adverse events according to CTCAE v5.0. Bayesian-designed stopping rules have been implemented for feasibility and safety. Secondary endpoints include assessment of pathologic response and radiographic response using RECIST 1.1 for MPM. Correlative analyses will be performed on tissue specimens obtained pre- and post-ICB, as well as blood obtained pre, during, and post-ICB. Key correlates include multiplex immunofluorescence and longitudinal ctDNA assessment. Whole exome sequencing, T-cell receptor sequencing, and the MANAFEST functional neoantigen assay will be utilized to identify neoantigen-specific T-cell clonotypes and track these clonotypes temporally (during/post ICB) and spatially (across immune compartments). Single-cell RNA sequencing will be used to characterize the functionality of expanded T-cell clonotypes. Accrual to arm B will commence following complete accrual to arm A with a planned total enrollment of 30 patients. This study is open with 1 patient enrolled at the time of submission. Clinical trial information: NCT03918252.


2021 ◽  
Vol 6 (64) ◽  
Author(s):  
Brendan L. Horton ◽  
Duncan M. Morgan ◽  
Noor Momin ◽  
Maria Zagorulya ◽  
Elen Torres-Mejia ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document