可溶性PD-L1与早期非小细胞肺癌(NSCLC)的复发和总生存率无关

IF 4.5 2区 医学 Q1 ONCOLOGY Lung Cancer Pub Date : 2024-09-16 DOI:10.1016/j.lungcan.2024.107955
F.O. Mildner , M.M. Sykora , H. Hackl , A. Amann , B. Zelger , S. Sprung , M.L. Buch , F. Nocera , P. Moser , H. Maier , F. Augustin , C. Manzl , F. Kocher , A. Pircher , J. Lindenmann , I Mykoliuk , S. Raftopoulou , J. Kargl , D. Wolf , S. Sopper , G. Gamerith
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引用次数: 0

摘要

背景癌症免疫逃避在非小细胞肺癌(NSCLC)中至关重要,已成为免疫疗法的靶点。高可溶性(s)PD-L1与晚期生存率降低和治疗失败有关。在此,我们评估了 sPD-L1 对早期 NSCLC 的 T 细胞、无复发生存率和总生存率的影响。方法在 sPD-L1 存在的情况下进行体外 T 细胞刺激,以评估其免疫调节活性。研究人员对癌症基因组图谱(TCGA)中的数据进行了调查,以了解PD-L1剪接变体和参与蛋白水解的酶(即ADAM10)。在治愈性手术前,收集了 74 例 NSCLC(IA-IIIB 期)患者和另外 73 例(对照组)患者的血浆。结果体外 sPD-L1 可抑制 IFN-γ 的产生和 T 细胞的增殖,并诱导表达 CD27 的终末效应 CD4 T 细胞亚型。TCGA 的数据表明,ADAM10 的 mRNA 水平升高是 NSCLC 患者预后的负面预测因子。为了研究这些体外研究和 TCGA 研究结果的临床意义,我们对早期 NSCLC 患者血浆中的 sPD-L1 进行了定量检测。在第一个队列中,我们发现复发 NSCLC 患者的 sPD-L1 水平明显较高,多变量分析显示高 sPD-L1(1000 pg/mL)是生存率的独立预测因子。讨论虽然体外和TCGA数据支持sPD-L1的抑制作用,但我们无法将其应用于临床。这些结果可能是由于患者人数少、异质性强以及缺乏标准化的 sPD-L1 酶联免疫吸附试验。关于 sPD-L1 在早期 NSCLC 中的价值,我们的研究结果尚无定论,因此需要在更大规模的(新)辅助试验中对检测方法进行验证和进一步研究。
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Soluble PD-L1 shows no association to relapse and overall survival in early stage non-small cell lung cancer (NSCLC)

Background

Cancer immune evasion is critical in non-small cell lung cancer (NSCLC) and has been targeted by immunotherapy. High soluble (s)PD-L1 is associated with reduced survival and treatment failure in advanced stages. Here we evaluated the effects of sPD-L1 on T cells, relapse free survival, and overall survival in early stage NSCLC.

Methods

In vitro T cell stimulation was performed in the presence of sPD-L1 to evaluate its immunomodulatory activity. Data from The Cancer Genome Atlas (TCGA) were investigated for PD-L1 splice variants and enzymes involved in proteolytic cleavage (i.e. ADAM10). Plasma from 74 NSCLC (stage IA-IIIB), as well as an additional 73 (control cohort) patients was collected prior to curative surgery. Thereafter sPD-L1 levels from an immunosorbent assay were correlated with patient outcome.

Results

In vitro sPD-L1 inhibited IFN-γ production and proliferation of T cells and induced a terminal effector CD4 T cell subtype expressing CD27. Data from the TCGA demonstrated that elevated mRNA levels of ADAM10 is a negative predictor of outcome in NSCLC patients. To investigate the clinical relevance of these in vitro and TCGA findings, we quantified sPD-L1 in the plasma of early-stage NSCLC patients. In the first cohort we found significantly higher sPD-L1 levels in relapsing NSCLC patients, with a multivariate analysis revealing high sPD-L1 (>1000 pg/mL) as an independent predictor of survival. However, these findings could not be validated in two independent control cohorts.

Discussion

Although in vitro and TCGA data support the suppressive effect of sPD-L1 we were unable to translate this in our clinical setting. These results may be due to the small patient number and their heterogeneity as well as the lack of a standardized sPD-L1 ELISA. Our inconclusive results regarding the value of sPD-L1 in early stage NSCLC warrant assay validation and further investigation in larger (neo-)adjuvant trials.

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来源期刊
Lung Cancer
Lung Cancer 医学-呼吸系统
CiteScore
9.40
自引率
3.80%
发文量
407
审稿时长
25 days
期刊介绍: Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.
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