1
|
Zhang X, Yang Y, Zhao H, Tian Z, Cao Q, Li Y, Gu Y, Song Q, Hu X, Jin M, Jiang X. Correlation of PD-L1 expression with CD8+ T cells and oxidative stress-related molecules NRF2 and NQO1 in esophageal squamous cell carcinoma. J Pathol Clin Res 2024; 10:e12390. [PMID: 38992928 PMCID: PMC11239754 DOI: 10.1002/2056-4538.12390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/15/2024] [Accepted: 06/21/2024] [Indexed: 07/13/2024]
Abstract
Oxidative stress and the immune microenvironment both contribute to the pathogenesis of esophageal squamous cell carcinoma (ESCC). However, their interrelationships remain poorly understood. We aimed to examine the status of key molecules involved in oxidative stress and the immune microenvironment, as well as their relationships with each other and with clinicopathological features and prognosis in ESCC. The expression of programmed death-ligand 1 (PD-L1), CD8, nuclear factor erythroid-2 related factor-2 (NRF2), and NAD(P)H quinone oxidoreductase 1 (NQO1) was detected using immunohistochemistry in tissue samples from 176 patients with ESCC. We employed both combined positive score (CPS) and tumor proportion score (TPS) to evaluate PD-L1 expression and found a positive correlation between CPS and TPS. Notably, PD-L1 expression, as assessed by either CPS or TPS, was positively correlated with both NRF2 nuclear score and NQO1 score in stage II-IV ESCC. We also observed a positive correlation between the density of CD8+ T cells and PD-L1 expression. Furthermore, high levels of PD-L1 CPS, but not TPS, were associated with advanced TNM stage and lymph node metastases. Moreover, both PD-L1 CPS and the nuclear expression of NRF2 were found to be predictive of shorter overall survival in stage II-IV ESCC. By using the Mandard-tumor regression grading (TRG) system to evaluate the pathological response of tumors to neoadjuvant chemotherapy (NACT), we found that the TRG-5 group had higher NRF2 nuclear score, PD-L1 CPS, and TPS in pre-NACT biopsy samples compared with the TRG-3 + 4 group. The NQO1 scores of post-NACT surgical specimens were significantly higher in the TRG-5 group than in the TRG 3 + 4 group. In conclusion, the expression of PD-L1 is associated with aberrant NRF2 signaling pathway, advanced TNM stage, lymph node metastases, and unfavorable prognosis. The dysregulation of PD-L1 and aberrant activation of the NRF2 signaling pathway are implicated in resistance to NACT. Our findings shed light on the complex interrelationships between oxidative stress and the immune microenvironment in ESCC, which may have implications for personalized therapies and improved patient outcomes.
Collapse
Affiliation(s)
- Xin Zhang
- Department of PathologyBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingPR China
| | - Yanan Yang
- Department of PathologyBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingPR China
| | - Hongying Zhao
- Department of PathologyBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingPR China
| | - Zhongqiu Tian
- Department of PathologyBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingPR China
| | - Qing Cao
- Department of PathologyBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingPR China
| | - Yunlong Li
- Department of PathologyBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingPR China
| | - Yajuan Gu
- Department of PathologyBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingPR China
| | - Qinfei Song
- Department of PathologyBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingPR China
| | - Xiumei Hu
- Department of PathologyBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingPR China
| | - Mulan Jin
- Department of PathologyBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingPR China
| | - Xingran Jiang
- Department of PathologyBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingPR China
| |
Collapse
|
2
|
Chen H, Molberg K, Carrick K, Niu S, Rivera Colon G, Gwin K, Lewis C, Lea J, Panwar V, Zheng W, Castrillon DH, Lucas E. Expression and Prognostic Significance of LAG-3, TIGIT, VISTA, and IDO1 in Endometrial Serous Carcinoma. Mod Pathol 2024; 37:100532. [PMID: 38848896 DOI: 10.1016/j.modpat.2024.100532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/27/2024] [Accepted: 05/29/2024] [Indexed: 06/09/2024]
Abstract
Endometrial serous carcinoma (ESC) is an uncommon, aggressive type of endometrial cancer. While immune checkpoint blockade has emerged as a promising treatment option for endometrial carcinomas, research on the expression of immune checkpoints that could serve as prospective immunotherapy targets in ESC is limited. We examined the prevalence and prognostic value of lymphocyte-activation gene 3 (LAG-3), T-cell immunoglobulin and ITIM domain (TIGIT), V-domain immunoglobulin (Ig) suppressor of T-cell activation (VISTA), and indoleamine 2,3-dioxygenase 1 in 94 cases of ESC and correlated their expression with CD8+ and FOXP3+ tumor-infiltrating lymphocytes (TILs). We observed a positive correlation among LAG-3, TIGIT, and VISTA expressed on immune cells, and among these markers and CD8+ and FOXP3+ TIL densities. In Kaplan-Meier survival analysis, tumors with high levels of LAG-3 and TIGIT expression had better progression-free survival (PFS) and overall survival (OS) than those with lower levels of expression (LAG-3: PFS, P = .03, OS, P = .04; TIGIT: PFS, P = .01, OS, P = .009). In multivariate analysis, only high TIGIT expression was of independent prognostic value for better OS. VISTA expression in immune or tumor cells, and indoleamine 2,3-dioxygenase 1 expression in tumor cells, did not show a significant association with survival. Our data indicate that LAG-3, TIGIT, and VISTA immune checkpoints have roles in the microenvironment of ESC, and their expression patterns highlight the complex interactions among the different components of this system. High levels of these markers, together with high CD8+ TIL, suggest the potential immunogenicity of a subset of these tumors. Further studies are needed to elucidate the roles of various immune components in the ESC microenvironment and their association with intrinsic tumor properties.
Collapse
Affiliation(s)
- Hao Chen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Pathology, Parkland Hospital, Dallas, Texas
| | - Kyle Molberg
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Pathology, Parkland Hospital, Dallas, Texas
| | - Kelley Carrick
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Pathology, Parkland Hospital, Dallas, Texas
| | - Shuang Niu
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Pathology, Parkland Hospital, Dallas, Texas
| | - Glorimar Rivera Colon
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Pathology, Parkland Hospital, Dallas, Texas
| | - Katja Gwin
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Pathology, Parkland Hospital, Dallas, Texas
| | - Cheryl Lewis
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jayanthi Lea
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Vandana Panwar
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Pathology, Parkland Hospital, Dallas, Texas
| | - Wenxin Zheng
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Pathology, Parkland Hospital, Dallas, Texas; Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Diego H Castrillon
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Pathology, Parkland Hospital, Dallas, Texas; Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elena Lucas
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Pathology, Parkland Hospital, Dallas, Texas.
| |
Collapse
|
3
|
Santoro A, Angelico G, Inzani F, Arciuolo D, d'Amati A, Addante F, Travaglino A, Scaglione G, D'Alessandris N, Valente M, Tinnirello G, Raffone A, Narducci N, Piermattei A, Cianfrini F, Bragantini E, Zannoni GF. The emerging and challenging role of PD-L1 in patients with gynecological cancers: An updating review with clinico-pathological considerations. Gynecol Oncol 2024; 184:57-66. [PMID: 38295614 DOI: 10.1016/j.ygyno.2024.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/06/2024] [Accepted: 01/21/2024] [Indexed: 02/02/2024]
Abstract
Over recent years, there has been significant progress in the development of immunotherapeutic molecules designed to block the PD-1/PD-L1 axis. These molecules have demonstrated their ability to enhance the immune response by prompting T cells to identify and suppress neoplastic cells. PD-L1 is a type 1 transmembrane protein ligand expressed on T lymphocytes, B lymphocytes, and antigen-presenting cells and is considered a key inhibitory checkpoint involved in cancer immune regulation. PD-L1 immunohistochemical expression in gynecological malignancies is extremely variable based on tumor stage and molecular subtypes. As a result, a class of monoclonal antibodies targeting the PD-1 receptor and PD-L1, known as immune checkpoint inhibitors, has found successful application in clinical settings. In clinical practice, the standard method for identifying suitable candidates for immune checkpoint inhibitor therapy involves immunohistochemical assessment of PD-L1 expression in neoplastic tissues. The most commonly used PD-L1 assays in clinical trials are SP142, 28-8, 22C3, and SP263, each of which has been rigorously validated on specific platforms. Gynecologic cancers encompass a wide spectrum of malignancies originating from the ovaries, uterus, cervix, and vulva. These neoplasms have shown variable response to immunotherapy which appears to be influenced by genetic and protein expression profiles, including factors such as mismatch repair status, tumor mutational burden, and checkpoint ligand expression. In the present paper, an extensive review of PD-L1 expression in various gynecologic cancer types is discussed, providing a guide for their pathological assessment and reporting.
Collapse
Affiliation(s)
- Angela Santoro
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Giuseppe Angelico
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, Catania, Italy
| | - Frediano Inzani
- Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS San Matteo Hospital, 27100 Pavia, Italy
| | - Damiano Arciuolo
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Antonio d'Amati
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Francesca Addante
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Antonio Travaglino
- Pathology Unit, Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy
| | - Giulia Scaglione
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Nicoletta D'Alessandris
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Michele Valente
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Giordana Tinnirello
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, Catania, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Nadine Narducci
- Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Alessia Piermattei
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Federica Cianfrini
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Emma Bragantini
- Department of Pathology, Santa Chiara Hospital, Trento, Italy
| | - Gian Franco Zannoni
- Unità Operativa Complessa Anatomia Patologica Generale, Dipartimento di scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy.
| |
Collapse
|
4
|
Su H, Hao JJ, Xu YB, Zhang FH. Clinicopathological features and prognostic value of CD276 expression in female reproductive system malignancies: A meta-analysis. Taiwan J Obstet Gynecol 2024; 63:154-160. [PMID: 38485307 DOI: 10.1016/j.tjog.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 03/19/2024] Open
Abstract
The relationship between CD276 and malignancies of the female reproductive system has previously been controversial. The purpose of this study was to evaluate the predictive value of CD276 expression in clinicopathological features and prognosis of female reproductive system malignant tumors through meta-analysis. PubMed, Embase, Cochrane Library, Web of Science, CNKI and Wanfang databases were searched for studies published up to December 2022 on the role of CD276 expression in the clinicopathological features and prognosis of female reproductive system malignancies. STATA 14.0 was used for meta-analysis. A total of 10 studies were included, involving 840 patients with malignant tumors of the female reproductive system. The results showed that in terms of clinicopathological features: CD276 expression was closely related to lymph node status [OR = 2.33, 95 %CI = 1.32-4.11, P = 0.003], tumor differentiation [OR = 2.15, 95 %CI = 1.27-3.63, P = 0.004], and FIGO stage [OR = 2.58, 95 %CI = 1.44-4.61, P = 0.001] of reproductive system malignant tumors. In terms of prognosis: CD276 expression is strongly associated with shorter OS in patients with female reproductive system malignancies [HR = 3.33, 95 % CI = 1.36-8.15, P = 0.01]. CD276 may be a new target for immunotherapy and a biomarker for predicting poor prognosis of female reproductive system malignancies.
Collapse
Affiliation(s)
- Hang Su
- Department of Thyroid and Breast Surgery, Hebei General Hospital, Shijiazhuang, China; Graduate School, North China University of Science and Technology, Tangshan, China
| | - Juan-Juan Hao
- Department of Radiology, Huailai Campus, Peking University People's Hospital, Zhangjiakou, China
| | - Yan-Bo Xu
- Department of Thyroid and Breast Surgery, Hebei General Hospital, Shijiazhuang, China; Graduate School, North China University of Science and Technology, Tangshan, China
| | - Feng-Hua Zhang
- Department of Thyroid and Breast Surgery, Hebei General Hospital, Shijiazhuang, China.
| |
Collapse
|
5
|
Koumprentziotis IA, Theocharopoulos C, Foteinou D, Angeli E, Anastasopoulou A, Gogas H, Ziogas DC. New Emerging Targets in Cancer Immunotherapy: The Role of B7-H3. Vaccines (Basel) 2024; 12:54. [PMID: 38250867 PMCID: PMC10820813 DOI: 10.3390/vaccines12010054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024] Open
Abstract
Immune checkpoints (ICs) are molecules implicated in the fine-tuning of immune response via co-inhibitory or co-stimulatory signals, and serve to secure minimized host damage. Targeting ICs with various therapeutic modalities, including checkpoint inhibitors/monoclonal antibodies (mAbs), antibody-drug conjugates (ADCs), and CAR-T cells has produced remarkable results, especially in immunogenic tumors, setting a paradigm shift in cancer therapeutics through the incorporation of these IC-targeted treatments. However, the large proportion of subjects who experience primary or secondary resistance to available IC-targeted options necessitates further advancements that render immunotherapy beneficial for a larger patient pool with longer duration of response. B7-H3 (B7 Homolog 3 Protein, CD276) is a member of the B7 family of IC proteins that exerts pleiotropic immunomodulatory effects both in physiologic and pathologic contexts. Mounting evidence has demonstrated an aberrant expression of B7-H3 in various solid malignancies, including tumors less sensitive to current immunotherapeutic options, and has associated its expression with advanced disease, worse patient survival and impaired response to IC-based regimens. Anti-B7-H3 agents, including novel mAbs, bispecific antibodies, ADCs, CAR-T cells, and radioimmunotherapy agents, have exhibited encouraging antitumor activity in preclinical models and have recently entered clinical testing for several cancer types. In the present review, we concisely present the functional implications of B7-H3 and discuss the latest evidence regarding its prognostic significance and therapeutic potential in solid malignancies, with emphasis on anti-B7-H3 modalities that are currently evaluated in clinical trial settings. Better understanding of B7-H3 intricate interactions in the tumor microenvironment will expand the oncological utility of anti-B7-H3 agents and further shape their role in cancer therapeutics.
Collapse
|
6
|
Sun Y, Zhou X, Lucas E, Chen L, Zhang H, Chen H, Zhou F. Expression of B7-H3 and TIM-3 in gastric-type endocervical adenocarcinoma: prevalence, association with PD-L1 expression, and prognostic significance. J Pathol Clin Res 2024; 10:e345. [PMID: 37798754 PMCID: PMC10766062 DOI: 10.1002/cjp2.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/23/2023] [Accepted: 09/03/2023] [Indexed: 10/07/2023]
Abstract
Gastric-type endocervical adenocarcinoma (GEA) is the second most common subtype of endocervical adenocarcinoma and has a poor prognosis. Anti-programmed death-1 and anti-programmed death-ligand 1 (PD-L1) inhibitors have emerged as a major treatment option for GEA; however, data on the expression of other immune checkpoints in GEA are limited. We analyzed the expression of T-cell immunoglobulin and mucin-domain containing-3 (TIM-3) and B7 homolog 3 protein (B7-H3) in 58 GEA and investigated their prognostic significance as well as association with PD-L1 expression and other known prognostic factors. Applying the tumor proportion score (TPS) with a cutoff of 1%, B7-H3 and TIM-3 were present in 48.3% and 17.2% of cases, respectively. Applying the combined positive score (CPS) with a cutoff of 1, TIM-3 expression was present in 70.7% of cases. Moreover, the expression of three checkpoints (B7-H3, TIM-3, and PD-L1) was incompletely overlapping. Patients with B7-H3 positive tumors (by TPS) or TIM-3 positive tumors (by TPS) had significantly worse recurrence-free survival (RFS) and overall survival (OS) (log-rank). Using CPS, patients with TIM-3 positive tumors showed significantly worse RFS (log-rank). Similarly, B7-H3 positivity (by TPS) and TIM-3 positivity (by TPS) were associated with worse RFS and OS in univariate analysis. TIM-3 positivity (by CPS) was associated with worse RFS in univariate analysis and the final Cox multivariate analysis. In conclusion, our results show that (1) B7-H3 and TIM-3 are frequently expressed in GEA and their expression overlaps incompletely with PD-L1; and (2) both B7-H3 and TIM-3 are independent negative prognostic markers in GEA.
Collapse
Affiliation(s)
- Yao Sun
- Department of PathologyZhejiang University School of Medicine Women's HospitalHangzhouZhejiang ProvincePR China
| | - Xin Zhou
- Department of PathologyZhejiang University School of Medicine Women's HospitalHangzhouZhejiang ProvincePR China
- Department of PathologyInternational Peace Maternity and Child Health Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiPR China
| | - Elena Lucas
- Department of PathologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
- Department of PathologyParkland HospitalDallasTXUSA
| | - Lili Chen
- Department of GynecologyZhejiang University School of Medicine Women's HospitalHangzhouZhejiang ProvincePR China
| | - Huijuan Zhang
- Department of PathologyInternational Peace Maternity and Child Health Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiPR China
| | - Hao Chen
- Department of PathologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
- Department of PathologyParkland HospitalDallasTXUSA
| | - Feng Zhou
- Department of PathologyZhejiang University School of Medicine Women's HospitalHangzhouZhejiang ProvincePR China
- Department of PathologyInternational Peace Maternity and Child Health Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiPR China
| |
Collapse
|
7
|
Zhang L, Zhu Q, Zhao Q, Lin X, Song H, Liu H, Zhu G, Lu S, Cao B. Tumor-infiltrating immune cell score as an independent prognostic predictor for endometrial carcinoma: Insights from a comprehensive analysis of the immune landscape. Cancer Rep (Hoboken) 2024; 7:e1939. [PMID: 38017652 PMCID: PMC10809205 DOI: 10.1002/cnr2.1939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/20/2023] [Accepted: 11/12/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Immune cells are crucial components in the tumor microenvironment and have a significant impact on the outcomes of patients. AIMS Here, we aimed to establish a prognostic score based on different types of tumor-infiltrating immune cells for Endometrial Carcinoma (EC). METHODS AND RESULTS We enrolled and analyzed 516 EC patients from The Cancer Genome Atlas. The relative abundance of 22 immune cells were estimated by using the CIBERSORTx algorithm. Cox regression was performed to identify potential prognostic immune cells, which were used to develop a Tumor-infiltrating Immune Cell Score (TICS). The prognostic and incremental value of TICS for overall survival were compared with traditional prognostic factors using the C-index and decision curves. Clustering analysis using all immune cells identified three immune landscape subtypes, which had weak correlation with survival. A TICS was constructed using CD8T cells, resting memory CD4 T cells, activated NK and activated DCs, and classified patients as low-, moderate- and high-risk subgroups. The low-risk subgroup had higher tumor mutation burden and activation of IL2/STAT5, IL2/STAT3 and IFN-gamma response pathways. Conversely, the high-risk subgroup was associated with DNA copy number variation, hypoxia and EMT process. The TICS subgroups significantly predicted overall survival, which was independent of patient age, tumor stage, grade and molecular classification. Moreover, we developed a nomogram incorporating TICS and clinicopathologic factors, which significantly improved the predictive accuracy compared to the clinicopathologic model alone. CONCLUSION The TICS is an effective and independent prognostic predictor for EC patients and may serve as a useful supplement to clinicopathological factors and molecular subtyping.
Collapse
Affiliation(s)
- Liping Zhang
- Department of Clinical Laboratory, Sichuan Provincial Maternity and Child Health Care Hospital, Affiliated Women's and Children's Hospital of Chengdu Medical CollegeChengdu Medical CollegeChengduChina
| | - Qiaoying Zhu
- Department of Clinical Laboratory, Sichuan Provincial Maternity and Child Health Care Hospital, Affiliated Women's and Children's Hospital of Chengdu Medical CollegeChengdu Medical CollegeChengduChina
| | - Qi Zhao
- Department of Biobank, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer CenterUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Xueping Lin
- Department of Clinical Laboratory, Sichuan Provincial Maternity and Child Health Care Hospital, Affiliated Women's and Children's Hospital of Chengdu Medical CollegeChengdu Medical CollegeChengduChina
| | - Hui Song
- Department of Clinical Laboratory, Sichuan Provincial Maternity and Child Health Care Hospital, Affiliated Women's and Children's Hospital of Chengdu Medical CollegeChengdu Medical CollegeChengduChina
| | - Hong Liu
- Department of Gynecologic Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer CenterUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Guiquan Zhu
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, Department of Head and Neck Oncology, West China Hospital of StomatologySichuan UniversityChengduChina
| | - Shun Lu
- Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer CenterUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Bangrong Cao
- Department of Biobank, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer CenterUniversity of Electronic Science and Technology of ChinaChengduChina
- Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer CenterUniversity of Electronic Science and Technology of ChinaChengduChina
| |
Collapse
|
8
|
Li HY, Chen YL, Deng XN, Li HH, Tan J, Liu GJ, Zheng YJ, Pei M, Peng KT, Yue LL, Chen XJ, Liu Y, Zhao YS, Wang CH. Bispecific antibody targeting both B7-H3 and PD-L1 exhibits superior antitumor activities. Acta Pharmacol Sin 2023; 44:2322-2330. [PMID: 37328649 PMCID: PMC10618207 DOI: 10.1038/s41401-023-01118-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/28/2023] [Indexed: 06/18/2023] Open
Abstract
Clinical application of PD-1 and PD-L1 monoclonal antibodies (mAbs) is hindered by their relatively low response rates and the occurrence of drug resistance. Co-expression of B7-H3 with PD-L1 has been found in various solid tumors, and combination therapies that target both PD-1/PD-L1 and B7-H3 pathways may provide additional therapeutic benefits. Up to today, however, no bispecific antibodies targeting both PD-1 and B7-H3 have reached the clinical development stage. In this study, we generated a stable B7-H3×PD-L1 bispecific antibody (BsAb) in IgG1-VHH format by coupling a humanized IgG1 mAb against PD-L1 with a humanized camelus variable domain of the heavy-chain of heavy-chain antibody (VHH) against human B7-H3. The BsAb exhibited favorable thermostability, efficient T cell activation, IFN-γ production, and antibody-dependent cell-mediated cytotoxicity (ADCC). In a PBMC humanized A375 xenogeneic tumor model, treatment with BsAb (10 mg/kg, i.p., twice a week for 6 weeks) showed enhanced antitumor activities compared to monotherapies and, to some degree, combination therapies. Our results suggest that targeting both PD-1 and B7-H3 with BsAbs increases their specificities to B7-H3 and PD-L1 double-positive tumors and induces a synergetic effect. We conclude that B7-H3×PD-L1 BsAb is favored over mAbs and possibly combination therapies in treating B7-H3 and PD-L1 double-positive tumors.
Collapse
Affiliation(s)
- Hua-Ying Li
- Shanghai Mabstone Biotechnologies, Ltd., Shanghai, 201203, China
- School of Life Science and Bio-Pharmaceutics, Shenyang Pharmaceutical University, Shenyang, 110016, China
- Biotherapeutics Discovery Research Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Yi-Li Chen
- Shanghai Mabstone Biotechnologies, Ltd., Shanghai, 201203, China.
| | - Xiang-Nan Deng
- School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Huan-Huan Li
- Shanghai Mabstone Biotechnologies, Ltd., Shanghai, 201203, China
| | - Jie Tan
- Shanghai Mabstone Biotechnologies, Ltd., Shanghai, 201203, China
| | - Guo-Jian Liu
- Dartsbio Pharmaceuticals, Ltd., Zhongshan, 528400, China
| | - Yu-Juan Zheng
- Biotherapeutics Discovery Research Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Min Pei
- Shanghai Mabstone Biotechnologies, Ltd., Shanghai, 201203, China
- Institute of Biomedicine & Department of Cell Biology, Jinan University, National Engineering Research Center of Genetic Medicine, Guangzhou, 510632, China
| | - Kai-Ting Peng
- Biotherapeutics Discovery Research Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Li-Li Yue
- Biotherapeutics Discovery Research Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, 211198, China
| | - Xiao-Jia Chen
- Institute of Biomedicine & Department of Cell Biology, Jinan University, National Engineering Research Center of Genetic Medicine, Guangzhou, 510632, China
| | - Yu Liu
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, 211198, China
| | - Yong-Shan Zhao
- School of Life Science and Bio-Pharmaceutics, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Chun-He Wang
- Biotherapeutics Discovery Research Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China.
- School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
- Dartsbio Pharmaceuticals, Ltd., Zhongshan, 528400, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
- Institute of Biomedicine & Department of Cell Biology, Jinan University, National Engineering Research Center of Genetic Medicine, Guangzhou, 510632, China.
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, 211198, China.
| |
Collapse
|
9
|
Su H, Li N, Chen Z, Hao J, Zhang F. Clinicopathological features and prognostic value of CD276 expression in head and neck cancer: A meta-analysis. Am J Otolaryngol 2023; 44:103968. [PMID: 37442085 DOI: 10.1016/j.amjoto.2023.103968] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/21/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE We conducted a meta-analysis to assess the predictive value of CD276 expression in the clinicopathological features and prognosis of head and neck cancer. METHODS Pubmed, Embase, Cochrane library, Web of science, CNKI and Wanfang databases were searched for studies focused on the role of CD276 expression in the clinicopathological features and prognosis of head and neck cancer, published up to December 2022. STATA 14.0 were used to perform the meta-analysis. RESULTS A total of 8 eligible studies involving 1417 patients with head and neck cancer were included in this meta-analysis. The results showed that in terms of clinicopathological features, CD276 expression was related to gender [OR = 1.35, 95%CI = 1.01-1.82, P = 0.04], lymph node status [OR = 3.43, 95%CI = 1.96-5.98, P < 0.001] and TNM stage [OR = 2.54, 95%CI = 1.72-3.74, P < 0.001] of head and neck cancer patients, but not age [OR = 0.76, 95%CI = 0.52-1.11, P = 0.15] and tumor differentiation [OR = 1.39, 95%CI = 0.92-2.13, P = 0.12] . In terms of prognosis, CD276 expression is significantly associated with shorter overall survival [HR = 2.08, 95%CI = 1.22-3.56, P = 0.01] in head and neck cancer patients. CONCLUSION CD276 expression was significantly correlated with gender, lymph node status, TNM stage and poor prognosis in head and neck cancer patients and may be a new target for immunotherapy and a biomarker for predicting poor prognosis in head and neck cancer.
Collapse
Affiliation(s)
- Hang Su
- Department of Thyroid and Breast Surgery, Hebei General Hospital, Shijiazhuang, China; Graduate School, North China University of Science and Technology, Tangshan, China
| | - Ning Li
- Department of Thyroid and Breast Surgery, Hebei General Hospital, Shijiazhuang, China; Graduate School, Hebei Medical University, Shijiazhuang, China
| | - Zitong Chen
- Department of Thyroid and Breast Surgery, Hebei General Hospital, Shijiazhuang, China; Graduate School, Hebei Medical University, Shijiazhuang, China
| | - Juanjuan Hao
- Department of Radiology, Huailai Campus, Peking University People's Hospital, Zhangjiakou, China
| | - Fenghua Zhang
- Department of Thyroid and Breast Surgery, Hebei General Hospital, Shijiazhuang, China.
| |
Collapse
|
10
|
Waluyo ST, Tjokroprawiro BA, Rahaju AS. Estrogen receptor and programmed death ligand-1 expression in type 1 endometrial cancer and its associated clinicopathological characteristics. Cancer Treat Res Commun 2023; 37:100766. [PMID: 37797425 DOI: 10.1016/j.ctarc.2023.100766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/13/2023] [Accepted: 09/23/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND This study aimed to determine the association of estrogen receptor (ER) and programmed death ligand-1 (PD-L1) expression with the clinicopathological characteristics of type 1 endometrial cancer. MATERIALS AND METHODS A total of 85 patients with type 1 endometrial cancer who underwent surgery at the Dr. Soetomo Hospital, Surabaya, Indonesia were retrospectively studied. Data about the age, menopausal status, body mass index, disease stage, cell differentiation, angiolymphatic invasion, myometrial invasion, and adjuvant therapy of the patients were collected from medical records. Immunohistochemistry with ER and PD-L1 antibodies was performed on all samples. The association between ER and PD-L1 expression and clinicopathological characteristics was statistically analyzed. RESULTS The positivity rates of ER and PD-L1 in type 1 endometrial cancer were 68.2 % and 78.5 %, respectively. ER positivity was significantly correlated with body mass index (BMI) ≥25, premenopausal status, early stage of disease, <1/2 myometrial invasion, negative nodal metastasis, and lack of adjuvant therapy. It was also associated with age <55 years, low-grade cells, and angiolymphatic invasion, but the correlation was not significant. Meanwhile, PD-L1 positivity was significantly correlated with BMI <25, menopausal status, advanced stage of disease, high-grade cells, angiolymphatic invasion, and adjuvant therapy. It was also associated with age ≥55 years and nodal metastasis, but the correlation was not significant. CONCLUSION ER and PDL-1 positivity is associated with the clinicopathological characteristics of type 1 endometrial cancer.
Collapse
Affiliation(s)
- Setyo Teguh Waluyo
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Subspecialist Education Program, Dr Soetomo General Academic Hospital, Medical Faculty - Universitas Airlangga, Surabaya, Indonesia
| | - Brahmana Askandar Tjokroprawiro
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
| | - Anny Setijo Rahaju
- Department of Anatomical Pathology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital/Universitas Airlangga Hospital, Surabaya, Indonesia
| |
Collapse
|
11
|
Liu X, Jin S, Zi D. Overall survival prediction models for gynecological endometrioid adenocarcinoma with squamous differentiation (GE-ASqD) using machine-learning algorithms. Sci Rep 2023; 13:8395. [PMID: 37225749 DOI: 10.1038/s41598-023-33748-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/18/2023] [Indexed: 05/26/2023] Open
Abstract
The actual 5-year survival rates for Gynecological Endometrioid Adenocarcinoma with Squamous Differentiation (GE-ASqD) are rarely reported. The purpose of this study was to evaluate how histological subtypes affected long-term survivors of GE-ASqD (> 5 years). We conducted a retrospective analysis of patients diagnosed GE-ASqD from the Surveillance, Epidemiology, and End Results database (2004-2015). In order to conduct the studies, we employed the chi-square test, univariate cox regression, and multivariate cox proportional hazards model. A total of 1131 patients with GE-ASqD were included in the survival study from 2004 to 2015 after applying the inclusion and exclusion criteria and the sample randomly split into a training set and a test set at a ratio of 7:3. Five machine learning algorithms were trained based on nine clinical variables to predict the 5-year overall survival. The AUC of the training group for the LR, Decision Tree, forest, Gbdt, and gbm algorithms were 0.809, 0.336, 0.841, 0.823, and 0.856 respectively. The AUC of the testing group was 0.779, 0.738, 0.753, 0.767 and 0.734, respectively. The calibration curves confirmed good performance of the five machine learning algorithms. Finally, five algorithms were combined to create a machine learning model that forecasts the 5-year overall survival rate of patients with GE-ASqD.
Collapse
Affiliation(s)
- Xiangmei Liu
- Guizhou Medical University, Guiyang, China
- Department of Gynecology and Obstetrics, Guizhou Provincial People's Hospital, Guiyang, China
| | - Shuai Jin
- School of Big Health, Guizhou Medical University, Guiyang, China
| | - Dan Zi
- Department of Gynecology and Obstetrics, Guizhou Provincial People's Hospital, Guiyang, China.
- Department of Gynecology and Obstetrics, The Affiliated People's Hospital of Guizhou Medical University, Guiyang, China.
| |
Collapse
|
12
|
Mortezaee K. B7-H3 immunoregulatory roles in cancer. Biomed Pharmacother 2023; 163:114890. [PMID: 37196544 DOI: 10.1016/j.biopha.2023.114890] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/06/2023] [Accepted: 05/12/2023] [Indexed: 05/19/2023] Open
Abstract
B7 homolog 3 (B7-H3, also called CD276) is a checkpoint of B7 family that is aberrantly and consistently expressed in several human cancers, and its overexpression correlates with weak prognosis. B7-H3 is expressed on a number of cells, and it acts as a driver of immune evasion. This is mediated through hampering T cell infiltration and promoting exhaustion of CD8+ T cells. Increased B7-H3 activity also promotes macrophage polarity toward pro-tumor type 2 (M2) phenotype. In addition, high B7-H3 activity induces aberrant angiogenesis to promote hypoxia, a result of which is resistance to common immune checkpoint inhibitor (ICI) therapy. This is mediated through the impact of hypoxia on dampening CD8+ T cell recruitment into tumor area. The immunosuppressive property of B7-H3 offers insights into targeting this checkpoint as a desired approach in cancer immunotherapy. B7-H3 can be a target in blocking monoclonal antibodies (mAbs), combination therapies, chimeric antigen receptor-modified T (CAR-T) cells and bispecific antibodies.
Collapse
Affiliation(s)
- Keywan Mortezaee
- Department of Anatomy, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| |
Collapse
|
13
|
Brummel K, Eerkens AL, de Bruyn M, Nijman HW. Tumour-infiltrating lymphocytes: from prognosis to treatment selection. Br J Cancer 2023; 128:451-458. [PMID: 36564565 PMCID: PMC9938191 DOI: 10.1038/s41416-022-02119-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
Tumour-infiltrating lymphocytes (TILs) are considered crucial in anti-tumour immunity. Accordingly, the presence of TILs contains prognostic and predictive value. In 2011, we performed a systematic review and meta-analysis on the prognostic value of TILs across cancer types. Since then, the advent of immune checkpoint blockade (ICB) has renewed interest in the analysis of TILs. In this review, we first describe how our understanding of the prognostic value of TIL has changed over the last decade. New insights on novel TIL subsets are discussed and give a broader view on the prognostic effect of TILs in cancer. Apart from prognostic value, evidence on the predictive significance of TILs in the immune therapy era are discussed, as well as new techniques, such as machine learning that strive to incorporate these predictive capacities within clinical trials.
Collapse
Affiliation(s)
- Koen Brummel
- University of Groningen, University Medical Center Groningen, Department of Obstetrics and Gynecology, Groningen, The Netherlands
| | - Anneke L Eerkens
- University of Groningen, University Medical Center Groningen, Department of Obstetrics and Gynecology, Groningen, The Netherlands
| | - Marco de Bruyn
- University of Groningen, University Medical Center Groningen, Department of Obstetrics and Gynecology, Groningen, The Netherlands
| | - Hans W Nijman
- University of Groningen, University Medical Center Groningen, Department of Obstetrics and Gynecology, Groningen, The Netherlands.
| |
Collapse
|