Peripheral cytokines are not influenced by the type of surgical approach for non-small cell lung cancer by four weeks postoperatively.

The influence of surgical approach on systemic inflammatory response and the subsequent oncologic impact for non-small cell lung cancer is debated. We aimed to measure the effects of thoracic surgical approach on peripheral cytokine milieu over time. Patients undergoing primary lung resection without neoadjuvant therapy (2016-2018) were evaluated. A panel of 43 cytokines, angiogenic factors, and inflammatory molecules (CAFs) were evaluated in peripheral blood preoperatively, at 24 -hs and 4-weeks postoperatively. Differences between CAFs in patients undergoing thoracotomy versus video-assisted thoracoscopic surgery (VATS) at all timepoints were assessed using Student's t-test. 76 patients with available peripheral CAF panels met inclusion criteria. Thoracotomy was performed in 53 (70 %) patients while VATS was undertaken in 23 (30 %). Upon examination of known inflammatory CAFs, including IL-1β, IL-6, IL-8, IL-10, IFN-γ, and soluble (s) CD27, no differences were detected at 24 h or 4 weeks postoperatively between surgical groups. Examination of trends over time did not demonstrate any temporal derangements for these CAFs, with return to baseline levels by 4 weeks postoperatively for both groups. Evaluation of soluble (s) checkpoint molecules, including sPD-1, sPD-L1, sTIM-3, and sCTLA-4, did not reveal any differences in the immediate postoperative or long-term recovery period. Peripheral immune profiles following pulmonary resection do not appear to differ between VATS and thoracotomy postoperatively. CAF fluctuations are transient and recover rapidly. These results, at the peripheral cytokine level, suggest that the surgical approach for lung cancer is unlikely to alter the effectiveness of novel immune-modulating systemic therapies, although more studies are needed to validate these findings.

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Déclaration de conflit d'intérêts

Declaration of Competing Interest Dr. Swisher discloses a financial relationship with Ethicon and the Peter MacCallum Cancer Center; Dr. Cascone with the Society for Immunotherapy of Cancer and Bristol-Myers Squibb; Dr. Sepesi with Bristol-Myers Squibb; Dr. Heymach with AstraZeneca, Boehringer Ingelheim, Exelixis, Genentech, GlaxoSmithKline, Guardant Health, Hengrui, Lilly, Novartis, Spectrum, EMD Serono, and Synta; Dr. Gibbons with AstraZeneca and Sanofi; and Dr. Jianjun Zhang with BMS, AstraZeneca, Geneplus, OrigMed, Innovent, Merck, and Johnson & Johnson. Dr. Gibbons has received research funding from AstraZeneca, Janssen, and Takeda. Dr. Heymach has received research support from AstraZeneca, Bayer, GlaxoSmithKline, and Spectrum. Dr. Cascone has received research funding to MD Anderson Cancer Center from Boehringer Ingelheim and Bristol-Myers Squibb.