Predictive value of NLR, TILs (CD4+/CD8+) and PD-L1 expression for prognosis and response to preoperative chemotherapy in gastric cancer.
Aged
Antineoplastic Agents
/ pharmacology
B7-H1 Antigen
/ biosynthesis
CD4-Positive T-Lymphocytes
/ cytology
CD8-Positive T-Lymphocytes
/ cytology
Female
Herpesvirus 4, Human
Humans
Immunohistochemistry
Immunotherapy
Inflammation
Kaplan-Meier Estimate
Lymphocytes, Tumor-Infiltrating
/ immunology
Male
Middle Aged
Multivariate Analysis
Neoadjuvant Therapy
Perioperative Period
Predictive Value of Tests
Preoperative Period
Prognosis
Receptor, ErbB-2
/ biosynthesis
Retrospective Studies
Stomach Neoplasms
/ diagnosis
Treatment Outcome
Tumor Microenvironment
Gastric cancer
Immunological status
Neoadjuvant chemotherapy
Precision medicine
Predictive factors
Journal
Cancer immunology, immunotherapy : CII
ISSN: 1432-0851
Titre abrégé: Cancer Immunol Immunother
Pays: Germany
ID NLM: 8605732
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
04
01
2021
accepted:
06
05
2021
pubmed:
20
5
2021
medline:
18
1
2022
entrez:
19
5
2021
Statut:
ppublish
Résumé
The combination of perioperative chemotherapy plus complete surgical resection is currently accounted as the first-choice strategy in patients with locally advanced Gastric Cancer (LAGC). Nevertheless, the partial response rate makes it necessary to search biological parameters useful to select patients who would benefit most from neoadjuvant chemotherapy (NAD-CT). We performed a retrospective analysis on a cohort of 65 LAGC cases, EBV negative and without MMR defect, submitted to perioperative chemotherapy plus surgical resection. We evaluated the neutrophil-lymphocytes ratio (NLR) in peripheral blood, the TILs density (reported as CD4/CD8 tissue ratio) and PD-L1 expression by immunohistochemistry on bioptic tissues before the treatment. Results were correlated with the biological features, histological response (TRG) and clinical outcome (PFS and OS). We found that NLR, TILs and PD-L1 expression showed a significant correlation with TNM stage, lymphovascular invasion and response to NAD-CT (TRG). Correlating the NLR, TILs and PD-L1 expression with PFS and OS, we found that patients with lower NLR levels (< 2.5 ratio), lower TILs (< 0.2 ratio) and higher PD-L1 level (CPS ≥ 1) had a significantly better PFS and OS than those with higher NLR, higher TILs and lower PD-L1 expression (p < 0.0001). Multivariate and multiple regression analyses confirmed the predictive and prognostic role of all three parameters, especially when all three parameters are combined. Our study demonstrated that pre-treatment NLR, TILs and PD-L1 expression are predictive and prognostic parameters in NAD-CT-treated LAGC suggesting a pivotal role of the systemic and tumor microenvironment immunological profile in the response to chemotherapy.
Identifiants
pubmed: 34009410
doi: 10.1007/s00262-021-02960-1
pii: 10.1007/s00262-021-02960-1
pmc: PMC8738448
doi:
Substances chimiques
Antineoplastic Agents
0
B7-H1 Antigen
0
CD274 protein, human
0
ERBB2 protein, human
EC 2.7.10.1
Receptor, ErbB-2
EC 2.7.10.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
45-55Subventions
Organisme : Università Cattolica del Sacro Cuore
ID : Linea D1 2017, 2018
Informations de copyright
© 2021. The Author(s).
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