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30-12-2022 | Checkpoint Inhibitors | Research

Response to neoadjuvant immune checkpoint inhibitors and chemotherapy in Chinese patients with esophageal squamous cell carcinoma: the role of tumor immune microenvironment

Authors: Xiaoyuan Wang, Xiaodong Ling, Changhong Wang, Jinfeng Zhang, Yingnan Yang, Hao Jiang, Yanzhong Xin, Luquan Zhang, Hao Liang, Chengyuan Fang, Dayong Zheng, Jinhong Zhu, Jianqun Ma

Published in: Cancer Immunology, Immunotherapy | Issue 6/2023

Abstract

Background

Immune checkpoint inhibitors (ICIs) through programmed cell death 1 blockade improve the survival outcomes of patients with advanced esophageal squamous cell carcinoma (ESCC). Recently, the use of neoadjuvant immunotherapy for the treatment of ESCC has been gradually increasing. We aimed to evaluate the efficacy of neoadjuvant treatment of ICIs with chemotherapy and explore tumor microenvironment (TME) immune profiles of ESCC samples during neoadjuvant therapy.

Methods

Patients with previously untreated, resectable, locally advanced ESCC (stage II or III) in Harbin Medical University Cancer Hospital were enrolled. Each patient received two to four cycles of neoadjuvant ICIs combined with chemotherapy before surgical resection. The TME immune profiles of formalin-fixed paraffin-embedded tumor samples at baseline and after surgery were evaluated by multiplex staining and multispectral imaging.

Results

In all, 18 patients were enrolled, and all patients received surgery with R0 resection. The postoperative pathological evaluation indicated that 7 (38.9%) patients had a pathological complete response (pCR) and 11 (61.1%) patients had a partial response. The neoadjuvant therapeutic regimens had acceptable side effect profiles. The TME immune profiles at baseline observed higher densities of stroma CD3 + , PD-1 + , and PD-1 + CD3 + cells in pCR patients than in non-pCR patients. Comparing TME immune profiles before and after neoadjuvant treatment, an increase in CD8 + T cells and a decrease in CD163 + CD68 + M2-like macrophage cells were observed after neoadjuvant treatment.

Conclusions

Neoadjuvant ICIs combined with chemotherapy produced a satisfactory treatment response, demonstrating its anti-tumor efficacy in locally advanced ESCC. Further large-scale studies are required to understand the role of tumor immunities and ICIs underlying ESCC.

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Title: Response to neoadjuvant immune checkpoint inhibitors and chemotherapy in Chinese patients with esophageal squamous cell carcinoma: the role of tumor immune microenvironment
Authors: Xiaoyuan Wang
Xiaodong Ling
Changhong Wang
Jinfeng Zhang
Yingnan Yang
Hao Jiang
Yanzhong Xin
Luquan Zhang
Hao Liang
Chengyuan Fang
Dayong Zheng
Jinhong Zhu
Jianqun Ma
Publication date: 30-12-2022
Publisher: Springer Berlin Heidelberg
Keywords: Checkpoint Inhibitors
Cytostatic Therapy
Published in: Cancer Immunology, Immunotherapy / Issue 6/2023
Print ISSN: 0340-7004
Electronic ISSN: 1432-0851
DOI: https://doi.org/10.1007/s00262-022-03354-7

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