Unravelling the Reasons Behind Limited Response to Anti-PD Therapy in ATC: A Comprehensive Evaluation of Tumor-Infiltrating Immune Cells and Checkpoints.

Autor: Boruah M; Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India., Agarwal S; Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India. drshipra0902@gmail.com., Mir RA; Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India. riyaz978@gmail.com., Choudhury SD; Confocal Microscopy Facility, Centralized Core Research Facility, All India Institute of Medical Sciences (AIIMS), New Delhi, India., Sikka K; Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India., Rastogi S; Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India., Damle N; Department of Nuclear Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India., Sharma MC; Department of Neuropathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Jazyk: angličtina
Zdroj: Endocrine pathology [Endocr Pathol] 2024 Dec; Vol. 35 (4), pp. 419-431. Date of Electronic Publication: 2024 Oct 31.
DOI: 10.1007/s12022-024-09832-1
Abstrakt: Inhibiting the immune checkpoint (ICP) PD-1 based on PD-L1 expression status has revolutionized the treatment of various cancers, yet its efficacy in anaplastic thyroid carcinoma (ATC) remains limited. The therapeutic response depends upon multiple factors, particularly the conduciveness of the tumor's immune milieu. This study comprehensively evaluated and classified ATC's immune microenvironment (IME) to elucidate the factors behind suboptimal response to anti-PD therapy. Utilizing multiplex-immunofluorescence and immunohistochemistry, we retrospectively analyzed 26 cases of ATC for expression of ICPs PD-L1, PD-1, CTLA4, TIM3, and Galectin-9 and tumor-infiltrating cytotoxic T lymphocytes (CTL)-the effector cells, the anti-tumor NK cells, the immune-inhibitory myeloid-derived suppressor (MDSC) and regulatory T (Treg) cells, and B lymphocytes. Most ATCs (65%) exhibited PD-L1 positivity, but only 31%, in addition, had abundant CTL (type I IME), a combination associated with a better response to ICP inhibition. Additionally, PD-1 expression levels on CTL were low/absent in most cases-a "target-missing" situation-unfavorable for an adequate therapeutic response. All but one ATC showed nuclear Galectin-9 expression. The documentation of nuclear expression of Galectin-9 akin to benign thyroid is a first, and its role in ATC pathobiology needs further elucidation. In addition to less abundant PD-1 expression on CTL, the presence of MDSC, Treg, and exhausted cytotoxic T lymphocytes in the immune milieu of ATC can contribute to anti-PD resistance. TIM3, the most frequently expressed ICP on CTL, followed by CTLA4, provides alternate therapeutic targets in ATC. The co-expression of multiple immune checkpoints is of great interest for ATC since these data also open the avenue for combination therapies.
Competing Interests: Declarations. Conflict of Interest: The authors declare no competing interests.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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