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Clinical Cancer Research
Article . 2024 . Peer-reviewed
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Chemotherapy Drives Tertiary Lymphoid Structures That Correlate with ICI-Responsive TCF1+CD8+ T Cells in Metastatic Ovarian Cancer

Authors: Tereza Lanickova; Michal Hensler; Lenka Kasikova; Sarka Vosahlikova; Artemis Angelidou; Josef Pasulka; Hannah Griebler; +21 Authors

Chemotherapy Drives Tertiary Lymphoid Structures That Correlate with ICI-Responsive TCF1+CD8+ T Cells in Metastatic Ovarian Cancer

Abstract

Abstract Purpose: Patients with high-grade serous ovarian carcinoma (HGSOC) are virtually insensitive to immune checkpoint inhibitors (ICI) employed as standalone therapeutics, at least in part reflecting microenvironmental immunosuppression. Thus, conventional chemotherapeutics and targeted anticancer agents that not only mediate cytotoxic effects but also promote the recruitment of immune effector cells to the HGSOC microenvironment stand out as promising combinatorial partners for ICIs in this oncological indication. Experimental Design: We harnessed a variety of transcriptomic, spatial, and functional assays to characterize the differential impact of neoadjuvant paclitaxel-carboplatin on the immunological configuration of paired primary and metastatic HGSOC biopsies as compared to neoadjuvant chemotherapy (NACT)-naïve HGSOC samples from five independent patient cohorts. Results: We found NACT-driven endoplasmic reticulum stress and calreticulin exposure in metastatic HGSOC lesions culminates with the establishment of a dense immune infiltrate including follicular T cells (TFH cells), a prerequisite for mature tertiary lymphoid structure (TLS) formation. In this context, TLS maturation was associated with an increased intratumoral density of ICI-sensitive TCF1+PD1+ CD8+ T cells over their ICI-insensitive TIM-3+PD1+ counterparts. Consistent with this notion, chemotherapy coupled with a PD1-targeting ICI provided a significant survival benefit over either therapeutic approach in syngeneic models of HGSOC bearing high (but not low) tumor mutational burden. Conclusions: Altogether, our findings suggest that NACT promotes TLS formation and maturation in HGSOC lesions, de facto preserving an intratumoral ICI-sensitive T-cell phenotype. These observations emphasize the role of rational design, especially relative to the administration schedule, for clinical trials testing chemotherapy plus ICIs in patients with HGSOC. See related commentary by Bravo Melgar and Laoui, p. 10

Keywords

Paclitaxel, MOLECULAR-BIOLOGY, CD8-Positive T-Lymphocytes, LYMPHOCYTES, Carboplatin, NEOADJUVANT CHEMOTHERAPY, Lymphocytes, Tumor-Infiltrating, STAGE-III, 3211 Oncology and carcinogenesis, Antineoplastic Combined Chemotherapy Protocols, Tumor Microenvironment, Humans, 1112 Oncology and Carcinogenesis, Oncology & Carcinogenesis, Hepatocyte Nuclear Factor 1-alpha, Immune Checkpoint Inhibitors, CONSENSUS CONFERENCE RECOMMENDATIONS, Translational Cancer Mechanisms and Therapy, Ovarian Neoplasms, Science & Technology, T Cells, 3202 Clinical sciences, Endoplasmic Reticulum Stress, TUMORS, Neoadjuvant Therapy, Ovarian Cancer, Cystadenocarcinoma, Serous, PATHOLOGY, Tertiary Lymphoid Structures, Oncology, SURVIVAL, Female, Life Sciences & Biomedicine

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
2
Average
Average
Average
Green
hybrid