Prognostic and predictive value of immunological parameters for chemoradioimmunotherapy in patients with pancreatic adenocarcinoma
Menée à partir de données portant sur 92 patients atteints d'un adénocarcinome du pancréas et inclus dans un essai évaluant l'intérêt d'ajouter l'interféron-alpha à une chimioradiothérapie adjuvante (âge moyen : 61,6 ans), cette étude évalue la valeur prédictive et pronostique de paramètres immunologiques (nombre de lympocytes infiltrant la tumeur, niveau sérique d'interleukine IL-2, ...)
Background : Chemoradioimmunotherapy of patients with pancreatic adenocarcinoma from the CapRI trial did not show any benefit of interferon-
α in addition to a 5-fluorouracil (5FU)-based treatment. The aim of this study was to identify immunological parameters in patients from this trial to be used for predictive and/or prognostic purposes.
Methods
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The following methods were used: tumour immunohistology, FACS analyses, cytokine measurement, as well as cytotoxicity and ELIspot. Immunological parameters were correlated with patients
’ survival using the Kaplan–Meier method.
Results : Irrespective of therapy type, high lymphocyte accumulation in tumours and frequencies of NK cells and effector (eff) CD8+ T cells in peripheral blood of the patients were associated with patients’ survival. Amount of CD3+ and effector-memory CD8+ blood lymphocytes, expression of CD152 and interleukin (IL)-2 serum level showed a predictive value for chemoradioimmunotherapy. Tumoural accumulation of CD3+ and CD8+ cells was predictive for outcome of chemotherapy alone. Besides, we identified the frequencies of CD3+ lymphocytes, effCD8+ T cells and NK cells in the peripheral blood of the patients, and IL-10 amount in serum, to be predictive values for 5FU-based chemotherapy.
Conclusions : Immunological parameters, identified in this trial as possible markers, may be of interest in personalized medicine towards the improvement of the treatment and prognosis of pancreatic carcinoma patients.
British Journal of Cancer , résumé, 2014