Intratumoral PD-1+CD8+ T cells associate poor clinical outcomes and adjuvant chemotherapeutic benefit in gastric cancer

Br J Cancer. 2022 Nov;127(9):1709-1717. doi: 10.1038/s41416-022-01939-8. Epub 2022 Aug 24.

Abstract

Background: Although PD-1 has been reported to be a marker of T-cell exhaustion in several malignancies, the biological role of PD-1+CD8+ T cells in gastric cancer (GC) remains unclear. Herein, we aimed to investigate the role of PD-1+CD8+ T cells in the tumour microenvironment and its clinical significance in GC.

Designs: This study included 441 tumour microarray specimens and 60 Flow cytometry specimens of GC patients from Zhongshan Hospital, and 250 GC patients from the Asian Cancer Research Group.

Results: Here, we demonstrated that PD-1+CD8+ T cells functioned as an independent adverse prognosticator in GC. In addition, an abundance of intratumoral PD-1+CD8+ T cells indicated worse chemotherapeutic responsiveness to fluorouracil in Stage III GC patients. Mechanistically, PD-1+CD8+ T cell high infiltration indicated an exhausted phenotype of global CD8+ T cells in GC tissues, which was characterised by elevated immune checkpoint expression including CTLA-4 and TIM-3, whereas decreased expression of perforin. Furthermore, PD-1+CD8+ T cell high-infiltration patients with Stage III GC held elevated activity of several therapeutic signal pathways.

Conclusions: Our study highlighted that PD-1+CD8+ T cell abundance predicts inferior prognosis in GC, and may serve as a novel predictive biomarker to guide therapeutic option.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • CD8-Positive T-Lymphocytes
  • CTLA-4 Antigen
  • Fluorouracil / therapeutic use
  • Hepatitis A Virus Cellular Receptor 2*
  • Humans
  • Perforin
  • Prognosis
  • Programmed Cell Death 1 Receptor
  • Stomach Neoplasms* / genetics
  • Tumor Microenvironment

Substances

  • Hepatitis A Virus Cellular Receptor 2
  • CTLA-4 Antigen
  • Programmed Cell Death 1 Receptor
  • Perforin
  • Fluorouracil