1. Immune Co-inhibitory Receptors PD-1, CTLA-4, TIM-3, LAG-3, and TIGIT in Medullary Thyroid Cancers: A Large Cohort Study.
- Author
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Shi X, Li CW, Tan LC, Wen SS, Liao T, Zhang Y, Chen TZ, Ma B, Yu PC, Lu ZW, Qu N, Wang Y, Shi RL, Wang YL, Ji QH, and Wei WJ
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Antigens, CD analysis, Antigens, CD metabolism, Biomarkers, Tumor analysis, CTLA-4 Antigen analysis, CTLA-4 Antigen metabolism, Carcinoma, Neuroendocrine diagnosis, Carcinoma, Neuroendocrine mortality, Carcinoma, Neuroendocrine pathology, Child, China epidemiology, Cohort Studies, Disease Progression, Female, Hepatitis A Virus Cellular Receptor 2 analysis, Hepatitis A Virus Cellular Receptor 2 metabolism, Humans, Immune Checkpoint Proteins analysis, Immunohistochemistry, Male, Middle Aged, Prognosis, Programmed Cell Death 1 Receptor analysis, Programmed Cell Death 1 Receptor metabolism, Receptors, Immunologic analysis, Receptors, Immunologic metabolism, Retrospective Studies, Survival Analysis, Thyroid Neoplasms diagnosis, Thyroid Neoplasms mortality, Thyroid Neoplasms pathology, Tissue Array Analysis, Young Adult, Lymphocyte Activation Gene 3 Protein, Biomarkers, Tumor metabolism, Carcinoma, Neuroendocrine metabolism, Immune Checkpoint Proteins metabolism, Thyroid Neoplasms metabolism
- Abstract
Context: Programmed cell death protein-1 (PD-1), cytotoxic T-lymphocyte antigen 4 (CTLA-4), T-cell immunoglobulin and mucin-domain containing-3 (TIM-3), lymphocyte activation gene-3 (LAG-3), and T-cell immunoglobulin and ITIM domain (TIGIT) are considered major immune co-inhibitory receptors (CIRs) and the most promising immunotherapeutic targets in cancer treatment, but they are largely unexplored in medullary thyroid carcinoma (MTC)., Objective: We aimed to provide the first evidence regarding the expression profiles and clinical significance of CIRs in a large cohort of MTC patients., Design and Patients: In total, 200 MTC patients who received initial surgery in our hospital were included. Immunohistochemistry was performed to evaluate CIR expressions in tissue microarrays (TMAs). Combined with the results of our previous programmed cell death ligand-1 (PD-L1) study, clinicopathologic and prognostic correlations of these proteins were retrospectively analyzed., Results: TIM-3, PD-1, CTLA-4, LAG-3, and TIGIT positivity was detected in 96 (48.0%), 27 (13.5%), 25 (12.5%), 6 (3.0%), and 6 (3.0%) patients, respectively, in whom TIM-3, PD-1, and CTLA-4 expressions were positively correlated. Log-rank tests and multivariate Cox analyses both indicated that TIM-3, CTLA-4 expression, and PD-1/PD-L1 coexpression were associated with worse structural recurrence-free survival. In addition, among 20 patients who developed advanced disease during follow-up, 12 (60%) showed TIM-3 positivity, among whom 6 cases also had concurrent moderate to strong PD-1, PD-L1, or CTLA-4 expression., Conclusions: Using the currently largest TMA cohort of this rare cancer, we delineated the CIR expression profiles in MTC, and identified TIM-3, CTLA-4 expression, and PD-1/PD-L1 coexpression as promising biomarkers for tumor recurrence. Furthermore, a subset of advanced MTCs are probably immunogenic, for which single or combined immunotherapy including TIM-3, PD-1, PD-L1, or CTLA-4 blockade may be potential therapeutic approaches in the future., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2021
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