Linking tumor immune infiltrate and systemic immune mediators to treatment response and prognosis in advanced cervical cancer

• Published in: Scientific reports Vol. 13; no. 1; p. 22634
• Main Authors: Rocha Martins, Patrícia, Luciano Pereira Morais, Kátia, de Lima Galdino, Nayane Alves, Jacauna, Adriana, Paula, Sálua O. C., Magalhães, Wagner C. S., Zuccherato, Luciana W., Campos, Larissa S., Salles, Paulo Guilherme O., Gollob, Kenneth J.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 19.12.2023; Nature Publishing Group; Nature Portfolio
• Subjects: 631/250/2520; 631/250/580; 692/4028/67/1517; B7-H1 Antigen; Biomarkers, Tumor; CD4 antigen; CD8 antigen; CD8-Positive T-Lymphocytes; Cervical cancer; Chemoradiotherapy; Female; Helper cells; Humanities and Social Sciences; Humans; Immunologic Factors; Interleukins; Lymphocytes; Lymphocytes T; Lymphocytes, Tumor-Infiltrating; Macrophages; multidisciplinary; PD-1 protein; PD-L1 protein; Prognosis; Science; Science (multidisciplinary); Tumor-infiltrating lymphocytes; Uterine Cervical Neoplasms - therapy
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-49441-2

Cervical cancer (CC) poses a significant burden on individuals in developing regions, exhibiting heterogeneous responses to standard chemoradiation therapy, and contributing to substantial mortality rates. Unraveling host immune dynamics holds promise for innovative therapies and discovery of clinically relevant biomarkers. We studied prospectively locally advanced CC patients pre-treatment, stratifying them as responders (R) or non-responders (NR). R patients had increased tumor-infiltrating lymphocytes (TILs), while NR patients showed elevated PD-1 scores, CD8+ and PD-L2+ TILs, and PD-L1 immune reactivity. NR patients exhibited higher systemic soluble mediators correlating with TIL immune markers. R patients demonstrated functional polarization of CD4 T cells (Th1, Th2, Th17, and Treg), while CD8+ T cells and CD68+ macrophages predominated in the NR group. Receiver operating characteristic analysis identified potential CC response predictors, including PD-L1-immunoreactive (IR) area, PD-L2, CD8, FGF-basic, IL-7, IL-8, IL-12p40, IL-15, and TNF-alpha. Dysfunctional TILs and imbalanced immune mediators contribute to therapeutic insufficiency, shedding light on local and systemic immune interplay. Our study informs immunological signatures for treatment prediction and CC prognosis.