학술논문

The intraprostatic immune environment after stereotactic body radiotherapy is dominated by myeloid cells
Document Type
article
Source
Prostate Cancer and Prostatic Diseases. 24(1)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Oncology and Carcinogenesis
Immunology
Vaccine Related
Prostate Cancer
Cancer
Clinical Trials and Supportive Activities
Urologic Diseases
Clinical Research
Evaluation of treatments and therapeutic interventions
6.5 Radiotherapy and other non-invasive therapies
Humans
Immunotherapy
Injections
Intralymphatic
Male
Middle Aged
Myeloid Cells
Neoadjuvant Therapy
Neoplasm Grading
Prostate
Prostatectomy
Prostatic Neoplasms
Quality of Life
Radiosurgery
Urology & Nephrology
Clinical sciences
Oncology and carcinogenesis
Language
Abstract
BackgroundHundreds of ongoing clinical trials combine radiation therapy, mostly delivered as stereotactic body radiotherapy (SBRT), with immune checkpoint blockade. However, our understanding of the effect of radiotherapy on the intratumoral immune balance is inadequate, hindering the optimal design of trials that combine radiation therapy with immunotherapy. Our objective was to characterize the intratumoral immune balance of the malignant prostate after SBRT in patients.MethodsSixteen patients with high-risk, non-metastatic prostate cancer at comparable Gleason Grade disease underwent radical prostatectomy with (n = 9) or without (n = 7) neoadjuvant SBRT delivered in three fractions of 8 Gy over 5 days completed 2 weeks before surgery. Freshly resected prostate specimens were processed to obtain single-cell suspensions, and immune-phenotyped for major lymphoid and myeloid cell subsets by staining with two separate 14-antibody panels and multicolor flow cytometry analysis.ResultsMalignant prostates 2 weeks after SBRT had an immune infiltrate dominated by myeloid cells, whereas malignant prostates without preoperative treatment were more lymphoid-biased (myeloid CD45+ cells 48.4 ± 19.7% vs. 25.4 ± 7.0%; adjusted p-value = 0.11; and CD45+ lymphocytes 51.6 ± 19.7% vs. 74.5 ± 7.0%; p = 0.11; CD3+ T cells 35.2 ± 23.8% vs. 60.9 ± 9.7%; p = 0.12; mean ± SD).ConclusionSBRT drives a significant lymphoid to myeloid shift in the prostate-tumor immune infiltrate. This may be of interest when combining SBRT with immunotherapies, particularly in prostate cancer.