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切除可能な肺アデノカルシノーマにおける腫瘍微環境に対するネオアジュバント標的治療の効果

Ling Yi¹, Heng Yao², Zhexin Bai³

¹Department of Cancer Research Center, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.

Cellular oncology (Dordrecht, Netherlands)

|August 27, 2025

まとめ

非小細胞肺がん (NSCLC) のネオアジュバント標的療法では,腫瘍の微小環境 (TME) の免疫細胞密度が増加する. 主要病理反応 (MPR) とALK変異を有する患者は,より高い免疫細胞浸透と生存率の改善を示しています.

科学分野:

腫瘍学
免疫学
胸部外科

背景:

ネオアジュバント標的治療は切除可能な非小細胞肺がん (NSCLC) の有望な戦略である.
標的治療後の腫瘍微環境 (TME) 免疫状態の分析は,治療の効果を理解し,相乗効果のアプローチの開発に不可欠です.

研究の目的:

切除可能な肺腺癌 (LUAD) の患者でネオアジュバント標的治療後のTMEの免疫状態を調査する.
TME免疫細胞の浸透と病理学的反応と患者のアウトカムを相関させる.

主な方法:

切除可能なLUADを持つ42人の患者は,ネオアジュバント標的治療 (ALK/ EGFR変異のTKI) を受けました.
マルチプレックス免疫光技術を使用して,TME免疫細胞の組成を分析した.
病理反応 (pCR,MPR) と無進行生存期 (PFS) を評価した.

主要な成果:

主要病理反応 (MPR) を達成した患者およびALK変異を有する患者は,非MPRおよびEGFRグループと比較して,CD8+ T細胞,GZMB+ CD8+ T細胞,PD-1+ CD8+ T細胞,マクロファージおよびM1マクロファージの密度が著しく高かった.
CD8+ T細胞と様々な免疫マーカー,またCD8+ T細胞とマクロファージ集団の間で正の相関が観察されました.
MPR患者はPFSが長くなる傾向を示し,TMEにおけるより高いマクロファージ密度はPFSが長くなる傾向を示した.

結論:

TKIを標的とした治療は,腫瘍の負荷を効果的に軽減し,完全な外科的切除を容易にする.
MPRとALKの変異は,TMEにおける炎症性免疫細胞密度の増加と関連しています.
TMEにおけるより高いマクロファージの密度は,著しく長く進行しない生存期間と相関する.

キーワード:

肺腺がんネオアジュバント病理的反応標的型療法腫瘍の微小環境

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