Assessing the Prognostic Value of Preoperative Carcinoembryonic Antigen-Specific T-Cell Responses in Colorectal Cancer
Menée à partir d'échantillons sériques prélevés sur 87 patients atteints d'un cancer colorectal traité par résection (durée de suivie : 5 ans), cette étude évalue l'intérêt de mesurer, ex-vivo et avant l'intervention chirurgicale, le niveau d'interféron-gamma produit par les lymphocytes T en réponse à différents antigènes tumoraux (antigène carcino-embryonnaire, protéine oncofœtale 5T4, ...) pour prédire le risque de récidive et la survie à 5 ans
Current dogma suggests that tumor-reactive IFN-
γ
–producing (TH1-type) T-cells are beneficial to patient outcome; however, the clinical consequence of these responses with respect to long-term prognosis in colorectal cancer (CRC) is not understood. Here, we compared the utility of preoperative, peripheral blood–derived IFN-
γ+ T-cell responses specific to carcinoembryonic antigen (CEA), 5T4, or control antigens (n = 64) with tumor staging and clinical details (n = 87) in predicting five-year outcome of CRC patients who underwent resection with curative intent. Although disease recurrence was more likely in patients with stage III tumors, the presence of preoperative, CEA-specific IFN-γ
–producing T-cells identified patients at a statistically significantly greater risk of tumor recurrence following surgical resection, irrespective of tumor stage (odds ratio = 5.00, 95% confidence interval = 1.96 to 12.77, two-sided P <.001). Responses to other antigens, including 5T4, did not reflect outcome. Whilst these results initially appear surprising, they could improve prognostication and help redirect adjuvant treatments.
Journal of the National Cancer Institute , résumé, 2015