Abstract 64P
Background
Current immunotherapy mainly concentrated on the spatial location and number of immune cells, but only 20% of individuals with the disease see a lasting clinical benefit from this type of treatment. The spatial structures of immune cells - Tertiary lymphoid structures (TLSs), were lack of understanding in prognostic value of cancer patients. Our objectives is to determine the prognostic impact of TLSs in human cancer.
Methods
Data sources: PubMed, Web of Science, and Embase databases were searched to identify eligible articles published before April 2021. Study selection: Records were assessed by 2 authors, which had to meet the following prespecified inclusion criteria: (1) paper written in English; (2) outcomes: overall survival (OS), progression-free survival (PFS) and Disease-free survival (DFS); (3) study design: The relationships between TLSs levels and prognosis were investigated; (4) original studies without restriction in study design; (5) studies containing enough data to estimate the effects. Data extraction and synthesis: Risk of bias on the study level was assessed using the Cochrane Bias Risk Assessment Tool. We performed a meta-analysis using Review Manager 5.3 to obtain a comprehensive estimate of the prognostic role of TLSs. Main outcomes and measures: Main outcomes were OS, PFS and DFS.
Results
In total, 16 studies were included in our analysis. Compared to cancer patients with low TLSs levels, high TLSs levels had better overall survival (OS; hazard ratio (HR) 0.64; 95% confidence interval (CI) 0.56-0.73; p<0.00001) and disease-free survival (DFS; HR 0.49; 95% CI 0.38–0.63; p<0.00001). To our surprise, after receiving immune checkpoint inhibitors (ICIs) therapy, the cancer patients also had a better OS (HR 0.28; 95% CI 0.16–0.48; p<0.00001) for TLSs level (high vs. low).
Conclusions
Our study focused on the fact for the first time that the spatial structures of immune cells - TLSs, had a better prognostic value. Moreover, TLSs were expected to be a potential marker for predicting anti-tumor immune response, which might help clinicians to select cancer patients who are sensitive to immunotherapy, and provide a new theoretical basis for future research on tumor immunotherapy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
This work was supported by grants from the National Natural Science Foundation of China (81770169) and National Natural Science Foundation of China (81102024).
Disclosure
All authors have declared no conflicts of interest.