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Lunch & Poster Display session

6P - Prognostic significance of tumour-infiltrating lymphocytes on survival outcomes of patients with resected pancreatic ductal adenocarcinoma: A systematic review and meta-analysis

Date

12 Dec 2019

Session

Lunch & Poster Display session

Presenters

Harold Nathan Tan

Citation

Annals of Oncology (2019) 30 (suppl_11): xi1-xi11. 10.1093/annonc/mdz447

Authors

H.N. Tan, L.I. Catedral, M. San Juan

Author affiliations

  • Medical Oncology, University of the Philippines - Philippine General Hospital, 1000 - Manila/PH
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Resources

Abstract 6P

Background

Pancreatic cancer remains a leading cause of cancer-related mortality worldwide. Tumor-infiltrating lymphocytes (TILs) play an important role in mediating tumor progression and treatment resistance in pancreatic cancer. However, the prognostic value of TILs in pancreatic cancer remains uncertain. This meta-analysis evaluated the prognostic significance of TIL subsets (CD3+, CD4+, CD8+, FoxP3+ T cells) on overall survival (OS) and disease-free survival (DFS) of patients with resected pancreatic ductal adenocarcinoma.

Methods

Pertinent studies were gathered through systematic search of PubMed, Google Scholar and Cochrane Library databases up to August 1, 2019. Using Review Manager version 5.3, pooled hazard ratios and 95% confidence intervals were calculated using random or fixed effects models, depending on the heterogeneity of studies.

Results

A total of 11 studies comprising 1760 patients were included. Pooled analysis revealed that high levels of CD8+ TILs were associated with improved OS (HR = 0.59, 95% CI = 0.51-0.69, p < 0.00001) and DFS (HR = 0.60, 95% CI = 0.50-0.73, p < 0.00001). Similarly, high levels of CD3+ TILs correlated with better OS (HR = 0.64, 95% CI = 0.54-0.75, p < 0.00001) and DFS (HR = 0.53, 95% CI = 0.31-0.92, p < 0.0001). In contrast, high FoxP3+ TILs associated with worse OS (HR = 1.37, 95% CI = 1.00-1.87, p = 0.05), with no significant difference in DFS (HR = 1.21, 95% CI = 0.88-1.67, p = 0.23). While high CD4+ TILs showed significant improvement in OS (HR = 0.74, 95% CI = 0.63-0.86, p = 0.0001), there was no significant disparity in DFS (HR = 0.79, 95% CI = 0.47-1.35, p = 0.39).

Conclusion

TILs are a promising prognostic biomarker in pancreatic cancer. High levels of CD8+ TILs correlated with favorable OS and DFS, while high levels of FoxP3+ TILs associated with poor OS. Nonetheless, results of this meta-analysis should be approached with caution due to the lack of established standards in assessment of TILs and the small number of available studies. Prospective studies that assess TILs in a more comprehensive and standardized manner are needed.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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