Discovery of a Good Responder Subtype of Esophageal Squamous Cell Carcinoma with Cytotoxic T-Lymphocyte Signatures Activated by Chemoradiotherapy

PLoS One. 2015 Dec 1;10(12):e0143804. doi: 10.1371/journal.pone.0143804. eCollection 2015.

Abstract

Definitive chemoradiotherapy (CRT) is a less invasive therapy for esophageal squamous cell carcinoma (ESCC). Five-year survival rate of locally advanced ESCC patients by definitive CRT were 37%. We previously reported that tumor-specific cytotoxic T-lymphocyte (CTL) activation signatures were preferentially found in long-term survivors. However, it is unknown whether the CTL activation is actually driven by CRT. We compared gene expression profiles among pre- and post-treatment biopsy specimens of 30 ESCC patients and 121 pre-treatment ESCC biopsy specimens. In the complete response (CR) cases, 999 overexpressed genes including at least 234 tumor-specific CTL-activation associated genes such as IFNG, PRF1, and GZMB, were found in post-treatment biopsy specimens. Clustering analysis using expression profiles of these 234 genes allowed us to distinguish the immune-activated cases, designating them as I-type, from other cases. However, despite the better CR rate in the I-type, overall survival was not significantly better in both these 30 cases and another 121 cases. Further comparative study identified a series of epithelial to mesenchymal transition-related genes overexpressed in the early relapse cases. Importantly, the clinical outcome of CDH2-negative cases in the I-type was significantly better than that of the CDH2-positive cases in the I-type. Furthermore, NK cells, which were activated by neutrophils-producing S100A8/S100A9, and CTLs were suggested to cooperatively enhance the effect of CRT in the CDH2-negative I-type. These results suggested that CTL gene activation may provide a prognostic advantage in ESCCs with epithelial characteristics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / genetics
  • Carcinoma, Squamous Cell / immunology
  • Carcinoma, Squamous Cell / prevention & control
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy*
  • Epithelial-Mesenchymal Transition
  • Esophageal Neoplasms / genetics
  • Esophageal Neoplasms / immunology
  • Esophageal Neoplasms / prevention & control
  • Esophageal Neoplasms / therapy*
  • Esophageal Squamous Cell Carcinoma
  • Humans
  • Middle Aged
  • Secondary Prevention
  • T-Lymphocytes, Cytotoxic / immunology*
  • Transcriptome

Grants and funding

This work was supported by The National Institute of Biomedical Innovation (the Advanced Research for Medical Products Mining Programme), Japan Agency for Medical Research and Development (Practical Research for Innovative Cancer Control), National Cancer Center Research and Development Fund, The Ministry of Education, Culture, Sports, Science and Technology of Japan, and The Princess Takamatsu Cancer Research Fund. Dr M Komatsu was the recipient of a Research Resident Fellowship from the Foundation of Promotion of Cancer Research in Japan.