Abstract
Several distinct innate lymphoid cell (ILC) populations have been recently identified and shown to play a critical role in the immediate immune defense. In the context of tumors, there is evidence to support a dual role for ILCs with pro- or antitumor effects, depending on the ILC subset and the type of cancer. This ambivalent role has been particularly well-described in colorectal cancer models (CRC), but the presence and the evolution of ILCs in the peripheral blood of metastatic CRC (mCRC) patients have not yet been explored. Here, we investigated the distribution of ILC subsets in 96 mCRC patients who were prospectively included in the “Epitopes-CRC02” trial. Peripheral blood mononuclear cells (PBMCs) were analyzed by flow cytometry at metastatic diagnosis and after 3-months of treatment. The treatments consisted of Oxaliplatin-based chemotherapies for 76% of the patients or Folfiri (5FU, Irinotecan) chemotherapies for 14% of patients. Compared to healthy donors, the frequency of total ILCs was dramatically increased at metastatic diagnosis. CD56+ ILC1-like cells were expanded, whereas ILC2, NCR− ILCP and NCR+ ILCP subsets were decreased. Combined analysis with the systemic anti-telomerase hTERT Th1 CD4 response revealed that patients with low anti-TERT Th1 CD4 responses had the highest frequencies of total ILCs at diagnosis. Of those, 91% had synchronous metastases, and their median progression-free survival was 7.43 months (vs. 9.17 months for the other patients). In these patients, ILC1 and ILC2 were significantly decreased, whereas CD56+ ILC1-like cells were significantly increased compared to patients with low frequency of total ILCs and high anti-TERT responses. After treatment, the NCR+ ILCP were further decreased irrespective of the chemotherapy regimen, whereas the balance between ILC1 and CD56+ ILC1-like cells was modulated mainly by the Folfiri regimen in favor of ILC1. Altogether our results describe the effects of different chemotherapies on ILCs in mCRC patients. We also establish for the first time a link between frequency of ILCs and anti-tumor CD4 T cell responses in cancer patients. Thus, our study supports an interest in monitoring ILCs during cancer therapy to possibly identify predictive biomarkers in mCRC.
Highlights
Colorectal cancer (CRC) has been used as a model to demonstrate the role of the immune system in cancer, notably to establish the prognostic role of memory T cell infiltration and Th17 predominance [1]
To evaluate the impact of metastatic CRC (mCRC) on innate lymphoid cells (ILCs), we investigated ILC frequency and subset distribution in Peripheral blood mononuclear cells (PBMCs) of 86 chemotherapy naïve mCRC patients included in the “EpitopeCRC02” study (Table S1)
We observed that the frequency of ILCtot are significantly increased in the PBMCs of mCRC patients at baseline compared to healthy donors (HD) (Figure 2B)
Summary
Colorectal cancer (CRC) has been used as a model to demonstrate the role of the immune system in cancer, notably to establish the prognostic role of memory T cell infiltration and Th17 predominance [1]. Fifteen percent of localized CRC patients present microsatellite instability (MSI), with a higher mutation load conferring a higher response to immunotherapy [2]. It was previously described that cytotoxic innate immune cells, so called conventional natural killer (NK) cells, were almost absent in human colorectal tumors, despite efficient T cell infiltration [4]. A recent study on 13 localized human CRC and 13 lung tumors showed that helper innate immune cells, the recently identified family of innate lymphoid cells (ILCs) are present in these tumors, at different levels [5]
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