Cancer immunotherapy responses persist after lymph node resection.
Hengbo ZhouJames W BaishMeghan J O'MeliaLaurel B DarraghEmma SpechtJuliane CzaplaPin-Ji LeiLutz MenzelJohanna J RajotteMohammad R NikmaneshiMohammad S RazaviMatthew G Vander HeidenJessalyn M UbellackerLance L MunnGenevieve M BolandSonia CohenSana D KaramTimothy P PaderaPublished in: bioRxiv : the preprint server for biology (2023)
Due to the critical role of lymph nodes (LNs) in the initiation and maintenance of adaptive immune responses, it is unclear whether surgical removal or ablative radiation therapy of LNs should be performed in patients with metastatic LNs that will receive immunotherapy. Surgical removal of LNs to prevent metastatic recurrence, including sentinel lymph node biopsy (SLNB) and completion lymph node dissection (CLND), are performed in routine practice. However, removing LNs eliminates opportunities for generating anti-cancer immune responses that are enhanced with immune checkpoint blockade (ICB). Balancing the potential risks and benefits of LN surgery is necessary to maximize outcomes for patients. In contrast to mouse studies using ectopic tumor implantation 1,2 , the phase III clinical trial NCT00636168 found patients with completely resected stage III melanoma (primary tumor, sentinel LNs and disease-related LNs all removed) still benefited from anti-CTLA4 inhibition. Our retrospective analysis demonstrated that stage III melanoma patients with SLNB or CLND have similar response to anti-PD1 inhibition. Using orthotopic murine mammary carcinoma and melanoma that have spontaneous LN metastases, we show that responses to ICB persist in mice after resection of TDLNs.
Keyphrases
- lymph node
- sentinel lymph node
- immune response
- clinical trial
- phase iii
- neoadjuvant chemotherapy
- radiation therapy
- end stage renal disease
- open label
- chronic kidney disease
- healthcare
- minimally invasive
- newly diagnosed
- small cell lung cancer
- ejection fraction
- magnetic resonance
- toll like receptor
- randomized controlled trial
- dendritic cells
- early stage
- prostate cancer
- peritoneal dialysis
- prognostic factors
- human health
- double blind
- primary care
- skeletal muscle
- contrast enhanced
- patient reported outcomes
- inflammatory response
- ultrasound guided
- acute coronary syndrome
- drug induced
- basal cell carcinoma
- weight loss
- insulin resistance