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      Reshaping the systemic tumor immune environment (STIE) and tumor immune microenvironment (TIME) to enhance immunotherapy efficacy in solid tumors

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          Abstract

          The development of combination immunotherapy based on the mediation of regulatory mechanisms of the tumor immune microenvironment (TIME) is promising. However, a deep understanding of tumor immunology must involve the systemic tumor immune environment (STIE) which was merely illustrated previously. Here, we aim to review recent advances in single-cell transcriptomics and spatial transcriptomics for the studies of STIE, TIME, and their interactions, which may reveal heterogeneity in immunotherapy responses as well as the dynamic changes essential for the treatment effect. We review the evidence from preclinical and clinical studies related to TIME, STIE, and their significance on overall survival, through different immunomodulatory pathways, such as metabolic and neuro-immunological pathways. We also evaluate the significance of the STIE, TIME, and their interactions as well as changes after local radiotherapy and systemic immunotherapy or combined immunotherapy. We focus our review on the evidence of lung cancer, hepatocellular carcinoma, and nasopharyngeal carcinoma, aiming to reshape STIE and TIME to enhance immunotherapy efficacy.

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          Most cited references248

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          Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma

          The combination of atezolizumab and bevacizumab showed encouraging antitumor activity and safety in a phase 1b trial involving patients with unresectable hepatocellular carcinoma.
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            TGF-β attenuates tumour response to PD-L1 blockade by contributing to exclusion of T cells

            Therapeutic antibodies that block the programmed death-ligand 1 (PD-L1)/programmed death-1 (PD-1) pathway can induce robust and durable responses in patients with various cancers, including metastatic urothelial cancer (mUC) 1–5 . However, these responses only occur in a subset of patients. Elucidating the determinants of response and resistance is key to improving outcomes and developing new treatment strategies. Here, we examined tumours from a large cohort of mUC patients treated with an anti–PD-L1 agent (atezolizumab) and identified major determinants of clinical outcome. Response was associated with CD8+ T-effector cell phenotype and, to an even greater extent, high neoantigen or tumour mutation burden (TMB). Lack of response was associated with a signature of transforming growth factor β (TGF-β) signalling in fibroblasts, particularly in patients with CD8+ T cells that were excluded from the tumour parenchyma and instead found in the fibroblast- and collagen-rich peritumoural stroma—a common phenotype among patients with mUC. Using a mouse model that recapitulates this immune excluded phenotype, we found that therapeutic administration of a TGF-β blocking antibody together with anti–PD-L1 reduced TGF-β signalling in stromal cells, facilitated T cell penetration into the centre of the tumour, and provoked vigorous anti-tumour immunity and tumour regression. Integration of these three independent biological features provides the best basis for understanding outcome in this setting and suggests that TGF-β shapes the tumour microenvironment to restrain anti-tumour immunity by restricting T cell infiltration.
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              Cancer immunology. Mutational landscape determines sensitivity to PD-1 blockade in non-small cell lung cancer.

              Immune checkpoint inhibitors, which unleash a patient's own T cells to kill tumors, are revolutionizing cancer treatment. To unravel the genomic determinants of response to this therapy, we used whole-exome sequencing of non-small cell lung cancers treated with pembrolizumab, an antibody targeting programmed cell death-1 (PD-1). In two independent cohorts, higher nonsynonymous mutation burden in tumors was associated with improved objective response, durable clinical benefit, and progression-free survival. Efficacy also correlated with the molecular smoking signature, higher neoantigen burden, and DNA repair pathway mutations; each factor was also associated with mutation burden. In one responder, neoantigen-specific CD8+ T cell responses paralleled tumor regression, suggesting that anti-PD-1 therapy enhances neoantigen-specific T cell reactivity. Our results suggest that the genomic landscape of lung cancers shapes response to anti-PD-1 therapy. Copyright © 2015, American Association for the Advancement of Science.
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                Author and article information

                Contributors
                liangliangxu89@126.com
                zou.chang@szhospital.com
                sasazss@yeah.net
                T.Chu1@newcastle.ac.uk
                hao.yu@siat.ac.cn
                libo76@mail.sysu.edu.cn
                Xyguan@hku.hk
                houyz1980@126.com
                Kong0001@hku.hk
                Journal
                J Hematol Oncol
                J Hematol Oncol
                Journal of Hematology & Oncology
                BioMed Central (London )
                1756-8722
                7 July 2022
                7 July 2022
                2022
                : 15
                : 87
                Affiliations
                [1 ]GRID grid.440671.0, ISNI 0000 0004 5373 5131, Department of Clinical Oncology, , The University of Hong Kong-Shenzhen Hospital, ; Shenzhen, Guangdong 518053 China
                [2 ]GRID grid.440218.b, ISNI 0000 0004 1759 7210, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), ; Shenzhen, Guangdong 518020 China
                [3 ]Shenzhen Public Service Platform on Tumor Precision Medicine and Molecular Diagnosis, Shenzhen, Guangdong 518020 China
                [4 ]GRID grid.410578.f, ISNI 0000 0001 1114 4286, Key Laboratory of Medical Electrophysiology of Education Ministry, School of Pharmacy, , Southwest Medical University, ; Luzhou, Sichuan 646100 China
                [5 ]GRID grid.263488.3, ISNI 0000 0001 0472 9649, Department of Chemical Biology, School of Life and Marine Sciences, , Shenzhen University, ; Shenzhen, Guangdong 518000 China
                [6 ]GRID grid.420004.2, ISNI 0000 0004 0444 2244, Royal Victoria Infirmary, , Newcastle upon Tyne Hospitals NHS Foundation Trust, ; Queen Victoria Road, Newcastle upon Tyne, NE1 4LP UK
                [7 ]GRID grid.1006.7, ISNI 0000 0001 0462 7212, Faculty of Medical Sciences, , Newcastle University, ; Newcastle upon Tyne, NE1 7RU UK
                [8 ]GRID grid.194645.b, ISNI 0000000121742757, Department of Clinical Oncology, LKS Faculty of Medicine, , The University of Hong Kong, ; Hong Kong, China
                [9 ]Advanced Energy Science and Technology Guangdong Laboratory, Huizhou, Guangdong 528200 China
                [10 ]GRID grid.458489.c, ISNI 0000 0001 0483 7922, Chinese Academy of Sciences Shenzhen Institutes of Advanced Technology, ; Shenzhen, Guangdong 518055 China
                [11 ]GRID grid.511083.e, ISNI 0000 0004 7671 2506, Guangdong Provincial Key Laboratory of Digestive Cancer Research, Scientific Research Center, , The Seventh Affiliated Hospital of Sun Yat-Sen University, ; Shenzhen, Guangdong 518107 China
                [12 ]GRID grid.43169.39, ISNI 0000 0001 0599 1243, Department of Pathogenic Microbiology and Immunology, School of Basic Medical Sciences, , Xi’an Jiaotong University, ; Xi’an, Shaanxi 710061 China
                Article
                1307
                10.1186/s13045-022-01307-2
                9264569
                35799264
                e1bc6c8f-d045-4257-8ce3-3dbdd2d767be
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 9 March 2022
                : 22 June 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100002858, China Postdoctoral Science Foundation;
                Award ID: 2021M693291
                Award Recipient :
                Funded by: Shenzhen Science and Technology Program
                Award ID: KQTD20180411185028798
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 8187110989
                Award Recipient :
                Categories
                Review
                Custom metadata
                © The Author(s) 2022

                Oncology & Radiotherapy
                tumor immune microenvironment (time),systemic tumor immune environment (stie),immunotherapy,radiotherapy,single-cell transcriptomics

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