基于人工智能的肿瘤免疫微环境数字评分预测晚期食管胃腺癌维持免疫治疗获益
An AI based Digital Score of Tumour-Immune Microenvironment Predicts Benefit to Maintenance Immunotherapy in Advanced Oesophagogastric Adenocarcinoma
AI总结：
本研究利用多重免疫荧光图像和AI构建肿瘤免疫微环境数字评分，可预测晚期食管胃腺癌患者维持免疫治疗应答及生存获益。
摘要：
胃癌和食管癌（OG）是全球癌症死亡的主要原因。在OG癌症中，近期研究表明，PDL1免疫检查点抑制剂（ICI）联合化疗可改善患者生存。然而，我们对OG癌症中肿瘤免疫微环境的理解仍然有限。在本研究中，我们分析了PLATFORM试验（NCT02678182）中接受一线氟嘧啶类和铂类化疗的晚期食管胃腺癌（OGA）患者的多重免疫荧光（mIF）图像，以预测治疗疗效，并探索患者对维持性durvalumab（一种PDL1抑制剂）产生应答的生物学基础。我们提出的基于人工智能（AI）的标志物成功区分了应答者与非应答者（p < 0.05），并识别出可能从ICI中潜在获益的人群，且在无进展生存期和总生存期方面均具有统计学显著性（p < 0.05）。研究结果表明，表达FOXP3的T细胞似乎对患者治疗应答和生存结局有重要影响。我们还观察到，无论是否接受ICI，较高水平的CD8+PD1+细胞始终与OS和PFS的不良预后相关。
英文摘要：
Gastric and oesophageal (OG) cancers are the leading causes of cancer mortality worldwide. In OG cancers, recent studies have showed that PDL1 immune checkpoint inhibitors (ICI) in combination with chemotherapy improves patient survival. However, our understanding of the tumour immune microenvironment in OG cancers remains limited. In this study, we interrogate multiplex immunofluorescence (mIF) images taken from patients with advanced Oesophagogastric Adenocarcinoma (OGA) who received first-line fluoropyrimidine and platinum-based chemotherapy in the PLATFORM trial (NCT02678182) to predict the efficacy of the treatment and to explore the biological basis of patients responding to maintenance durvalumab (PDL1 inhibitor). Our proposed Artificial Intelligence (AI) based marker successfully identified responder from non-responder (p < 0.05) as well as those who could potentially benefit from ICI with statistical significance (p < 0.05) for both progression free and overall survival. Our findings suggest that T cells that express FOXP3 seem to heavily influence the patient treatment response and survival outcome. We also observed that higher levels of CD8+PD1+ cells are consistently linked to poor prognosis for both OS and PFS, regardless of ICI.
机构、总结、中文摘要均由AI分析而来，可能存在错误，请以论文正文为准。
