Prognostic significance of immune cells in non-small cell lung cancer: Meta-analysis

Ross A. Soo, Zhaojin Chen, Rebecca Siew Yan Teng, Hon Lyn Tan, Barry Iacopetta, Bee Choo Tai, Richie Soong

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Tumor-associated immune cells are prognostic in non-small cell lung cancer (NSCLC) but findings have been conflicting. Objectives: To determine the prognostic role of immune cells according to localization in NSCLC patients. Methods: A systematic literature review and meta-analysis was performed on dendritic cell (DC), tumor associated macrophages (TAM), mast cells (MC), natural killer (NK) cells, T and B cells and tumor CTLA-4 and PD-L1 studies. Results: We analysed 96 articles (n= 21,752 patients). Improved outcomes were seen with increased tumor DCs (overall survival (OS) hazard ratio (HR) 0.55; 95% confidence interval (CI) 0.44-0.68), NK cells (OS HR 0.45; 0.31-0.65), TAMs (OS HR 0.33; 0.17-0.62), M1 TAMs (OS HR 0.10; 0.05-0.21), CD3+ T cells (disease specific survival (DSS) HR 0.64; 0.48-0.86), CD8+ T cells (OS HR 0.78; 0.66-0.93), B cells (OS HR 0.65; 0.42-0.99) and with increased stroma DC (DSS HR 0.62; 0.47-0.83), NK cells (DSS HR 0.51; 0.32-0.82), M1 TAMs (OS HR 0.63; 0.42-0.94), CD4+ T cells (OS HR 0.45; 0.21-0.94), CD8+ T cells (OS HR 0.77; 0.69-0.86) and B cells (OS HR 0.74;0.56-0.99). Poor outcomes were seen with stromal M2 TAMs (OS HR 1.44; 1.06-1.96) and Tregs (relapse free survival (RFS) HR 1.80; 1.34-2.43). Tumor PD-L1 was associated with worse OS (1.40; 1.20-1.69), RFS (1.67) and DFS (1.24). Conclusion: Tumor and stroma DC, NK cells, M1 TAMs, CD8+ T cells and B cells were associated with improved prognosis and tumor PD-L1, stromal M2 TAMs and Treg cells had poorer prognosis. Higher quality studies are required for confirmation.

Original languageEnglish
Pages (from-to)24801-24820
Number of pages20
JournalOncotarget
Volume9
Issue number37
DOIs
Publication statusPublished - 15 May 2018

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Non-Small Cell Lung Carcinoma
Meta-Analysis
Survival
Cell Survival
T-Lymphocytes
Natural Killer Cells
B-Lymphocytes
Neoplasms
Dendritic Cells
Recurrence
Regulatory T-Lymphocytes
Mast Cells
Macrophages
Confidence Intervals

Cite this

Soo, R. A., Chen, Z., Yan Teng, R. S., Tan, H. L., Iacopetta, B., Tai, B. C., & Soong, R. (2018). Prognostic significance of immune cells in non-small cell lung cancer: Meta-analysis. Oncotarget, 9(37), 24801-24820. https://doi.org/10.18632/oncotarget.24835
Soo, Ross A. ; Chen, Zhaojin ; Yan Teng, Rebecca Siew ; Tan, Hon Lyn ; Iacopetta, Barry ; Tai, Bee Choo ; Soong, Richie. / Prognostic significance of immune cells in non-small cell lung cancer : Meta-analysis. In: Oncotarget. 2018 ; Vol. 9, No. 37. pp. 24801-24820.
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title = "Prognostic significance of immune cells in non-small cell lung cancer: Meta-analysis",
abstract = "Background: Tumor-associated immune cells are prognostic in non-small cell lung cancer (NSCLC) but findings have been conflicting. Objectives: To determine the prognostic role of immune cells according to localization in NSCLC patients. Methods: A systematic literature review and meta-analysis was performed on dendritic cell (DC), tumor associated macrophages (TAM), mast cells (MC), natural killer (NK) cells, T and B cells and tumor CTLA-4 and PD-L1 studies. Results: We analysed 96 articles (n= 21,752 patients). Improved outcomes were seen with increased tumor DCs (overall survival (OS) hazard ratio (HR) 0.55; 95{\%} confidence interval (CI) 0.44-0.68), NK cells (OS HR 0.45; 0.31-0.65), TAMs (OS HR 0.33; 0.17-0.62), M1 TAMs (OS HR 0.10; 0.05-0.21), CD3+ T cells (disease specific survival (DSS) HR 0.64; 0.48-0.86), CD8+ T cells (OS HR 0.78; 0.66-0.93), B cells (OS HR 0.65; 0.42-0.99) and with increased stroma DC (DSS HR 0.62; 0.47-0.83), NK cells (DSS HR 0.51; 0.32-0.82), M1 TAMs (OS HR 0.63; 0.42-0.94), CD4+ T cells (OS HR 0.45; 0.21-0.94), CD8+ T cells (OS HR 0.77; 0.69-0.86) and B cells (OS HR 0.74;0.56-0.99). Poor outcomes were seen with stromal M2 TAMs (OS HR 1.44; 1.06-1.96) and Tregs (relapse free survival (RFS) HR 1.80; 1.34-2.43). Tumor PD-L1 was associated with worse OS (1.40; 1.20-1.69), RFS (1.67) and DFS (1.24). Conclusion: Tumor and stroma DC, NK cells, M1 TAMs, CD8+ T cells and B cells were associated with improved prognosis and tumor PD-L1, stromal M2 TAMs and Treg cells had poorer prognosis. Higher quality studies are required for confirmation.",
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Soo, RA, Chen, Z, Yan Teng, RS, Tan, HL, Iacopetta, B, Tai, BC & Soong, R 2018, 'Prognostic significance of immune cells in non-small cell lung cancer: Meta-analysis' Oncotarget, vol. 9, no. 37, pp. 24801-24820. https://doi.org/10.18632/oncotarget.24835

Prognostic significance of immune cells in non-small cell lung cancer : Meta-analysis. / Soo, Ross A.; Chen, Zhaojin; Yan Teng, Rebecca Siew; Tan, Hon Lyn; Iacopetta, Barry; Tai, Bee Choo; Soong, Richie.

In: Oncotarget, Vol. 9, No. 37, 15.05.2018, p. 24801-24820.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic significance of immune cells in non-small cell lung cancer

T2 - Meta-analysis

AU - Soo, Ross A.

AU - Chen, Zhaojin

AU - Yan Teng, Rebecca Siew

AU - Tan, Hon Lyn

AU - Iacopetta, Barry

AU - Tai, Bee Choo

AU - Soong, Richie

PY - 2018/5/15

Y1 - 2018/5/15

N2 - Background: Tumor-associated immune cells are prognostic in non-small cell lung cancer (NSCLC) but findings have been conflicting. Objectives: To determine the prognostic role of immune cells according to localization in NSCLC patients. Methods: A systematic literature review and meta-analysis was performed on dendritic cell (DC), tumor associated macrophages (TAM), mast cells (MC), natural killer (NK) cells, T and B cells and tumor CTLA-4 and PD-L1 studies. Results: We analysed 96 articles (n= 21,752 patients). Improved outcomes were seen with increased tumor DCs (overall survival (OS) hazard ratio (HR) 0.55; 95% confidence interval (CI) 0.44-0.68), NK cells (OS HR 0.45; 0.31-0.65), TAMs (OS HR 0.33; 0.17-0.62), M1 TAMs (OS HR 0.10; 0.05-0.21), CD3+ T cells (disease specific survival (DSS) HR 0.64; 0.48-0.86), CD8+ T cells (OS HR 0.78; 0.66-0.93), B cells (OS HR 0.65; 0.42-0.99) and with increased stroma DC (DSS HR 0.62; 0.47-0.83), NK cells (DSS HR 0.51; 0.32-0.82), M1 TAMs (OS HR 0.63; 0.42-0.94), CD4+ T cells (OS HR 0.45; 0.21-0.94), CD8+ T cells (OS HR 0.77; 0.69-0.86) and B cells (OS HR 0.74;0.56-0.99). Poor outcomes were seen with stromal M2 TAMs (OS HR 1.44; 1.06-1.96) and Tregs (relapse free survival (RFS) HR 1.80; 1.34-2.43). Tumor PD-L1 was associated with worse OS (1.40; 1.20-1.69), RFS (1.67) and DFS (1.24). Conclusion: Tumor and stroma DC, NK cells, M1 TAMs, CD8+ T cells and B cells were associated with improved prognosis and tumor PD-L1, stromal M2 TAMs and Treg cells had poorer prognosis. Higher quality studies are required for confirmation.

AB - Background: Tumor-associated immune cells are prognostic in non-small cell lung cancer (NSCLC) but findings have been conflicting. Objectives: To determine the prognostic role of immune cells according to localization in NSCLC patients. Methods: A systematic literature review and meta-analysis was performed on dendritic cell (DC), tumor associated macrophages (TAM), mast cells (MC), natural killer (NK) cells, T and B cells and tumor CTLA-4 and PD-L1 studies. Results: We analysed 96 articles (n= 21,752 patients). Improved outcomes were seen with increased tumor DCs (overall survival (OS) hazard ratio (HR) 0.55; 95% confidence interval (CI) 0.44-0.68), NK cells (OS HR 0.45; 0.31-0.65), TAMs (OS HR 0.33; 0.17-0.62), M1 TAMs (OS HR 0.10; 0.05-0.21), CD3+ T cells (disease specific survival (DSS) HR 0.64; 0.48-0.86), CD8+ T cells (OS HR 0.78; 0.66-0.93), B cells (OS HR 0.65; 0.42-0.99) and with increased stroma DC (DSS HR 0.62; 0.47-0.83), NK cells (DSS HR 0.51; 0.32-0.82), M1 TAMs (OS HR 0.63; 0.42-0.94), CD4+ T cells (OS HR 0.45; 0.21-0.94), CD8+ T cells (OS HR 0.77; 0.69-0.86) and B cells (OS HR 0.74;0.56-0.99). Poor outcomes were seen with stromal M2 TAMs (OS HR 1.44; 1.06-1.96) and Tregs (relapse free survival (RFS) HR 1.80; 1.34-2.43). Tumor PD-L1 was associated with worse OS (1.40; 1.20-1.69), RFS (1.67) and DFS (1.24). Conclusion: Tumor and stroma DC, NK cells, M1 TAMs, CD8+ T cells and B cells were associated with improved prognosis and tumor PD-L1, stromal M2 TAMs and Treg cells had poorer prognosis. Higher quality studies are required for confirmation.

KW - Dendritic cells

KW - Immune cells

KW - Mast cells

KW - Non-small cell lung cancer

KW - Tumor associated macrophages

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DO - 10.18632/oncotarget.24835

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