ArticleCancer science2023
Tertiary lymphoid structure and neutrophil-lymphocyte ratio coordinately predict outcome of pembrolizumab.
Article in Cancer science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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The trial behind it
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Pooled it
- Association between tertiary lymphoid structures and clinical outcomes in cancer patients treated with immune checkpoint inhibitors: an updated meta-analysis.Frontiers in immunology · 2024Pooled it
- Associations between tertiary lymphoid structure density and immune checkpoint inhibitor efficacy in solid tumors: systematic review and meta-analysis.Frontiers in immunology · 2024Pooled it
- Integrated Analysis of HER2 Expression and ERBB2 Alterations in Bladder Cancer.Cancer science · 2026Article
- Case Report: Mature tertiary lymphoid structures in a metastatic urothelial carcinoma patient with an exceptional response to sequential immune checkpoint inhibitor and antibody-drug conjugate therapy.Frontiers in oncology · 2026Article
- Dissecting Tertiary Lymphoid Structures in Cancer: Maturation, Localization and Density.Theranostics · 2025Review
- Intratumoral bacterial load and tertiary lymphoid structure density in hepatocellular carcinoma: association and prognostic significance.Frontiers in immunology · 2025Article
- The role of KRT18 in lung adenocarcinoma development: integrative bioinformatics and experimental validation.Discover oncology · 2024Article
- Construction and verification of an innovative immune-related and hallmark gene sets prognostic model for bladder cancer.Translational cancer research · 2024Article
- Tertiary lymphoid structures in diseases: immune mechanisms and therapeutic advances.Signal transduction and targeted therapy · 2024Review
- Article
- Chemotherapy combined with immune checkpoint inhibitors may overcome the detrimental effect of high neutrophil-to-lymphocyte ratio prior to treatment in esophageal cancer patients.Frontiers in oncology · 2024Article
- Tertiary lymphoid structure and neutrophil-lymphocyte ratio coordinately predict outcome of pembrolizumab.Cancer science · 2023Article
Corrections and comments
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Authors and funding
24 authors at 4 institutions in 2 countries.
Funding
Abstract
Emerging evidence suggests that the presence of tertiary lymphoid structures (TLS) and neutrophil-lymphocyte ratio (NLR) in peripheral blood is associated with the treatment response to checkpoint inhibitors (CPIs), whereas there is limited knowledge regarding whether these factors reciprocally impact the treatment outcomes of CPIs in metastatic urothelial carcinoma (mUC). Herein, we investigated treatment outcomes of platinum-refractory mUC patients (50 cases with whole-exome and transcriptome sequencing) treated with pembrolizumab. The pathological review identified 24% of cases of TLS in the specimens. There was no significant difference in the NLR between the TLS- and TLS+ groups (p = 0.153). In the lower NLR group, both overall survival and progression-free survival were significantly longer in patients with TLS than in those without TLS, whereas the favorable outcomes associated with TLS were not observed in patients in the higher NLR group. We explored transcriptomic differences in UC with TLS. The TLS was comparably observed between luminal (20%) and basal (25%) tumor subtypes (p = 0.736). Exploring putative immune-checkpoint genes revealed that ICOSLG (B7-H2) was significantly increased in tumors with lower NLR. KRT expression levels exhibited higher basal cell markers (KRT5 and KRT17) in the higher NLR group and lower differentiated cell markers (KRT8 and KRT18) in patients with TLS. In conclusion, the improved outcomes of pembrolizumab treatment in mUC are restricted to patients with lower NLR. Our findings begin to elucidate a distinct molecular pattern for the presence of TLS according to the NLR in peripheral blood.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.