ArticleESMO open2026
Predictive potential of patient-specific immunological characteristics in solid cancers: circulating monocytes, myeloid-derived suppressor cells, T cells, and the T-cell receptor repertoire.
Article in ESMO open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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24 authors.
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Abstract
backgroundResponse prediction to immune checkpoint inhibitors (ICIs) relies on tumor-specific biomarkers, while patient-specific characteristics are underrepresented. Therefore, we explored patient-specific immunological characteristics, including peripheral monocytes, myeloid-derived suppressor cells (MDSCs), T cells, and the T-cell receptor (TCR) repertoire, to investigate associations with survival and therapy response. PATIENTS AND
methodsPatients with solid tumors were prospectively recruited to explore the association of absolute lymphocyte and monocyte counts, leukocyte-to-lymphocyte ratio (LLR), and monocyte-to-lymphocyte ratio (MLR) with overall survival (OS). Monocytes, MDSCs, T cells, and the TCR repertoire were characterized before therapy start (baseline) and, if available, at first radiological restaging (follow-up). We analyzed their association with radiological therapy response using current guidelines, OS, and progression-free survival (PFS).
resultsA total of 1063 patients were included. High LLR [≥3.92; hazard ratio (HR) 1.48, 95% confidence interval (CI) 1.21-1.82, P < 0.001] and high MLR (≥0.31; HR 1.43, 95% CI 1.16-1.76, P < 0.001) at baseline were associated with worse OS. In 108 patients, high non-classical monocytes (NCMs) at baseline were linked to improved PFS (≥8.94%; HR 0.41, 95% CI 0.18-0.91, P = 0.03), indicating a prognostic effect independent of therapy type. High NCMs at baseline were associated with response to chemotherapy (P = 0.03), but not to ICI therapy (P = 0.47). Longitudinal analyses revealed an increase in intermediate monocytes (IMs) among ICI responders compared with ICI non-responders (P = 0.01). IMs were unaltered in chemotherapy-treated patients (P = 0.69). The TCR repertoire, T cells, and MDSCs revealed no differences between responders and non-responders, regardless of therapy.
conclusionsIn our study, monocyte subsets were associated with survival and therapy response. These results highlight the potential of monocyte subsets to serve as patient-specific, tumor-agnostic biomarkers that may help predict therapy response.
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