Immune Netw.  2021 Aug;21(4):e31. 10.4110/in.2021.21.e31.

Tumor-Infiltrating Neutrophils and Non-Classical Monocytes May Be Potential Therapeutic Targets for HER2 negative Gastric Cancer

Affiliations
  • 1Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul 03080, Korea
  • 2Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Korea
  • 3Department of Surgery, Seoul National University Hospital, Seoul 03080, Korea
  • 4Department of Surgery, Seoul National University College of Medicine, Seoul 03080, Korea
  • 5Cancer Research Institute, Seoul National University, Seoul 03080, Korea
  • 6Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea

Abstract

Gastric cancer (GC) is the fourth most common cause of cancer-related death globally. The classification of advanced GC (AGC) according to molecular features has recently led to effective personalized cancer therapy for some patients. Specifically, AGC patients whose tumor cells express high levels of human epidermal growth factor receptor 2 (HER2) can now benefit from trastuzumab, a humanized monoclonal Ab that targets HER2. However, patients with HER2negative AGC receive limited clinical benefit from this treatment. To identify potential immune therapeutic targets in HER2negative AGC, we obtained 40 fresh AGC specimens immediately after surgical resections and subjected the CD45 + immune cells in the tumor microenvironment to multi-channel/multi-panel flow cytometry analysis. Here, we report that HER2 negativity associated with reduced overall survival (OS) and greater tumor infiltration with neutrophils and non-classical monocytes. The potential pro-tumoral activities of these cell types were confirmed by the fact that high expression of neutrophil or non-classical monocyte signature genes in the gastrointestinal tumors in The Cancer Genome Atlas, Genotype-Tissue Expression and Gene Expression Omnibus databases associated with worse OS on Kaplan-Meir plots relative to tumors with low expression of these signature genes. Moreover, advanced stage disease in the AGCs of our patients associated with greater tumor frequencies of neutrophils and non-classical monocytes than early stage disease. Thus, our study suggests that these 2 myeloid populations may serve as novel therapeutic targets for HER2negative AGC.

Keyword

Neutrophils; Non-classical monocytes; Tumor microenvironment; Immunotherapy; Gastric cancer
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