Why are cancer patients prone to anemia? Why is the benefit of immunotherapy particularly poor in tumor patients with anemia? On June 14, the latest issue of the international top oncology journal “Tumor Cell” published the latest research results of Professor Zhu Bo’s team from the Department of Oncology, Xinqiao Hospital, Army Medical University – “Tumor-induced erythroid-derived marrow” in the form of a cover article. Cell-mediated immunosuppression and limiting efficacy of anti-PD-1/PD-L1 antibody therapy”. This study is the first to discover and reveal a unique hematopoietic pattern of erythroid-to-myeloid cell development under tumor “hostage”. This finding is of great value for the adjustment of treatment strategies for anemia in cancer patients, the screening of immunotherapy advantaged populations, and the development of novel immunotherapy combined strategies.
The traditional theory holds that the fate of hematopoietic cells is determined very early, that is, a hematopoietic precursor cell can only develop into one of red blood cells, lymphocytes and myeloid cells. Zhu Bo introduced that the team found that the erythroid precursor cells that have entered the erythroid developmental trajectory will turn to the myeloid lineage development under the “hostage” of the tumor, which not only leads to the occurrence of anemia, but also becomes an important source of immune suppressive cells in the body. This pattern is significantly different from the normal hematopoietic pattern.
In the past, immune checkpoint inhibitor (ICI) drugs represented by αPD-1/αPD-L1 antibodies (hereinafter referred to as ICI therapy) had poor results in patients with tumors complicated by anemia, and the clinical explanation remained at ” Poor general condition, insufficient bone marrow reserve, poor treatment tolerance” and other empirical inferences. This study revealed a new hematopoietic developmental pattern in which erythroid precursor cells turned to myeloid differentiation under tumor “hostage”, which not only explained the clinical phenomenon of poor benefit after ICI treatment in patients with anemia, but also suggested that the tumor local erythroid The number of source myeloid cells infiltrated and the degree of anemia are new concepts as predictive markers of ICI efficacy, and also provide new ideas for the development of combined immunotherapy strategies targeting tumor-associated myeloid cells.
The findings are important for developing strategies to restore T-cell anti-tumor immunity in cancer patients, leading to synergistic immunotherapy strategies, according to a peer-reviewed paper published in Tumor Cell.
(Technology Daily)