Assessing the prognostic value of preoperative carcinoembryonic antigen-specific T-cell responses in colorectal cancer

J Natl Cancer Inst. 2015 Feb 9;107(4):djv001. doi: 10.1093/jnci/djv001. Print 2015 Apr.

Abstract

Current dogma suggests that tumor-reactive IFN-γ-producing (TH1-type) T-cells are beneficial to patient outcome; however, the clinical consequence of these responses with respect to long-term prognosis in colorectal cancer (CRC) is not understood. Here, we compared the utility of preoperative, peripheral blood-derived IFN-γ(+) T-cell responses specific to carcinoembryonic antigen (CEA), 5T4, or control antigens (n = 64) with tumor staging and clinical details (n = 87) in predicting five-year outcome of CRC patients who underwent resection with curative intent. Although disease recurrence was more likely in patients with stage III tumors, the presence of preoperative, CEA-specific IFN-γ-producing T-cells identified patients at a statistically significantly greater risk of tumor recurrence following surgical resection, irrespective of tumor stage (odds ratio = 5.00, 95% confidence interval = 1.96 to 12.77, two-sided P <.001). Responses to other antigens, including 5T4, did not reflect outcome. Whilst these results initially appear surprising, they could improve prognostication and help redirect adjuvant treatments.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / blood*
  • Carcinoembryonic Antigen / immunology*
  • Colorectal Neoplasms / immunology*
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Female
  • Humans
  • Interferon-gamma / immunology*
  • Lymphatic Metastasis
  • Male
  • Membrane Glycoproteins / immunology*
  • Middle Aged
  • Neoplasm Recurrence, Local / immunology*
  • Neoplasm Staging
  • Odds Ratio
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • T-Lymphocytes / immunology*

Substances

  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Membrane Glycoproteins
  • trophoblastic glycoprotein 5T4, human
  • Interferon-gamma