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SYSTEMATIC REVIEW article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1414884
This article is part of the Research Topic Tertiary lymphoid structures (TLS) in the tumor immune microenvironment View all 14 articles

Associations Between Tertiary Lymphoid Structure Density and Immune Checkpoint Inhibitor Efficacy in Solid Tumors: Systematic Review and Meta-Analysis

Provisionally accepted
Bin Jiang Bin Jiang Xueying Yang Xueying Yang *Zhuo Wu Zhuo Wu Yang Zhang Yang Zhang *
  • The Fourth Affiliated Hospital of China Medical University, Shenyang, China

The final, formatted version of the article will be published soon.

    Tertiary lymphoid structures (TLS) play a crucial role in tumor immunity, yet their relationship with the efficacy of immune checkpoint inhibitors (ICI) in cancer therapy is not fully understood. This study aims to systematically evaluate how TLS density influences treatment outcomes in cancer patients receiving ICI therapy.The PubMed, Embase, Cochrane Library, and Web of Science databases were searched for eligible studies published before January 22, 2024. Our analysis encompassed odds ratios (ORs) for response rates (RRs) and hazard ratios (HRs) for progression-free survival (PFS), each with their respective 95% confidence intervals (CIs).Our meta-analysis, including 19 clinical trials with 1,752 patients, identified a strong correlation between high TLS density and increased RR to ICIs (OR= 2.99, 95% CI: 2.14-4.18, P < 0.001). Furthermore, a higher TLS density was associated with prolonged PFS (HR=0.75, 95% CI: 0.63-0.88, P < 0.001). Specifically, in the context of non-small cell lung cancer (NSCLC), breast cancer (BC), renal cell carcinoma (RCC), esophageal cancer (EC), and urothelial carcinoma (UC), a significant relationship was observed between high TLS density and better ICI efficacy. Publication bias did not affect the integrity of our conclusions. Sensitivity analysis further reinforced the reliability of our aggregated outcomes.Our meta-analysis underscores the predictive role of TLS density in determining the RR and PFS among cancer patients undergoing ICI therapy. These results highlight the prognostic significance of TLS, suggesting its potential as a biomarker for guiding treatment decisions, even in tumor types traditionally considered ICI-resistant.Clinicians are recommended to assess TLS density as a part of patient evaluation to optimize ICI therapy initiation.

    Keywords: Tertiary Lymphoid Structures (TLS), immune checkpoint inhibitors, Immunotherapy, solid tumors, PD1/ PDL1

    Received: 09 Apr 2024; Accepted: 11 Oct 2024.

    Copyright: © 2024 Jiang, Yang, Wu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xueying Yang, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
    Yang Zhang, The Fourth Affiliated Hospital of China Medical University, Shenyang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.