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Integrated peripheral blood multi-omics profiling identifies immune signatures predictive of neoadjuvant PD-1 blockade efficacy in head and neck squamous cell carcinoma

Journal of Translational Medicine, 2025

Zhang H., Wu W., Wang M., Zhang J., Guo C., Han G., Wang L.

Disease areaApplication areaSample typeProducts
Oncology
Immunotherapy
Patient Stratification
Plasma
Olink Target 96

Olink Target 96

Abstract

Background
Neoadjuvant PD-1 inhibitor therapy has shown promise in locally advanced head and neck squamous cell carcinoma (HNSCC), but only a subset of patients achieves major pathological responses. Liquid biopsy, the analysis of tumor-derived biomarkers in readily accessible bodily fluids (primarily blood), offers significant advantages over traditional tissue biopsies for predicting cancer treatment outcomes. The aim of this study is to develop a predictive model for neoadjuvant PD-1 therapy response in HNSCC patients using exclusively liquid biopsy approaches-namely, peripheral blood immune profiling (CyTOF) and plasma cytokine panels (Olink).

Methods
In a prospective trial involving 50 HNSCC patients treated with neoadjuvant tislelizumab plus chemotherapy, peripheral blood samples were collected pre- and post-treatment. Immune cell subsets were analyzed by mass cytometry (CyTOF), and circulating protein markers were quantified via a 92-plex targeted proteomics panel (Olink). Multimodal features were integrated into a predictive model using logistic regression.

Results
Baseline immune profiles differed significantly between responder (RD) and non-responder (NRD): RD showed higher frequencies of CD103−CD8+ central memory T cells (Tcm, c03) and elevated plasma interleukins (IL-5, IL-13), whereas NRD had more CD28−TIGIThighcPARP−CD8+ terminally differentiated effector memory CD45RA+ T cells (Temra, c17) and higher levels of chemokines (CCL3, CCL4) and MMP7. Neoadjuvant therapy reactivated both subsets, evidenced by downregulation of PD-1 and increased expression of activation markers (e.g., CD38) and cytotoxic mediators (e.g., granzyme B and interferon γ). A multimodal predictive model incorporating CD8+T cell subsets (c03, c17) and plasma biomarkers (IL-5, MMP7) demonstrated superior predictive accuracy (AUC = 0.9219).

Conclusions
Integrated peripheral immune profiling enables robust, noninvasive prediction of neoadjuvant PD-1 blockade efficacy in HNSCC. The identified immune cell subsets and plasma biomarkers provide a clinically applicable framework for early response stratification and personalized immunotherapy, supporting liquid biopsy as a viable platform for clinical decision-making.

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