PD-L1+ CD49f+ CD133+ Circulating tumor cells predict outcome of patients with vulvar or cervical cancer after radio- and chemoradiotherapy

• DOI: 10.1186/s12967-025-06277-w
• Publication Date: 2025-03-13T14:59:23Z
• Authors: Selina Gies; Patrick Melchior; Istvan Molnar; Gregor Olmes; Russalina Stroeder; Tanja Tänzer; Maike Pohlers; Moritz Schäfer; Laura Theobald; Martina Sester; Erich Franz Solom...; Barbara Walch-Rüc...
• Keywords: Circulating tumor cell; Chemoradiotherapy

Abstract Background Monitoring individual therapy responses of patients with cancer represents a major clinical challenge providing the basis to early identify metastases and relapse. We previously demonstrated that radio- or chemoradiotherapy affects systemic cellular milieu vulvar cervical creates post-therapeutic environments associated Circulating tumor cells (CTCs) in are related relapse; however, their quantitative phenotypic characteristics during still unknown. Methods In this prospective, longitudinal study, we verified presence CTCs via immunofluorescence systemically characterized by flow cytometry from blood 40 115 receiving surgery, adjuvant radiotherapy (aRT), (aCRT) primary (pCRT) linked different CTC subpopulations outcome disease. Results Pre-therapeutic cytokeratin + CD45 − numbers significantly correlated FIGO stages, lymph node While surgery only did not alter occurrence, aRT aCRT as well pCRT differentially decreased increased both entities compared baseline levels. Therapy-mediated were directly subsequent recurrence on follow-up. Phenotypic characterization revealed enhanced expression stem cell marker CD133 integrin α6 (CD49f) after aRT, pCRT. Furthermore, cohorts exhibited proportions Programmed Cell Death Protein Ligand (PD-L1) expressing among CTCs. Notably, PD-L1 CD49f ≥ 5/ml 2/ml reduced recurrence-free survival Conclusion Our study unravels therapy-induced changes occurrence patients’ association results may help explain differences courses disease suggest PD-L1, targets for immunotherapy cancer.