ESMO Immuno-Oncology 2025 | Neoadjuvant ICI reshapes B cell immunity in MMRd endometrial cancer
Hans Nijman, MD, University Medical Center, Groningen, Netherlands, highlights results from a Phase I study (NCT04262089) investigating how neoadjuvant immune checkpoint inhibition (ICI) such as pembrolizumab modulates the B cell response in mismatch repair-deficient (MMRd) endometrial cancer. Using single-cell RNA sequencing and spatial transcriptomics, the study reveals a highly organized B cell landscape in untreated tumors and shows that neoadjuvant ICI significantly alters B cell architecture and antibody isotype expression. This interview took place at 2025 European Society for Medical Oncology (ESMO) Immuno-Oncology Congress in London, UK.
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Transcript
Well, let’s first start off with the fact that we had the unique opportunity to really study what’s going on within the tumor using neoadjuvant checkpoint inhibitors, in our case, pembrolizumab in MMRd and in mural cancer. Because it is neoadjuvant, we therefore, after two courses of pembrolizumab, because that was the amount of courses we gave, we have given to the patients, we then perform full surgery on those patients...
Well, let’s first start off with the fact that we had the unique opportunity to really study what’s going on within the tumor using neoadjuvant checkpoint inhibitors, in our case, pembrolizumab in MMRd and in mural cancer. Because it is neoadjuvant, we therefore, after two courses of pembrolizumab, because that was the amount of courses we gave, we have given to the patients, we then perform full surgery on those patients. So removing the uterus and the lymph nodes. And not only that, also during the neoadjuvant course of treatment within the disease of endometrial cancer you have the unique opportunity to get tissue from the endometrial tumor by biopsies via the cervix. So we had great material for those wonderful patients who were willing to enter this study to really look into the aspects which were changing upon treatment with neoadjuvant pembrolizumab. And within that, we got to the observation that there was a difference in the antibodies produced by the B cells compared to those who had no neo-adjuvant treatment upon doing surgery. And that will be the main part of my talk, skewing the B-cell response in a sense that normally spoken, you have good amounts of IgA and IgG. But the moment you come in with neoadjuvant checkpoint inhibitor, almost no IgA anymore and an increase of your IgG.
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