Summary
This translational oncology study demonstrates that E. coli-specific adaptive immune responses, particularly CXCL13-producing TFH cells and corresponding IgG antibodies, associate with clinical benefit in muscle-invasive bladder cancer patients treated with the PD-1 inhibitor pembrolizumab. The work identifies tumour-infiltrating bacterial immunity as a potential mechanism and biomarker of immunotherapy response, with implications for patient stratification and future bacterially informed immunomodulatory strategies.
Regional applicability
The findings are relevant to UK oncology practice and NHS immunotherapy selection strategies for bladder cancer, although the mechanistic basis—linking commensal or invasive E. coli infection to ICB response—would require validation in UK patient populations with different epidemiological and microbiota contexts.
Key measures
Follicular helper T cell frequency and phenotype; CXCL13 plasma levels; E. coli-specific IgG titres; tumoral CD8+ T cell density; PD-L1 expression; progression-free survival; tertiary lymphoid structure formation
Outcomes reported
The study identified E. coli-specific CXCL13-producing follicular helper T cells (TFH) and IgG as biomarkers predicting clinical benefit from neoadjuvant pembrolizumab in muscle-invasive bladder cancer patients. The findings were validated across three independent patient cohorts.
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