• Claire Germain, Sacha Gnjatic, Fella Tamzalit, Samantha Knockaert, Romain Remark, Jérémy Goc, Alice Lepelley, Etienne Becht, Sandrine Katsahian, Geoffray Bizouard, Pierre Validire, Diane Damotte, Marco Alifano, Pierre Magdeleinat, Isabelle Cremer, Jean-Luc Teillaud, Wolf-Herman Fridman, Catherine Sautès-Fridman, and Marie-Caroline Dieu-Nosjean.
• 1 Laboratory "Immune Microenvironment and Tumors" and.
• Am. J. Respir. Crit. Care Med. 2014 Apr 1; 189 (7): 832-44.

RationaleIt is now well established that immune responses can take place outside of primary and secondary lymphoid organs. We previously described the presence of tertiary lymphoid structures (TLS) in patients with non-small cell lung cancer (NSCLC) characterized by clusters of mature dendritic cells (DCs) and T cells surrounded by B-cell follicles. We demonstrated that the density of these mature DCs was associated with favorable clinical outcome.ObjectivesTo study the role of follicular B cells in TLS and the potential link with a local humoral immune response in patients with NSCLC.MethodsThe cellular composition of TLS was investigated by immunohistochemistry. Characterization of B-cell subsets was performed by flow cytometry. A retrospective study was conducted in two independent cohorts of patients. Antibody specificity was analyzed by ELISA.Measurements And Main ResultsConsistent with TLS organization, all stages of B-cell differentiation were detectable in most tumors. Germinal center somatic hypermutation and class switch recombination machineries were activated, associated with the generation of plasma cells. Approximately half of the patients showed antibody reactivity against up to 7 out of the 33 tumor antigens tested. A high density of follicular B cells correlated with long-term survival, both in patients with early-stage NSCLC and with advanced-stage NSCLC treated with chemotherapy. The combination of follicular B cell and mature DC densities allowed the identification of patients with the best clinical outcome.ConclusionsB-cell density represents a new prognostic biomarker for NSCLC patient survival, and makes the link between TLS and a protective B cell-mediated immunity.

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