Immune tumor microenvironment (TME) in neuroblastoma (NBL) contributes to tumor behavior and treatment response. T cells and natural killer (NK) cells have been shown to play important roles in the neuroblastoma TME. However, few reports address the clinical relevance of natural killer T cells (NKTs) and interleukin-15 (IL-15), one of the crucial cytokines controlling the activation and expansion of NK/NKT cells, in NBL. In this study, we examined NKT immunoscores and IL-15 expression in both MYCN-amplified and MYCN-non-amplified NBL to correlate with clinical outcomes such as event-free survival (EFS) and overall survival (OS). From Gene Expression Omnibus (GEO) datasets GSE45480 (n = 643) and GSE49711 (n = 493), we found that NKT immunoscore and IL-15 expression were both significantly lower in MYCN-amplified NBL, and similar results were observed using our clinical NBL samples (n = 53). Moreover, NBL patients (GEO dataset GSE49711 and our clinical samples) with both lower NKT immunoscore and IL-15 expression exhibited decreased EFS and OS regardless of MYCN gene amplification status. Multivariate analysis further showed that the combination of low NKT immunoscore and low IL-15 expression level was an independent prognostic factor for poor EFS and OS in our NBL patients. These findings provide the rationale for the development of strategy to incorporate IL-15 and NKT cell therapy into the treatment regimen for neuroblastoma.

We aim to establish a noninvasive diagnostic platform to capture early phenotypic transformation for metastasis using ¹⁸F-FDG PET and ¹H-NMR-based serum metabolomics. Mice with implantation of NCI-H460 cells grew only primary lung tumors in the localized group and had both primary and metastatic lung tumors in the metastatic group. The serum metabolites were analyzed using ¹H-NMR at the time of PET/CT scan. The glycolysis status and cell proliferation were validated by Western blotting and staining. A receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic accuracy of SUV_mean and serum metabolites in metastasis. In the metastatic mice, the SUV_mean of metastatic tumors was significantly higher than that of primary lung tumors in PET images, which was supported by elevated glycolytic protein expression of HK2 and PKM2. The serum pyruvate level in the metastatic group was significantly lower than that in the localized group, corresponding to increased pyruvate-catalyzed enzyme and proliferation rates in metastatic tumors. In diagnosing localized or metastatic tumors, the areas under the ROC curves of SUV_mean and pyruvate were 0.92 and 0.91, respectively, with p < 0.05. In conclusion, the combination of ¹⁸F-FDG PET and ¹H-NMR-based serum metabolomics demonstrated the feasibility of a glycolytic platform for diagnosing metastatic lung cancers.

(1) Background: The C-ros oncogene 1 (ROS1) gene translocation is an important biomarker for selecting patients for crizotinib-targeted therapy. The aim of this study was to understand the incidence, diagnostic algorithm, clinical course and objective response to crizotinib in ROS1 translocated lung non-small cell lung cancers (NSCLCs) in Taiwan. (2) Methods: First, we retrospectively studied the ROS1 status in 100 NSCLC samples using break-apart fluorescent in situ hybridization (FISH) and immunohistochemical (IHC) staining to establish a diagnostic algorithm. Then, we performed routine ROS1 IHC tests in 479 NSCLCs, as crizotinib was available from 2018 in Taiwan. We analyzed the objective response rate and the survival impact of crizotinib. (3) Results: Four ROS1 translocations were clustered in epidermal growth factor receptor (EGFR) wild-type adenocarcinomas but not in cases with EGFR mutations. Strong ROS1 expression was positively correlated with ROS1 translocation (p < 0.001). NSCLCs with ROS1 translocation had a poor prognosis compared to those without ROS1 translocation (p = 0.004) in the pre-crizotinib stage. Twenty NSCLCs were detected with ROS1 translocation in 479 wild-type EGFR specimens from 2018. Therefore, the incidence of ROS1 translocation is approximately 4.18% in EGFR wild-type NSCLCs. In these 20 ROS1 translocation cases, 19 patients received crizotinib treatment, with an objective response rate (ORR) of 78.95% (confidence interval = 69.34% to 88.56%), including 1 complete response, 14 partial responses, 3 stable cases and 1 progressive case. Overall survival and progression-free survival were better in the 19 ROS1-translocated NSCLCs of the prospective group with crizotinib treatment than the four ROS1-translocated NSCLCs of the retrospective group without crizotinib treatment. (4) Conclusions: ROS1-translocated NSCLCs had a poor prognosis and could have a beneficial outcome with crizotinib.

Background: SSEA3, SSEA4, and Globo H glycosphingolipids have been implicated in tumor progression and immune modulation across various malignancies. However, their clinical significance in extrahepatic cholangiocarcinoma (eCCA) remains largely undefined. This study aimed to evaluate the expression levels and prognostic relevance of SSEA3, SSEA4, and Globo H in patients with eCCA. Methods: Immunohistochemical staining for SSEA3, SSEA4, and Globo H was performed on formalin‐fixed, paraffin‐embedded tumor samples from 175 patients with resected eCCA. Expression levels were quantified using H‐scores, and optimal cut‐off values determined from receiver operating characteristic curve analysis defined high and low expression groups. Kaplan–Meier analysis with log‐rank test was used to evaluate relapse‐free survival (RFS) and overall survival (OS), and Cox regression analysis identified independent prognostic factors. Results: Elevated expression of SSEA4 and Globo H was significantly associated with late stage of eCCA. Kaplan–Meier analysis revealed that high expression of all three glycans was significantly correlated with shorter RFS (all p < 0.001). Similar results were observed in patients with early stage. In multivariate Cox regression analysis, high expression of SSEA3 (HR = 2.77, 95% CI: 1.03–7.46, p = 0.044) and Globo H (HR = 2.88, 95% CI: 1.05–7.94, p = 0.040) independently predicted poor RFS. Conclusion: SSEA3 and Globo H independently predict RFS. These findings support the potential prognostic relevance of Globo H and SSEA3 in eCCA; however, external validation and functional studies are required before clinical implementation or therapeutic translation.