Figure 1 from Pulsed Electric Field Ablation Reprograms Tumor Immunity and Stimulates Germinal Center Formation in Tertiary Lymphoid Structures in Patients with Non–Small Cell Lung Cancer
Year: 2026
Type: other
Abstract: Ablation with a specialized form of PEF energy induces a cellular depletion zone (CDZ) devoid of cancer cells, accompanied by TLS presence. A, Ablation needles are placed either via bronchoscopic or percutaneous access with three-dimensional image guidance. Energy delivery results in tumor cell death in the ablation zone. B, Multiple ROIs are defined in histopathologic tissue sections collected from resected tumors after ablation, including the CDZ, a transition zone (TZ) extending beyond the CDZ with a greater density of tumor cells but less than those observed in the remaining tumor (RT), and a peritumoral region extending 1.5 mm beyond the invasive margin of the RT. These four regions are collectively referred to as “TLS-relevant zones.” C, The intent for this study was incomplete ablation for patients in the ablation group. Patients in the control group received only a biopsy, and tumor resection in both groups was approximately 21 days after the biopsy. Representative images from duplex PanCK/CD20, duplex CD4/CD8, and H&E-stained tissue sections are shown. Top left, A whole-tissue image from the resection sample from a nonablated control tumor; (top middle) an example of a preablation biopsy; (top right) the paired resection sample after ablation. The asterisk (*) denotes the approximate location of the CDZ. Scale bars in the top represent 2 mm. The panels below show a representative example of a TLS evident in a resection sample from an ablated tumor. Scale bars represent 100 μm. D, Violin plot showing the total TLS counts by individual tumor for the control (n = 29) and ablation groups (n = 34). The control group (n = 7) was supplemented with additional, nonablated resection samples from patients with characteristics similar to key eligibility criteria who were not enrolled in the study (n = 22; see Supplementary Fig. S3). P values were calculated using the Mann–Whitney test. E, Bar plot demonstrating the percentage of tumors in the ablation group with at least one TLS compared with preablation biopsies. P values were calculated using Fisher's exact test. We additionally compared the proportion of TLS-positive tumors before and after ablation in patients with paired pre- and postablation samples (n = 17) and found a significant difference between the two time points (P < 0.005, calculated using McNemar's χ2 test, data not shown). F, Plot demonstrating the significant difference in TLS count between pre- and postablation tissue samples from patients with paired samples (n = 17). P values were calculated using the Wilcoxon signed-rank test. [Created in BioRender. Pastori, C. (2026) https://BioRender.com/4uwlfv7.].
Authors: Marcelo Jimenez, Beryl A. Hatton, Alicia Moreno-Gonzalez, Jeffrey S. Iding, Javier Flandes, Erik H.F.M. van der Heijden, Calvin S.H. Ng, Carlos Prieto, Cristina Teodosio, Juan A. Flores-Montero, Marta Rodríguez-González, Oderay Mabel Cedeño Diaz, Shoko Vos, Rainbow W.H. Lau, Medard E. Kaiza, William H. Moore, Alberto Orfao, Tullia C. Bruno
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W7204878557