CX3CR1⁺ CD8⁺ Cytotoxic T Cells Drive Tumor Killing in Esophageal Squamous Cell Carcinoma During Neoadjuvant Therapy
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ABSTRACT: The efficacy of immune checkpoint blockade (ICB) in esophageal squamous cell carcinoma (ESCC) remains highly variable, and the underlying mechanisms driving differential responses are poorly understood. Here, we performed single-cell RNA sequencing (scRNA-seq), T cell receptor (TCR) sequencing, and whole exome sequencing (WES) on 52 ESCC patients from a phase III neoadjuvant clinical trial to characterize the tumor microenvironment (TME) and its association with therapeutic outcomes. We identified a selective expansion of non-exhausted cytotoxic CD8⁺ T cells, particularly CX3CR1⁺ CD8⁺ T cells, in well responders, driven by the CX3CL1-CX3CR1 axis. These cells exhibited high cytotoxicity, clonal expansion, and tumor-killing potential, while exhausted T cell subsets, including CXCL13⁺ CD8⁺ T cells, were reduced in well responders. Pre-treatment tumor mutational profiles revealed that a high cancer cell fraction (CCF) mutation burden and neoantigen abundance were predictive of response, with immune editing reducing immunogenic mutations post-treatment. Additionally, tumor epithelial differentiation (Gp1/Gp2 subtypes) and stromal remodeling influenced treatment outcomes, with Gp2 tumors associated with immune suppression and resistance. Our findings provide new insights into the immune dynamics of ESCC, highlighting CX3CR1⁺ CD8⁺ T cells, the CX3CL1-CX3CR1 axis, and tumor differentiation as potential therapeutic targets to enhance ICB efficacy.
ORGANISM(S): Homo sapiens
PROVIDER: GSE314906 | GEO | 2026/08/10
REPOSITORIES: GEO
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