We present an exceptional case of a patient with high-grade serous ovarian cancer, treated with multiple chemotherapy regimens, who exhibited regression of some metastatic lesions with concomitant progression of other lesions during a treatment-free period. Using immunogenomic approaches, we found that progressing metastases were characterized by immune cell exclusion, whereas regressing and stable metastases were infiltrated by CD8⁺ and CD4⁺ T cells and exhibited oligoclonal expansion of specific T cell subsets. We also detected CD8⁺ T cell reactivity against predicted neoepitopes after isolation of cells from a blood sample taken almost 3 years after the tumors were resected. These findings suggest that multiple distinct tumor immune microenvironments co-exist within a single individual and may explain in part the heterogeneous fates of metastatic lesions often observed in the clinic post-therapy. VIDEO ABSTRACT.

中文翻译：

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卵巢癌患者不同生长转移灶中的异质肿瘤免疫微环境。

我们介绍了一个特殊病例，一名高级别浆液性卵巢癌患者接受了多种化疗方案治疗，在无治疗期间表现出一些转移性病变的消退，同时其他病变的进展。使用免疫基因组学方法，我们发现进行性转移的特征是免疫细胞排斥，而退化和稳定的转移被 CD8 ⁺和 CD4 ⁺ T 细胞浸润，并表现出特定 T 细胞亚群的寡克隆扩增。我们还检测到 CD8 ⁺从肿瘤切除近 3 年后采集的血液样本中分离细胞后，T 细胞对预测的新表位的反应性。这些发现表明，多个不同的肿瘤免疫微环境共存于一个个体中，并且可以部分解释临床治疗后经常观察到的转移性病变的异质命运。视频摘要。