Intratumoral CCR5 neutrophils identify immunogenic subtype muscle-invasive bladder cancer with favorable prognosis and therapeutic responses.

Our previous studies revealed tumor-infiltrating neutrophils (TINs) played dichotomous roles in different cancers, indicating diverse TINs subtypes might orchestrate anti-tumor immunity or immune evasion, respectively. This study aimed to investigate the clinical significance and immune characteristics of CCR5TINs in muscle-invasive bladder cancer (MIBC). Two hundred and fifty-seven MIBC patients from two clinical centers and 95 fresh MIBC samples were included. CCR5TINs were stained by immunohistochemistry, and the relationship between patients' clinic-pathological features and prognosis was evaluated, respectively. Immunohistochemistry and flow cytometry were applied to assess the immune features of CCR5TINs and their correlations with other immune cells. In vitro study was conducted to estimate immune characteristics of CCR5TINs and their predictive potential for pembrolizumab therapeutic response. In the two MIBC cohorts, we found that high CCR5TINs infiltration could predict better overall survival (OS, = .032, 0.039) and recurrence-free survival (RFS, = .001, 0.006) and be associated with survival benefit from adjuvant chemotherapy (ACT, < .001 for OS and = .022 for RFS, respectively) in merely pT2N0 MIBC. Maraviroc could partly reduce IFN-γ secretion by CCR5TINs (< .001). CCR5TINs correlated with higher expression of effector molecules within CD8T cells. Notably, pembrolizumab treatment could only elevate the apoptosis status of tumor cells in the CCR5TINs high subgroup (.001), other than CCR5TINs low subgroup (= .481). Our results indicate that CCR5TINs could prime anti-tumor immune response through autonomous IFN-γ release, thus leading to favorable prognosis and superior therapeutic response to ACT and immunotherapy in MIBC.