Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Netherlands Cancer Institute, Amsterdam, The Netherlands.
Cancer Immunol Immunother. 2021 May;70(5):1227-1237. doi: 10.1007/s00262-020-02747-w. Epub 2020 Oct 30.
Approximately 15% of advanced head and neck squamous cell carcinomas (HNSCC) respond to anti-PD-(L)1 monotherapies. Tumor PD-L1 expression and human papillomavirus (HPV) status have been proposed as biomarkers to identify patients likely to benefit from these treatments. We aimed to understand the potential immune effects of HPV in HNSCC and to characterize additional potentially targetable immune-regulatory pathways in primary, treatment-naïve tumors. CD3, CD4, CD8, CD20, CD68, FoxP3, PD-1, PD-L2, LAG-3, IDO-1, and GITR cell densities were determined in 27 HNSCC specimens. IHC for PD-L1 assessed percentage of positive tumor cells and immune cells separately or as a combined positive score (CPS), and whether PD-L1 was expressed in an adaptive or constitutive pattern (i.e., PD-L1+ tumor cells juxtaposed to TILs or in the absence of TILs, respectively). HPV testing with p16 IHC was confirmed by HPV genotyping. When compared to HPV(-) tumors (n = 14), HPV+ tumors (n = 13) contained significantly higher densities of CD3+, CD4+, CD8+, CD20+, and PD-1+ cells (P < 0.02), and there was a trend towards increased density of FoxP3 + cells. PD-L1 expression patterns did not vary by tumor viral status, suggesting possible heterogeneous mechanisms driving constitutive vs adaptive PD-L1 expression patterns in HNSCC. IDO-1 expression was abundant (> 500 IDO-1+ cells/mm in 17/27 specimens) and was found on tumor cells as well as immune cells in 12/27 (44%) cases (range 5-80% tumor cells+). Notably, the studied markers varied on a per-patient basis and were not always related to the degree of T cell infiltration. These findings may inform therapeutic co-targeting strategies and raise consideration for a personalized treatment approach.
约 15%的晚期头颈部鳞状细胞癌 (HNSCC) 对抗 PD-(L)1 单克隆抗体治疗有反应。肿瘤 PD-L1 表达和人乳头瘤病毒 (HPV) 状态已被提议作为生物标志物,以识别可能从这些治疗中获益的患者。我们旨在了解 HPV 在 HNSCC 中的潜在免疫作用,并描述原发性、未经治疗的肿瘤中其他潜在的可靶向免疫调节途径。在 27 个 HNSCC 标本中测定了 CD3、CD4、CD8、CD20、CD68、FoxP3、PD-1、PD-L2、LAG-3、IDO-1 和 GITR 细胞密度。PD-L1 的免疫组化评估了肿瘤细胞和免疫细胞的阳性百分比,或作为一个联合阳性评分 (CPS),以及 PD-L1 是在适应性还是组成性模式下表达(即,PD-L1+肿瘤细胞与 TIL 相邻或不存在 TIL)。用 p16 IHC 进行 HPV 检测,并用 HPV 基因分型进行确认。与 HPV(-)肿瘤(n=14)相比,HPV+肿瘤(n=13)中 CD3+、CD4+、CD8+、CD20+和 PD-1+细胞的密度明显更高(P<0.02),FoxP3+细胞的密度也有增加的趋势。肿瘤病毒状态对 PD-L1 表达模式没有影响,提示在 HNSCC 中,可能存在驱动组成性与适应性 PD-L1 表达模式的不同机制。IDO-1 的表达丰富(>27 个标本中的 17 个标本中有>500 个 IDO-1+细胞/mm),在 12/27(44%)的病例中,IDO-1 表达于肿瘤细胞和免疫细胞上(范围为 5-80%的肿瘤细胞+)。值得注意的是,所研究的标志物在个体患者中存在差异,并不总是与 T 细胞浸润程度相关。这些发现可能为治疗性联合靶向策略提供信息,并引起对个性化治疗方法的考虑。
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