Prognostic and Therapeutic Implications of Immune Classification by CD8+ Tumor-Infiltrating Lymphocytes and PD-L1 Expression in Sinonasal Squamous Cell Carcinoma |
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Authors: | Rocí o Garcí a-Marí n,Sara Reda,Cristina Riobello,Virginia N. Cabal,Laura Suá rez-Ferná ndez,Blanca Vivanco,Cé sar Á lvarez-Marcos,Fernando Ló pez,José L. Llorente,Mario A. Hermsen |
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Affiliation: | 1.Department Head and Neck Oncology, Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain; (R.G.-M.); (C.R.); (V.N.C.); (L.S.-F.);2.Department Otolaryngology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (S.R.); (C.Á.-M.); (F.L.); (J.L.L.);3.Department Pathology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; |
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Abstract: | Sinonasal squamous cell carcinoma (SNSCC) is an aggressive tumor predominantly arising in the maxillary sinus and nasal cavities. Advances in imaging, surgical and radiotherapeutic techniques have reduced complications and morbidity; however, the prognosis generally remains poor, with an overall 5-year survival rate of 30–50%. As immunotherapy may be a new therapeutic option, we analyzed CD8+ tumor-infiltrating lymphocytes (TILs) and the tumor microenvironment immune type (TMIT, combining CD8+ TILs and PD-L1) in a series of 57 SNSCCs. Using immunohistochemistry, tissue samples of 57 SNSCCs were analyzed for expression of CD8 on TILs and of PD-L1 on tumor cells. The results were correlated to the clinical and survival data. In total, 88% (50/57) of the tumors had intratumoral CD8+ TILs; 19% (11/57)—CD8high (>10%); and 39/57 (68%)—CD8low (1–10%). PD-L1 positivity (>5%) was observed in 46% (26/57) of the SNSCCs and significantly co-occurred with CD8+ TILs (p = 0.000). Using univariate analysis, high intratumoral CD8+ TILs and TMIT I (CD8high/PD-L1pos) correlated with a worse survival rate. These results indicate that SNSCCs are immunogenic tumors, similar to head and neck squamous cell carcinomas. Nineteen percent of the cases were both CD8high and PD-L1pos and this subgroup may benefit from therapy with immune checkpoint inhibitors. |
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Keywords: | sinonasal cancer squamous cell carcinoma CD8+ TILs PD-L1 immunotherapy |
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