Immune-Active Microenvironment in Small Cell Carcinoma of the Ovary, Hypercalcemic Type: Rationale for Immune Checkpoint Blockade.

Immune-Active Microenvironment in Small Cell Carcinoma of the Ovary, Hypercalcemic Type: Rationale for Immune Checkpoint Blockade.
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DOI:
10.1093/jnci/djx277
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发表时间:
2018-07-01
期刊:
Journal of the National Cancer Institute
影响因子:
--
通讯作者:
Zamarin D
Zamarin D
中科院分区:
其他
文献类型:
--
作者:
Jelinic P;Ricca J;Van Oudenhove E;Olvera N;Merghoub T;Levine DA;Zamarin D

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高钙血症型卵巢小细胞癌 (SCCOHT) 是一种由 SMARCA4 突变驱动的高度侵袭性单基因癌症。在这里,我们报告了四名患者对抗 PD1 免疫治疗的反应,并使用定量免疫荧光和基因表达谱描述了 SCCOHT 肿瘤的免疫景观。出乎意料的是,对于低突变负荷癌症,大多数肿瘤(11 个病例中的 8 个)表现出 PD-L1 表达与强相关的 T 细胞浸润(R2 = 0.60-0.95)。在肿瘤和基质细胞中均检测到 PD-L1 表达,其中巨噬细胞是某些肿瘤中最丰富的 PD-L1 阳性细胞(11 例中有 3 例)。转录分析显示,PD-L1 高肿瘤中与 Th1 和细胞毒性细胞功能相关的基因表达增加,表明 PD-L1 在 SCCOHT 中充当适应性免疫抵抗的途径。这些发现表明,尽管 SCCOHT 是低突变负荷肿瘤,但其免疫原性微环境类似于对 PD-1/PD-L1 阻断治疗反应良好的肿瘤。
Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT), is a highly aggressive monogenic cancer driven by SMARCA4 mutations. Here, we report responses to anti-PD1 immunotherapy in four patients and characterize the immune landscape of SCCOHT tumors using quantitative immunofluorescence and gene expression profiling. Unexpectedly for a low mutation burden cancer, the majority of the tumors (eight of 11 cases) demonstrated PD-L1 expression with strong associated T-cell infiltration (R2 = 0.60–0.95). PD-L1 expression was detected in both tumor and stromal cells, with macrophages being the most abundant PD-L1-positive cells in some tumors (three of 11 cases). Transcriptional profiling revealed increased expression of genes related to Th1 and cytotoxic cell function in PD-L1-high tumors, suggesting that PD-L1 acts as a pathway of adaptive immune resistance in SCCOHT. These findings suggest that although SCCOHT are low–mutational burden tumors, their immunogenic microenvironment resembles the landscape of tumors that respond well to treatment with PD-1/PD-L1 blockade.
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