1179P - Tumor-infiltrating lymphocytes expression in stage IIIc/IV of high-grade Serous Ovarian Cancer: variation with neoadjuvant chemotherapy and prognos...

Date 10 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Cancer in Adolescents
Ovarian Cancer
Cancer Immunology and Immunotherapy
Gynaecologic Malignancies
Presenter Carmen Bárcena
Citation Annals of Oncology (2017) 28 (suppl_5): v403-v427. 10.1093/annonc/mdx376
Authors C. Bárcena1, K. Rojas2, L. Lema2, L. Manso Sánchez2, J. Rios3, R. García-Martín1, A. Maroto1, J.L. Rodríguez-Peralto1, E.M. Ciruelos Gil2, D.C. Mendiola2, L. Paz-Ares2
  • 1Pathology, University Hospital 12 De Octubre, 28041 - Madrid/ES
  • 2Medical Oncology, University Hospital 12 De Octubre, 28041 - Madrid/ES
  • 3Medical Statistics, Hospital Clinic Barcelona, Madrid/ES

Abstract

Background

Ovarian cancer is a malignancy with a complex immune suppressive microenvironment mediated by the recruitment or induction of CD4+ regulatory T cell. The purpose of this study was to assess the effect of neoadjuvant chemotherapy (NACT) on immune activation in stage IIIc/IV of high-grade serous ovarian carcinoma (HGSOC), and its relationship to treatment response.

Methods

We retrospectively identified 33 patients diagnosed with HGSOC and treated with neoadjuvant platinum-paclitaxel from 2005-2014. Pre and post-neoadjuvant treatment tissue samples were submitted to immunohistochemical analyses with anti-CD3, CD4 and CD8 antibodies for the identification of tumor-infiltrating lymphocytes (TILs). Pathological response classification to NACT was made according to Steffen Bohm (JCO 2015). Response score system (CRS) was explicitly defined (CRS-1; No or minimal tumor response, CRS-2; Appreciable tumor response amid viable tumor that is readily identifiable, CRS-3; Complete or near-complete response).

Results

The average age of patients was 63.44 years (46.53-84.14). BRCA-mutation status was negative in 78.8% of patients (26/33); BRCA-mutation was positive in 6.1% (2/33); and variant of uncertain significance was found in 15.1% (5/33). The majority of patients (78.8%) were stage IIIc. The area under the ROC curve of post-surgery TILs for complete pathological response were: CD4 (epithelial): [0.73 (0.5; 0.97), p: 0.084]; CD4 (stromal): [0.74 (0.51; 0.97), p: 0.077] and CD8 (epithelial): [0.81 (0.63; 1.0), p: 0.02]. The expression of epithelial CD4 TILs in pre-surgery samples (≤ 0.5 [OR: 0.7(0.01; 0.86), p: 0.038]) and epithelial CD8 TILs in post-surgery samples (≤ 5.4 [OR: 0.1(0.01; 1.19, p: 0.06]) proved to be a marker of good prognosis for pathological response. Survival analysis demonstrated that the expression of epithelial CD3 ≤ 4.3 in pre-surgery samples is a marker of poor prognosis.

Conclusions

The high number of tumor-infiltrating lymphocytes in post-surgery samples was significantly associated with higher rates of complete pathological response and better prognosis. It is convenient to carry out further and multicentric studies to validate these results.

Clinical trial identification

Legal entity responsible for the study

Hospital 12 de Octubre.

Funding

None

Disclosure

All authors have declared no conflicts of interest.