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Poster display session

3343 - LAG-3 expression in tumor infiltrating immune cells is associated with poor prognosis in patients with microsatellite instability high colon cancer


09 Sep 2017


Poster display session


Translational Research;  Colon and Rectal Cancer


InHee Lee


Annals of Oncology (2017) 28 (suppl_5): v158-v208. 10.1093/annonc/mdx393


I. Lee1, S.J. Lee2, B.W. Kang2, Y.S. Chae2, H.J. Kim3, S.Y. Park3, J.S. Park3, G.S. Choi3, J.G. Kim2

Author affiliations

  • 1 Department Of Oncology/hematology, Kyungpook National University Medical Center, 702-210 - Daegu/KR
  • 2 Department Of Oncology/hematology, Kyungpook National University Medical Center, Daegu/KR
  • 3 Department Of Surgery, Kyungpook National University Medical Center, Daegu/KR


Abstract 3343


Recent findings demonstrated that microsatellite instability high (MSI-H) colon cancer contains high T-cell infiltration and highly upregulated expression of multiple immune checkpoints. There is increasing evidence on the role of LAG-3 in the downregulation of T cell responses and on its involvement in tumor-infiltrated T regulatory function. The aim of this study was to reveal the prognostic impact of MSI-H colon cancer showing immune checkpoint protein expressions, which are good candidates for immunotherapy.


From January 2011 to April 2015, we included 98 patients with MSI-H colon cancer who underwent curative surgery at Kyungpook National University Medical Center. Inhibitory receptors such as cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), lymphocyte-activation gene 3 (LAG-3), programmed death-ligand 1 (PD-L1), programmed cell death 1 (PD-1) and indolamine 2’3’-dioxygenase (IDO) expression status were retrospectively analyzed using immunohistochemistry (IHC). Positivity in tumor cells (T) and immune cells (I) were separately evaluated. IHC values were determined to be positive when moderate or strong intensity of the membranous to cytoplasmic staining pattern were shown in more than 5% of the tumor cells or immune cells.


Among the 93 patients, 22 patients (23.9%) and 63 (68.5%) were determined as PD-L1(T) positive and PD-L1 (I) positive, while 12 (13.2%) and 42 (45.7%) were determined as LAG-3(I) positive and PD-1 (I) positive. Twenty-seven patients (29.3%) and 66 (71.7%) were determined as CTLA-4 (T) positive and CTLA-4 (I) positive, while 66 (71.7%) and 26 (28.3%) were determined as IDO (T) and IDO (I) positive. During median follow-up duration of 39 months, 16 (17.4%) patients experienced recurrence. LAG-3 (I) positivity was significantly associated shorter relapse-free survival (p = 0.016). Moreover, LAG-3 expression was significantly correlated with PD-L1 (T) expression (p = 0.003). Co-expression of PD-L1 and LAG-3 showed worse prognosis for relapse-free survival (p 


In conclusion, LAG-3 positivity showed worse prognosis in patients with MSI-H colon cancer.

Clinical trial identification

Legal entity responsible for the study

Kyungpook National University Medical Center




All authors have declared no conflicts of interest.

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