Abstract 2016
Background
The presence of high levels of tumor immune infiltrate has been recognized to be associated with better prognosis in Head and Neck cancer (H&N). The consensus Immunoscore quantifies the densities of CD3 and CD8 in the center of the tumour (CT) and the invasive margin (IM) and stratifies patients into 3 Immunoscore categories (Low, Intermediate and High).
Methods
This retrospective ongoing study evaluated the Immunoscore in 110 patients with advanced laryngeal (n = 57) or hypopharyngeal (n = 53) cancers who received neo-adjuvant chemotherapy in the setting of an organ preservation protocol. Good responders (tumor reduction > 50%) were subsequently treated by radiation/chemoradiation, whereas non-responders were subjected to surgery followed by post-operative radiation/chemoradiation. Pre-treatment tumor samples were immune-stained for T-cell (CD3, CD8) markers and quantitative analysis of the immune cells was carried out in different tumor locations using a computer-assisted image analysis.
Results
60% of patients were good responders. Densities of T cell infiltration were significantly higher for Hypopharyngeal cancer patients compared to those with laryngeal cancer. ( P < 0.001) Analysis of the entire cohort showed that good-responders had a higher Immunoscore than non-responders (69% vs. 39%% respectively, Odd Ratio = 2.7303 CI 95%[0.8497-9.24], P = 0.069). Immunoscore Low, Intermediate and High represented respectively 16.5%, 45.6% and 37.9% of the cohort. High Immunoscore patients were at low risk of relapse, with 5-year Time to Recurrence rates of 71.4 (CI 53.9 − 94.6) as compared to 54.6 CI 95% (40.4 − 73.9) and 31.4 CI 95% (13.3 − 74.1) in intermediate and low Immunoscore patients respectively (HR = 1.9 CI 95% (1.2 − 3.0), P < 0.02). Similar results were found in Larynx and Hypopharynx separately. Regardless of treatment type and tumor location, a high Immunoscore was associated with better progression-free survival and overall survival.Table: 1115PD
Cutpoint | Sensitivity | Specificity | N (prevalence) | ORR, % | Odds Ratio (CI) | PFS HR (CI) | OS HR (CI) |
---|---|---|---|---|---|---|---|
TPS ≥50% | 0.47 | 0.77 | 65 (0.27) | 26.2 | 3.83 (1.31, 11.15) | 0.59 (0.40, 0.87) | 0.54 (0.36, 0.82) |
TPS ≥20% | 0.56 | 0.64 | 94 (0.39) | 21.3 | 1.84 (0.83, 4.11) | 0.72 (0.52, 0.99) | 0.66 (0.47, 0.93) |
TPS ≥1% | 0.64 | 0.44 | 140 (0.57) | 16.4 | 1.56 (0.79, 3.10) | 0.95 (0.74, 1.22) | 0.75 (0.57, 0.97) |
CPS ≥50 | 0.50 | 0.78 | 64 (0.26) | 28.1 | 4.70 (1.62, 13.59) | 0.60 (0.41, 0.89) | 0.60 (0.40, 0.91) |
CPS ≥20 | 0.58 | 0.64 | 96 (0.39) | 21.9 | 2.42 (1.10, 5.33) | 0.75 (0.55, 1.01) | 0.63 (0.46, 0.86) |
CPS ≥1 | 0.94 | 0.23 | 195 (0.80) | 17.4 | 1.85 (1.01, 3.37) | 0.89 (0.72, 1.11) | 0.72 (0.58, 0.91) |
All | 1.00 | 0.00 | 244 (1.00) | 14.8 | 1.43 (0.83, 2.46) | 0.94 (0.77, 1.14) | 0.79 (0.65, 0.97) |
CPS, combined positive score; HR, hazard ratio; ORR, objective response rate; OS, overall survival; PFS, progression-free survival; SOC, standard of care; TPS, tumor proportion score.
Sensitivity, specificity, N (prevalence), and ORR are for the pembrolizumab arm. Odds ratio, PFS HR, and OS HR compare pembrolizumab and SOC.
Conclusions
The results of this ongoing study show a significant prognostic and potentially predictive role of Immunoscore in H&N cancer patients with important therapeutic implications.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Haitham Mirghani.
Funding
HalioDx.
Disclosure
H. Mirghani: Advisory / Consultancy: MSD vaccin; Travel / Accommodation / Expenses: BMS. B. Mlecnik: Licensing / Royalties: HalioDx. F. Hermitte: Shareholder / Stockholder / Stock options, Full / Part-time employment, Officer / Board of Directors: HalioDx. C. Even: Advisory / Consultancy: MSD; Advisory / Consultancy, Travel / Accommodation / Expenses: BMS; Advisory / Consultancy, Travel / Accommodation / Expenses: Merck Serono; Advisory / Consultancy: Innate Pharma; Advisory / Consultancy, Travel / Accommodation / Expenses: AstraZeneca. J. Galon: Advisory / Consultancy, Research grant / Funding (institution), Shareholder / Stockholder / Stock options: HalioDx; Honoraria (self): AstraZeneca; Honoraria (self): Novartis; Honoraria (self): Merck Serono; Honoraria (self): MSD; Honoraria (self): BMS; Honoraria (self): Sanofi; Honoraria (self): Gilead; Advisory / Consultancy, Research grant / Funding (institution): IOBiotech; Advisory / Consultancy: Illumina; Advisory / Consultancy: Northwest Biotherapeutics; Advisory / Consultancy: Actelion; Advisory / Consultancy: Amgen; Research grant / Funding (institution): Perkin-Helmer; Research grant / Funding (institution): MedImmune; Research grant / Funding (institution): Janssen; Research grant / Funding (institution): Imcheck; Licensing / Royalties: Inserm. All other authors have declared no conflicts of interest.
Resources from the same session
Poster Discussion – Head and neck cancer - Invited Discussant 1119PD and 1120PD
Presenter: Amanda Psyrri
Session: Poster Discussion – Head and neck cancer
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