Abstract 1050
Background
Inflammation has a significant impact on cervical cancer (CC) development and therapy response. We sought to determine if splenic metabolic activity reflects host immune status and could improve prognostic and predictive categorization of CC.
Methods
Ninety-two consecutive patients with FIGO stage IB1 to IVB CC who received neo-adjuvant (chemo)radiation (NA-CRT) with curative intent were included. PET scans were performed at diagnosis and after completion of the NA-CRT. PET images were retrospectively assessed for pretreatment spleen-to-liver SUV ratio (preSLR), posttreatment spleen-to-liver SUV ratio (postSLR) and ΔSLR (post-pre) on Oasis Nuclear Medicine Workstations. (Δ)SLR was calculated as both (Δ)SLRmaxand (Δ)SLRmean. The prognostic (DFS) and predictive (pCR) abilities of these variables together with established predictors were calculated by C-index and ROC analysis, respectively. The optimal long-rank statistic and Youden index determined cutoff values. Multivariate Cox proportional hazard regression models were ranked based on their Akaike information criterion (AIC). Clinicopathological differences between patients with low or high SLR were performed by chi-square and Mann-Whitney U tests.
Results
For preSLRmaxand preSLRmean, association with DFS was found for preSLRmax>0.92 with HR = 2.25 (95% CI (1.08-4.66); p = 0.026) and for preSLRmean>0.94 with HR = 2.79 (95% CI (1.33-5.86); p = 0.005), respectively. The selected multivariate model consisted of three factors: preSLRmax, ΔSLRmaxand parametrial invasion (dichotomized; HR = 6.40 95% CI (2.70-15.20); p < 0.001). The model’s prognostic ability was quite favorable compared to FIGO staging (C-index 0.69 vs. 0.64). Further, uni- and multivariate analyses suggest that both low preSLRmaxand low preSLRmean influence pCR. Patients (n = 31) with high preSLRmaxhad a higher density of CD3+,CD4+, CD8+, CD20+(77.8% vs. 36.4%; p = 0.036), CD68+ (88.9% vs. 40.9%; p = 0.015), CD163+, FoxP3+and PD-L1+immune cells, as well as PD-L1+tumor cells (85.7% vs. 55.6%; p = 0.019) in the primary tumor using IHC; the same trends were observed for preSLRmean
Conclusions
SLR is a promising prognostic and predictive biomarker in CC and is associated with the tumor immune infiltrate.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Ghent University Hospital.
Funding
Research Foundation-Flanders (FWO).
Disclosure
E.A. De Jaeghere: Travel / Accommodation / Expenses: PharmaMar. F. Laloo: Honoraria (institution): Bayer. K. De Man: Travel / Accommodation / Expenses: Bayer. H. Denys: Honoraria (institution), Travel / Accommodation / Expenses: Pfizer; Honoraria (institution), Research grant / Funding (institution), Travel / Accommodation / Expenses: Roche; Honoraria (institution), Travel / Accommodation / Expenses: PharmaMar; Travel / Accommodation / Expenses: Teva; Honoraria (institution), Travel / Accommodation / Expenses: AstraZeneca; Honoraria (institution): Eli Lilly and Company; Honoraria (institution): Novartis; Honoraria (institution): Amgen; Honoraria (institution): Tesaro. K. Vandecasteele: Travel / Accommodation / Expenses: PharmaMar. All other authors have declared no conflicts of interest.
Resources from the same session
5705 - External validation and longitudinal extension of the LIPI (Lung Immune Prognostic Index) for immunotherapy outcomes in advanced non-small cell lung cancer.
Presenter: Jakob Riedl
Session: Poster Display session 3
Resources:
Abstract
5758 - Changes of TCR Repertoire in Metastatic Renal Cell Carcinoma and Metastatic Melanoma Patients Treated with Nivolumab
Presenter: Martin Klabusay
Session: Poster Display session 3
Resources:
Abstract
1743 - Expression of MHC class I, HLA-A and HLA-B identifies immune activated breast tumors with favorable outcome
Presenter: María Del Mar Noblejas López
Session: Poster Display session 3
Resources:
Abstract
2219 - Prognostic Significance of Tumor Tissue NeuGcGM3 Ganglioside Expression and Predictive Value of Circulating Tumor Cell Count Monitoring in Patients Receiving Racotumomab Immunotherapy
Presenter: Necdet Üskent
Session: Poster Display session 3
Resources:
Abstract
2996 - Evolution of Myeloid-Derived Suppressor Cells and Objective Response Rate in Relapsed/Refractory Diffuse Large B Cell Lymphoma (R/R DLBCL) patients after receiving immunotherapy
Presenter: Carlos Jiménez Cortegana
Session: Poster Display session 3
Resources:
Abstract
2110 - A Phase Ia/Ib trial of the anti-programmed death-ligand 1 (PD-L1) human monoclonal antibody (mAb), CS1001, in patients (pts) with advanced solid tumors or lymphomas
Presenter: Lin Shen
Session: Poster Display session 3
Resources:
Abstract
3515 - Results from a randomised Phase 1/2 trial evaluating the safety and antitumour activity of anti-PD-1 (MEDI0680)/anti-PD-L1 (durvalumab) vs anti-PD-1 (nivolumab) alone in metastatic clear cell renal cell carcinoma (ccRCC)
Presenter: Martin Voss
Session: Poster Display session 3
Resources:
Abstract
3566 - Pembrolizumab in Advanced Rare Cancers
Presenter: Aung Naing
Session: Poster Display session 3
Resources:
Abstract
3567 - High clinical benefit rates of pembrolizumab in very rare sarcoma histotypes: first results of the AcSé Pembrolizumab study
Presenter: Jean-Yves Blay
Session: Poster Display session 3
Resources:
Abstract
2421 - Lenvatinib plus PD-1 blockade in advanced bile tract carcinoma.
Presenter: Jianzhen Lin
Session: Poster Display session 3
Resources:
Abstract