Abstract 604P
Background
Quantification of tumor infiltrating lymphocytes (TILs) in the cancer microenvironment has become of increasing interest in immuno-oncology. Only little is known about TILs infiltration and its predictive value in vulvar cancer.
Methods
Immunohistochemistry and automated digital image analysis was applied to measure the densities of CD3+ (DAKO, Santa Clara, US; #IR503) and CD8+ (DAKO, Santa Clara, US; #IR623) TILs at the invasive margin (IM) and in the center of 530 vulvar carcinomas.
Results
At the invasive margin the mean immune cell density was significantly higher compared to the center of the tumor (CD3: 1772±1105, CD8: 769±644 cells/mm2 vs. CD3: 518±570, CD8: 301±445 cells/mm2, p≤0.0001). An elevated density of CD3+ T-cell at the invasive margin was significantly associated with low tumor stage (p=0.0012). The 2-years OS and PFS rate was significantly different between the group with high (OS: 82%, PFS: 65%), moderate (OS: 76%, PFS: 55%), and low CD3+ T-cell density at the IM (OS: 64%, p=0.008, PFS: 44%, p=0.02). The prognostic impact of CD3+ cells in the center of the tumor was weaker compared to the invasive margin (OS p=0.046, PPS p=0.031) and lacking for CD8+ T-cell densities at any location (p≥0.14 each). Unsupervised clustering of CD3+ and CD8+ T-cell densities identified three major subgroups corresponding to the immune desert (137 patients), immune excluded (220 patients) and immune inflamed phenotypes (133 patients). Survival analysis revealed a particular poor prognosis for the immune desert phenotype for OS (0.0071) and PFS (0.0027).
Conclusions
This study demonstrates a prognostic relevance of the immunphenotype and the distribution of CD3+ T-cells in vulvar cancer. Their value for therapeutic decision making has to be determined in the future.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
AGO study group.
Funding
Medac Oncology.
Disclosure
L. Woelber: Financial Interests, Personal, Advisory Board: Sanofi, TESARO/GSK, Roche, MSD, Eisai, Seagen; Financial Interests, Personal, Invited Speaker: Pfizer, Roche, MSD, medac oncology; Financial Interests, Personal, Other, scientific board: med update GmbH; Financial Interests, Personal, Other, speaker: Med publico GmbH; Financial Interests, Institutional, Invited Speaker: Seagene, MSD, Medac Oncology, Vaccibody AS, Roche. S. Mahner: Financial Interests, Personal, Advisory Board: AbbVie, AstraZeneca, Clovis, Tesaro, MSD; Financial Interests, Personal, Other, Grant: Eisai; Financial Interests, Personal, Invited Speaker: GSK, Pfizer, Roche. M. Kalder: Financial Interests, Personal, Research Grant: University Hospital Marburg Germany; Financial Interests, Personal, Full or part-time Employment: University Hospital Marburg; Financial Interests, Personal, Other, Travel /Accomodation expenses: DGGG German Society for Gyn and Ob. I. Braicu: Financial Interests, Personal, Advisory Board: MSD, AstraZeneca, GSK Clovis, Noggo; Financial Interests, Personal, Invited Speaker: MSD, AstraZeneca, GSK, Clovis, RochePharma. K. Prieske: Financial Interests, Personal, Other, Honoraria for education: GSK. All other authors have declared no conflicts of interest.