Introduction/Background We investigated the potential of tumour-infiltrating immune cells in pre- and post-treatment tissue specimens and their changes during treatment as predictive or prognostic biomarkers for cervical cancer patients.
Methodology Cervical cancer patients treated with (chemo)radiotherapy and subsequent surgery were included in the current study. Pre- and post-treatment specimens were retrospectively analysed via immunohistochemistry. Immune cell markers for T cells (CD3, CD4, CD8, and FoxP3), macrophages (CD68 and CD163), and B cells (CD20), as well as interleukin-33 (IL33) and (programmed death-ligand 1 (PD-L1), were analysed. Patients were grouped in the low score or high score group based on the amount of positive cells on immunohistochemistry. Correlations to pathological complete response (pCR), cause-specific survival (CSS), and metastasis development during follow-up were evaluated.
Results In total, 38 patients were included. In analysis of pre-treatment biopsies, significantly more pCR was seen for patients with CD8=CD3, CD8≥CD4, positive IL33 tumour cell (TC) scores, IL33 immune cell (IC)<TC, and PD-L1 TC≥5%. Besides patients with high CD8 scores, also patients with CD8≥CD4, CD163≥CD68, or PD-L1 IC≥5% had better CSS. In analysis of post-treatment specimens, less pCR was observed for patients with high CD8 or CD163 scores. Patients with decreasing CD8 or CD163 scores between pre- and post-treatment samples showed more pCR, whereas those with increasing CD8 or decreasing IL33 IC scores showed a worse CSS. Meanwhile, patients with an increasing CD3 score or stable/increasing PD-L1 IC score showed more metastasis during follow-up (figure 1).
Conclusion The intratumoural immune cell landscape is a tool for prediction of outcome and response to (chemo)radiation.
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