Association of POLE-mutated and MSI endometrial cancers with an elevated number of tumor-infiltrating and peritumoral lymphocytes and higher expression of PD-L1.

Authors

null

Brooke E. Howitt

Brigham and Women's Hospital, Boston, MA

Brooke E. Howitt , Lynette M. Sholl , Lauren Ritterhouse , Jaclyn C Watkins , Scott J. Rodig , Kyle Strickland , Alan D. D'Andrea , Ursula Matulonis , Panagiotis Konstantinopoulos

Organizations

Brigham and Women's Hospital, Boston, MA, Department of Pathology, Division of Hematopathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, Dana Farber Cancer Inst, Boston, MA, Dana-Farber Cancer Inst, Boston, MA

Research Funding

No funding sources reported

Background: TCGA identified two groups of endometrial cancers with high mutation frequency: an ultramutated group of tumors which harbored mutations in polymerase e (POLE) and a hypermutated group with microsatellite instability (MSI). We hypothesized that these hypermutated tumors may harbor more neoantigens and thus stimulate a stronger immune response compared to tumors with low mutation frequency. In this regard, we evaluated whether hypermutated tumors are associated with an elevated number of tumor-infiltrating lymphocytes (TILs) and peritumoral lymphocytes and higher expression of the immune modulatory molecule PD-L1. Methods: We evaluated 4 POLE-mutated (determined via Sanger sequencing of mutational hotspots), 28 MSI-tumors and 32 microsatellite stable (MSS) endometrioid endometrial tumors. MSI status was determined using immunohistochemistry (IHC). IHC was performed for CD3, CD4, CD8, CD20, PD-1 and PD-L1 using standard protocols. For evaluation of TILs, a photomicrograph (40X) of the area of maximum CD3+ intraepithelial lymphocytes was obtained with corresponding photomicrographs for the additional stains. For peritumoral lymphocytes, a semi-quantitative scoring method was utilized. Results: POLE-mutated and MSI tumors exhibited significantly elevated CD3+ (p = 0.001), CD4+ (p = 0.078) and CD8+ (p < 0.001) TILs compared to MSS tumors. CD20+ TILs were not statistically significantly different between MSI/POLE tumors and MSS tumors. Expression of PD-1 (p < 0.001) and PD-L1 (p = 0.022) was higher in TILs of POLE and MSI tumors compared to MSS tumors. Furthermore, POLE and MSI tumors harbored more peritumoral T-lymphocytes (p < 0.001) and higher expression of PD-1 (p = 0.001) and PD-L1 (p < 0.001) compared to MSS tumors. There were no significant differences in TILs, peritumoral lymphocytes and PD-1/PD-L1 expression between POLE-mutated and MSI tumors. Conclusions: POLE-mutated and MSI endometrial cancers are associated with an elevated number of TILs and peritumoral lymphocytes, and higher expression of PD-1 and PD-L1. These data support trials of immune-checkpoint inhibitors in hypermutated endometrial cancers.

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Abstract Details

Meeting

2015 ASCO Annual Meeting

Session Type

Clinical Science Symposium

Session Title

Intersection of the Mutanome and the Immunome

Track

Gynecologic Cancer

Sub Track

Uterine Cancer

Citation

J Clin Oncol 33, 2015 (suppl; abstr 5511)

DOI

10.1200/jco.2015.33.15_suppl.5511

Abstract #

5511

Abstract Disclosures

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