Profiling of immune checkpoint biomarkers by multiplex immunofluorescence in breast cancer brain metastases.

Authors

null

Gaia Griguolo

Department of Surgery, Oncology and Gastroenterology, University of Padua, and Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy

Gaia Griguolo , Anna Tosi , Valentina Guarneri , Maria Vittoria Dieci , Susan Fineberg , Annavera Ventura , Luc Bauchet , Jack Jacob , Valerie Rigau , William Jacot , Antonio Rosato , Amelie Darlix , Pierfranco Conte

Organizations

Department of Surgery, Oncology and Gastroenterology, University of Padua, and Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy, Department of Surgery, Oncology and Gastroenterology - University of Padova, Padova, Italy, Department of Surgery, Oncology and Gastroenterology, University of Padua, and Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy, Department of Surgery, Oncology and Gastroenterology, University of Padua, Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, Istituto Oncologico Veneto-IRCCS, Padua, Italy, Neurosurgery CHU Montpellier, Montpellier, France, Department of Pathology - Beth Israel Deaconess Medical Center, Boston, MA, Pathological Department CHU Montpellier, Montpellier, France, IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France, Department of Medical Oncology, Institut du Cancer de Montpellier, Institut de Génomique fonctionnelle, CNRS, University of MontpellierOncology, Montpellier, France, Department of Surgery, Oncology and Gastroenterology, University of Padua and Oncology Unit 2, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy

Research Funding

Conquer Cancer Foundation of the American Society of Clinical Oncology
Conquer Cancer Foundation of the American Society of Clinical Oncology

Background: Despite potential clinical implications, the complexity of immune microenvironment in breast cancer (BC) brain metastases (BM) is still poorly understood. Multiplex immunofluorescence (mIF) allows simultaneous visualization of several IF labeled proteins while maintaining spatial information. This novel technique can be used to comprehensively describe BCBM immune microenvironment, potentially providing useful information to guide novel therapeutic approaches. Methods: Clinical data and archival BM samples from 60 BC patients undergoing neurosurgery (2003-2018) at three institutions were collected. BCBMs were characterized using a custom mIF panel, including immune checkpoint and co-inhibitory molecules (CD3, PD1, PD-L1, TIM3, LAG3, CD163) and localization (keratin for tumor recognition) markers. Mean marker density was determined by digital image analysis (positive cells/mm2) and classified in tumor and stroma areas. Associations between immune marker densities, BC subtype and overall survival from BM diagnosis (OS) were studied. Results: Sixty BCBM samples were analyzed; 32% HR+/HER2-, 38% HER2+, 30% HR-/HER2-. At a median follow-up of 43 months, the only clinical variable associated with OS was BC subtype (shortest for HR-/HER2- and longest for HER2+, p=0.02). In the total sample area and tumor area, no significant difference in marker density was observed according to BC subtype. In the stroma area, a significant difference in TIM3+ cell density was observed according to BC subtype (highest density in HR+/HER2- and lowest density in HER2+ tumors, Kruskal-Wallis p=0.017). Higher CD163 density (a marker of M2 macrophage polarization), both in the tumor and in the stroma area, was significantly associated with worse OS, even after correction by BC subtype. In the subgroup of patients with HR+/HER2- BCBM, high TIM3+ cell density in the stroma area was significantly associated with longer OS (median OS 54.1 versus 23 months respectively for TIM3+ density above and below median value; p=0.01). Conclusions: In BCBM, stromal TIM3+ immune infiltrate differs according to BC subtype. M2 macrophage polarization is consistently associated with worse OS across all BC subtypes and might represent a potential therapeutic target for these patients.

Univariate Cox Model for OSMultivariable Cox Model for OS

(correction by BC subtype)
Hazard Ratio (95% CI)p-valueHazard Ratio (95% CI)p-value
CD163+ tumor area (positive cells/mm2)1.004 (1.000-1.007)0.0341.005 (1.001-1.009)0.016
CD163+ stroma area (positive cells/mm2)1.001 (1.000-1.002)0.0211.001 (1.000-1.002)0.024
CD163+ total area (positive cells/mm2)1.003 (1.002-1.005)<0.0011.004 (1.002-1.007)<0.001

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Brain Metastases

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 2021)

DOI

10.1200/JCO.2021.39.15_suppl.2021

Abstract #

2021

Abstract Disclosures

Funded by Conquer Cancer

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