Differential expression of PDL-1 and tumour-associated macrophages in N0 and N+ penile cancer.

Authors

null

Fowz Azhar

GenitoUrinary Cancer Research Group, The University of Manchester, The Christie NHS Foundation Trust, Salford Royal NHS Foundation Trust, Manchester, United Kingdom

Fowz Azhar , Ashwin Sachdeva , Claire Alexandre Hart , Mick D. Brown , Vijay Sangar , Arie Parnham , Maurice Lau , Pedro Oliveria , Noel W Clarke

Organizations

GenitoUrinary Cancer Research Group, The University of Manchester, The Christie NHS Foundation Trust, Salford Royal NHS Foundation Trust, Manchester, United Kingdom, GenitoUrinary Cancer Research Group, FASTMAN Movember Centre of Excellence, University of Manchester, Manchester, United Kingdom, GenitoUrinary Cancer Research Group, The University of Manchester, Manchester, United Kingdom, The Christie NHS Foundation Trust, Manchester, United Kingdom, Christie Hospital NHS Foundation Trust, Manchester, United Kingdom, The University of Manchester, The Christie NHS Foundation Trust, Salford Royal NHS Foundation Trust, Manchester, United Kingdom

Research Funding

Other
The Salford Urology Fund

Background: Penile squamous cell carcinoma (PSCC) is rare, representing 0.4-0.6% of all male malignancies in the global-north, as compared with 2-10% in the global-south. Overall survival (OS) dramatically decreases with increased lymph node metastases (LNM). Increased prevalence of pro-tumorigenic M2 CD163+ tumour associated macrophages (TAM) is associated with poor PSCC OS, whereas increased prevalence of the generic M1/2 CD68+ TAMs is associated with better PSCC OS. PDL-1 expression has been noted in 40-60% of PSCC primary lesions. However, there is a paucity of evidence on the overall tumour immune microenvironment (TME) within penile LNM disease. This study describes the relationship between PDL-1 expression and TAMs within the TME of the primary tumour and paired LNMs, with the goal of predicting the utility of PD-1 inhibitors in clinical trials in PSCC. Methods: The Ventana Discovery ULTRA platform was used to optimise a 7-marker multiplex immunofluorescence panel on whole FFPE sections of primary and LNM lesions. Multispectral images were captured using a Vectra 3 microscope. Single cell spatial analysis was performed using HALO software, with statistical analysis of data using R 4.2.1. Results: 52 cases with differing LN stages were identified: N0 (N=20); N1/N2 (N=21); N3 (N=11). Increased expression of PDL-1 was noted at the primary lesion invasive margin (IM) of N+, compared with N0 patients. High expression in inguinal LNMs (iLN+) and pelvic LNMs (pLN+) was also observed, with no expression detected in microscopically normal, tumour free LNs (LN-) in the N0 cohort. More CD163+ M2 TAMs were observed at the IM of N+ compared with N0. However, no significant difference was observed between the three LN groups. M1/2 CD68+ TAMs were more prevalent within pLN+ vs iLN+ or LN-. There was no significant difference in M1/2 CD68+ TAMs number at the IM. Conclusions: Our data highlights increased prevalence of M2 CD163+ TAMs within the IM is associated with LNM. Increased presence of CD68+ M1/2 TAMs in pLN+ may represent active inflammation at the leading microscopic edge of metastatic deposits. A significant difference in the expression of PDL-1 between localised and metastatic disease at both primary and LN location is noted. High PDL-1 expression at the IM of the primary lesion is associated with increased LNMs, where PDL-1 expression is significantly higher as compared to LN-. This study supports the rationale for the use of anti-PD-1/PDL-1 therapies in patients with LNM disease.

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Abstract Details

Meeting

2023 ASCO Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Renal Cell Cancer; Adrenal, Penile, Urethral and Testicular Cancers

Track

Renal Cell Cancer,Adrenal Cancer,Penile Cancer,Testicular Cancer,Urethral Cancer

Sub Track

Translational Research, Tumor Biology, Biomarkers, and Pathology

Citation

J Clin Oncol 41, 2023 (suppl 6; abstr 12)

DOI

10.1200/JCO.2023.41.6_suppl.12

Abstract #

12

Poster Bd #

D17

Abstract Disclosures