Assessing tumor-infiltrating immune cells and outcomes with cisplatin- versus carboplatin-based treatment in advanced urothelial cancer (UC): Survival analysis of three platinum-treated UC cohorts.

Authors

null

Konrad Stawiski

Medical University of Lodz, Lodz, Poland

Konrad Stawiski , Júlia Perera-Bel , Alejo Rodriguez-Vida , Núria Juanpere Rodero , Kent William Mouw , Aristotelis Bamias , Filipe Lf Carvalho , Joaquim Bellmunt

Organizations

Medical University of Lodz, Lodz, Poland, PSMAR Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain, Medical Oncology Department, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain, Dana-Farber Cancer Institute, Brookline, MA, National and Kapodistrian University of Athens, Athens, Greece, Brigham and Women's Hospital, Boston, MA, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA

Research Funding

No funding received
None.

Background: The association between tumor-infiltrating immune cells and the response to platinum-based chemotherapy (cisplatin vs carboplatin) in advanced urothelial cancer is not well characterized. We dissected the immune microenvironment of 3 large UC cohorts to define populations of immune cells associated with survival following carboplatin- or cisplatin-based chemotherapy. Methods: Two advanced UC cohorts – Hospital del Mar (HM; n = 55) and GREEK (n = 62) – treated with platinum-based chemotherapy were profiled using bulk RNA sequencing (RNA-seq) with tumor-infiltrating immune cells inferred using CIBERSORTx. Our findings were validated in a publicly available platinum-treated UC cohort (n = 93; Taber et al. Nat Comm 2020). Additionally, we assessed the impact of tumor-infiltrating immune cells in IMvigor210, an anti-PD-L1 treated cohort. Analysis was adjusted by tumor stage, and treatment regimen (cisplatin, carboplatin, atezolizumab) to determine associations between tumor-immune cell populations and overall survival (OS). Results: In platinum-treated patients, increased lymphoid cell infiltration was associated with improved OS. Specifically, the presence of naive and memory B-cells and CD4+ T cells was associated with prolonged OS (Table). Interestingly, infiltration of memory B-cells was associated with a better prognosis in patients treated with cisplatin (HR = 0.14) and detrimental in patients treated with carboplatin (HR = 249.53; difference p = 0.006). Additionally, macrophages (HR = 3.44; p = 0.027) and resting dendritic cell (HR = 41.47; p = 0.009) infiltration was associated with worse OS in patients treated with platinum therapy alone, but enrichment of pro-inflammatory M1 macrophages was associated with prolonged OS in patients treated with immunotherapy (p < 0.001). Conclusions: Immune cell infiltration is associated with differential outcomes to cisplatin- and carboplatin-based chemotherapy in advanced UC. Our findings suggest better OS in advanced UC treated with cisplatin in tumors enriched with memory B-cells compared to carboplatin treatment.

Cohort description with initial TNM- and treatment-adjusted hazard ratios (with 95%CI) of selected cell fractions.

CohortHMGREEKTABERPooled
T4 vs. T2 or T314 (22.6%)19 (34.5%)20 (21.5%)-
N+ vs. N028 (45.2%)26 (47.3%)40 (43.0%)-
M1 vs. M021 (33.9%)26 (47.3%)18 (19.4%)-
Lymphoid linage0.24 [0.06-0.92]0.13 [0.03-0.56]0.48 [0.16-1.42]0.29 [0.14-0.59]
B-cells (naïve & memory)0.14 [0.01-1.92]0.04 [0.00-0.82]0.28 [0.05-1.58]0.16 [0.04-0.60]
B-cells memory0.16 [0.01-2.37]0.01 [0.00-0.62]0.31 [0.06-1.64]0.18 [0.05-0.68]
T-cells0.24 [0.05-1.21]0.20 [0.03-1.28]0.52 [0.12-2.16]0.32 [0.12-0.80]
T-cells CD4+0.13 [0.02-0.83]0.35 [0.04-2.79]0.50 [0.12-2.08]0.31 [0.12-0.84]

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Genitourinary Cancer—Kidney and Bladder

Track

Genitourinary Cancer—Kidney and Bladder

Sub Track

Urothelial Cancer - Advanced/Metastatic Disease

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 4583)

DOI

10.1200/JCO.2023.41.16_suppl.4583

Abstract #

4583

Poster Bd #

75

Abstract Disclosures

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