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
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 | HM | GREEK | TABER | Pooled |
---|---|---|---|---|
T4 vs. T2 or T3 | 14 (22.6%) | 19 (34.5%) | 20 (21.5%) | - |
N+ vs. N0 | 28 (45.2%) | 26 (47.3%) | 40 (43.0%) | - |
M1 vs. M0 | 21 (33.9%) | 26 (47.3%) | 18 (19.4%) | - |
Lymphoid linage | 0.24 [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 memory | 0.16 [0.01-2.37] | 0.01 [0.00-0.62] | 0.31 [0.06-1.64] | 0.18 [0.05-0.68] |
T-cells | 0.24 [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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