International Journal of Radiation Oncology*Biology*Physics
Poster Viewing Q&A SessionPrognostic Significance of Immune Microenvironmental Factors in Undifferentiated Nasopharyngeal Carcinoma Patients Treated with Chemoradiotherapy
Section snippets
Purpose/Objective(s)
EBV-associated UNPC is characterized by an abundant immune infiltrate, which may have a prognostic relevance, considering EBV-specific immune response and microenvironmental immunesuppression. Our primary aim was to retrospectively assess the significance of immunesuppression in the UNPC microenvironment as prognostic biomarker of treatment failure in a non-endemic area population. As secondary aim we investigated the immunomodulating effects of chemoradiotherapy (CRT) monitoring the variation
Materials/Methods
We reviewed 63 consecutive patients (pts) with EBV-associated stage II-IVB UNPC undergoing radical CRT. Our policy was of administering concurrent CRT in pts with stage II disease, and sequential therapy in pts with advanced stages. The number of relapsed pts was 11 (cases), while 52 pts (controls) were free from treatment failure at a minimum follow-up of 2 years. DNA and RNA were extracted from tumor (T) and adjacent normal mucosa (M) frozen biopsies at diagnosis. We verified the expression
Results
Quantitative RT-PCR analyses showed significantly higher expression levels of several immune-related genes (i.e. BARF1, CD8, IFN-g, IDO, PD-L1, and PD-1) in UNPC samples respect to healthy tissues. Interestingly, CD8 expression was significantly reduced in both tumor and healthy tissues in UNPC patients who relapsed within two years (P<0.001). Similarly, quantitative methylation-specific PCR analyses identified a hypomethylated FOXP3 intron 1 exclusively in relapsed UNPC patients. Finally, we
Conclusion
Altogether, our data suggest that a high level of immunosuppression (low CD8, hypomethylated FoxP3) in UNPC microenvironment may predict treatment failure and early identify those patients who could benefit from the addition of an immunotherapy improving first line CRT.
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Author Disclosure: E. Muraro: None. E. Vaccher: None. C. Furlan: None. E. Fratta: None. D.A. Fae': None. D. Martorelli: None. J. Polesel: None. G. Fanetti: None. E. Farina: None. F. Navarria: None. E. Comaro: None. V. Lupato: None. V. Giacomarra: None. S. Sulfaro: None. L. Barzan: None. G. Grando: None. R. Dolcetti: None. A. Steffan: None. V. Canzonieri: None. G. Franchin: None.