Changes in the tumor immune microenvironment during disease progression in clear cell ovarian cancer.

Jung-Yun Lee; Yong Jae Lee; Ha Young Woo; Eun Ji Nam; Sang Wun Kim; Sunghoon Kim; Young Tae Kim

Objective: The tumor immune microenvironment (TIME) have not been clearly defined in clear cell ovarian cancer (CCC). We analyzed the immunologic changes from treatment-naive to recurrence to correlate them with clinical outcomes. Methods: We compared the changes in the immune infiltration of advanced-stage CCC samples before treatment and at the time of recurrence via immunohistochemistry (programmed death-ligand 1 [PD-L1], CD8, forkhead box P3 [FOXP3]), tumor infiltration lymphocytes (TIL) and next-generation sequencing (NGS) (54 paired samples). We analyzed the association between platinum-sensitivity status and TIME. Results: Immunohistochemistry showed significantly increased PD-L1 (p=0.048) and CD8 (p=0.022) expression levels after progression. There was no significant difference in the TIL density and FOXP3 expression level. The most common genomic alterations were in PIK3CA (41.7%). ARID1A (41.7%) and ERBB2 amplification (11.1%). There were no differences in immunologic changes and survival outcomes according to PIK3CA and ARID1A mutation. Of 54 patients, 42 were platinum sensitive and 12 resistant. In patients with recurrent platinum sensitive disease showed higher level of TIL expression. There was no significant difference in the PD-L1, CD8 and FOXP3 expression level between platinum-sensitive and platinum-resistant disease. Conclusion: We characterized the TIME of patients with advanced-stage CCC. PD-L1 and CD8 expression was significantly increased after progression. Whether this could select patients for immunotherapy in the recurrence setting should be investigated.

OVARIAN cancer; TUMOR microenvironment; DISEASE progression; CANCER cells; PROGRAMMED death-ligand 1

Journal of Gynecologic Oncology, 2024, Vol 35, p23

2005-0380

Academic Journal

10.3802/jgo.2024.35.S2.P5