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Analysis of tumor-infiltrating CD103 resident memory T-cell content in recurrent laryngeal squamous cell carcinoma

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Abstract

Background

Recurrent laryngeal squamous cell carcinomas (LSCCs) are associated with poor outcomes, without reliable biomarkers to identify patients who may benefit from adjuvant therapies. Given the emergence of tumor-infiltrating lymphocytes (TIL) as a biomarker in head and neck squamous cell carcinoma, we generated predictive models to understand the utility of CD4+, CD8+ and/or CD103+ TIL status in patients with advanced LSCC.

Methods

Tissue microarrays were constructed from salvage laryngectomy specimens of 183 patients with recurrent/persistent LSCC and independently stained for CD4+, CD8+, and CD103+ TIL content. Cox proportional hazards regression analysis was employed to assess combinations of CD4+, CD8+, and CD103+ TIL levels for prediction of overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) in patients with recurrent/persistent LSCC.

Results

High tumor CD103+ TIL content was associated with significantly improved OS, DSS, and DFS and was a stronger predictor of survival in recurrent/persistent LSCC than either high CD8+ or CD4+ TIL content. On multivariate analysis, an “immune-rich” phenotype, in which tumors were enriched for both CD103+ and CD4+ TILs, conferred a survival benefit (OS hazard ratio: 0.28, p = 0.0014; DSS hazard ratio: 0.09, p = 0.0015; DFS hazard ratio: 0.18, p = 0.0018) in recurrent/persistent LSCC.

Conclusions

An immune profile driven by CD103+ TIL content, alone and in combination with CD4+ TIL content, is a prognostic biomarker of survival in patients with recurrent/persistent LSCC. Predictive models described herein may thus prove valuable in prognostic stratification and lead to personalized treatment paradigms for this patient population.

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Abbreviations

ACE-27:

Adult Comorbidity Evaluation-27

AJCC:

American Joint Committee on Cancer

CRT:

Chemoradiation

DFS:

Disease-free survival

DSS:

Disease-specific survival

FFPE:

Formalin-fixed paraffin-embedded

HNSCC:

Head and neck squamous cell carcinoma

LSCC:

Laryngeal squamous cell carcinoma

OS:

Overall survival

PD-1:

Programmed cell death protein 1

RT:

Radiation

TIL:

Tumor-infiltrating lymphocyte(s)

TMA:

Tissue microarray

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Funding

J. Chad Brenner received funding from NIH Grants U01-DE025184, P30-CA046592 and R01-CA194536. Thomas E. Carey received funding from NIH Grants U01-DE025184 and R01-CA194536. Jacqueline E. Mann was funded by NIH Grant F31-DE02760001. Joshua D. Smith received funding from NIH Grant T32-DC535615. J. Chad Brenner and Matthew E. Spector also received funding from the American Head and Neck Society.

Author information

Author notes

  1. Jacqueline E. Mann, Joshua D. Smith, Andrew C. Birkeland, Matthew E. Spector and J. Chad Brenner contributed equally.

Authors and Affiliations

  1. Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1150 E. Medical Center Dr., 9301B MSRB3, Ann Arbor, 48109-0602, MI, USA

    Jacqueline E. Mann, Joshua D. Smith, Andrew C. Birkeland, Steven B. Chinn, Andrew G. Shuman, Kelly M. Malloy, Keith A. Casper, Scott A. McLean, Jeffery S. Moyer, Gregory T. Wolf, Carol R. Bradford, Mark E. Prince, Thomas E. Carey, Matthew E. Spector & J. Chad Brenner

  2. Department of Pathology, University of Michigan, Ann Arbor, MI, USA

    Jacqueline E. Mann & Jonathan B. McHugh

  3. Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA

    Emily Bellile

  4. Department of Hematology and Oncology, University of Michigan, Ann Arbor, MI, USA

    Paul Swiecicki

  5. Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA

    Michelle Mierzwa

  6. Rogel Cancer Center, University of Michigan, 1500 E. Medical Center Dr., 1904 Taubman Center, 48109-5312, Ann Arbor, MI, USA

    Gregory T. Wolf, Carol R. Bradford, Mark E. Prince, Thomas E. Carey, Jonathan B. McHugh, Matthew E. Spector & J. Chad Brenner

  7. Department of Pharmacology, University of Michigan, Ann Arbor, MI, USA

    Thomas E. Carey & J. Chad Brenner

Authors
  1. Jacqueline E. Mann
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  2. Joshua D. Smith
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  3. Andrew C. Birkeland
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  4. Emily Bellile
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  6. Michelle Mierzwa
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  7. Steven B. Chinn
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  8. Andrew G. Shuman
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  9. Kelly M. Malloy
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  12. Jeffery S. Moyer
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  13. Gregory T. Wolf
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  16. Thomas E. Carey
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  17. Jonathan B. McHugh
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  18. Matthew E. Spector
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  19. J. Chad Brenner
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Contributions

JEM and JDS designed and performed experiments and wrote the manuscript. ACB and EB performed statistical analyses. PS, MM, SBC, AGS, KMM, KAC, SAM, JSM, GTW, CRB, MEP and TEC contributed to study design and sample procurement. JBM ensured quality of pathological specimens and tissue microarray. MES and JCB oversaw study design, execution, data analysis and manuscript drafts. All authors provided edits and approved of the final manuscript.

Corresponding authors

Correspondence to Matthew E. Spector or J. Chad Brenner.

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Conflict of interest

All authors declare that they have no potential conflicts of interest relevant to this paper.

Ethical approval and ethical standards

This study was approved by the University of Michigan Hospital and Health Systems Institutional Review Board (HUM00081554).

Informed consent

The patients had provided informed consent to a prospectively maintained clinical epidemiology and tissue database.

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Mann, J.E., Smith, J.D., Birkeland, A.C. et al. Analysis of tumor-infiltrating CD103 resident memory T-cell content in recurrent laryngeal squamous cell carcinoma. Cancer Immunol Immunother 68, 213–220 (2019). https://doi.org/10.1007/s00262-018-2256-3

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  • DOI: https://doi.org/10.1007/s00262-018-2256-3

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