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Characteristics and impact of programmed death-ligand 1 expression, CD8+ tumor-infiltrating lymphocytes, and p16 status in head and neck squamous cell carcinoma

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Abstract

Background

No predictive biomarker of immune checkpoint inhibitors in head and neck squamous cell carcinoma (HNSCC) has been well established. The impact of programmed death-ligand 1 (PD-L1) expression, CD8+ tumor-infiltrating lymphocytes (TILs), and p16 status in HNSCC is unclear and may vary according to ethnicity.

Methods

HNSCC patients treated between 2007 and 2013 were reviewed. Archival tissues were retrieved for PD-L1, CD8+ TILs, and p16 analyses. PD-L1 expression was evaluated by using the validated SP142 assay on the VENTANA platform. CD8+ TILs were defined by using semiquantitative scoring.

Results

A total of 203 patients were analyzed. PD-L1 expression was observed in 80% of patients and was significantly associated with older age (P < 0.001). A high CD8+ TIL score (≥ 6) was significantly associated with never-smoking (P = 0.020), oral cavity cancer (P < 0.001), and stage M0 at presentation (P = 0.025). The p16 status was positive in 12% of patients. Patients with a high TIL score had a significantly longer OS (P = 0.032). Patients with PD-L1 expression of 1–49% and ≥ 50% were associated with a significantly shorter OS compared with those with PD-L1 < 1% (P = 0.027 and P = 0.011, respectively). Multivariate analysis showed that PD-L1 ≥ 50% was significantly associated with a poor OS. (HR 2.98 [95% CI 1.2–7.39]; P = 0.019.)

Conclusions

A high prevalence of PD-L1 expression was observed in HNSCC using the validated SP142 assay. PD-L1 expression was associated with older age, while highly PD-L1 expression (≥ 50%) was an independent prognostic factor for poor OS in anti-PD1/PD-L1 untreated HNSCC patients.

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Acknowledgements

This work was supported by a grant from the Ramathibodi Cancer Center Grant. N. Ngamphaiboon received funding from the Research University Network (RUN), and the Thailand Research Fund (TRF), and the Research Development Grant from the Ramathibodi Hospital. The authors thank Ms. Dollapas Punpanich for statistical analysis.

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Authors and Affiliations

  1. Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand

    Nuttapong Ngamphaiboon, Teeranuch Chureemas, Teerada Siripoon & Ekaphop Sirachainan

  2. Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

    Lalida Arsa & Noppadol Larbcharoensub

  3. Ramathibodi Research Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

    Narumol Trachu

  4. Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

    Chuleeporn Jiarpinitnun & Poompis Pattaranutaporn

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  1. Nuttapong Ngamphaiboon
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Informed consent

The Ramathibodi Ethic Committee approved a waiver of consent for this study as a retrospective chart review. Archrival tissues used in this study were considered as a leftover specimen. The research involves no more than minimal risk to the subject and is not adversely affect the rights and welfare of the subjects. All patient identifications were protected according to the GCP guideline and not published in the manuscript. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Ngamphaiboon, N., Chureemas, T., Siripoon, T. et al. Characteristics and impact of programmed death-ligand 1 expression, CD8+ tumor-infiltrating lymphocytes, and p16 status in head and neck squamous cell carcinoma. Med Oncol 36, 21 (2019). https://doi.org/10.1007/s12032-018-1241-1

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