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Prediction of treatment response from the microenvironment of tumor immunity in cervical cancer patients treated with chemoradiotherapy

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Abstract

To supplement clinical decision-making in the management of cervical cancer, various prognostic factors, including tumor immune microenvironments, were examined in patients with cervical cancer treated with definitive chemoradiotherapy. We retrospectively analyzed the expression of CD8, FoxP3, HLA-1, PD-L1, and XRCC4 in 100 cases of cervical cancer. The observed tumor immune microenvironments were also classified into three types: inflamed, excluded, and cold type. Less FoxP3+ T cells and cold-type tumor were found to be poor prognostic factors in addition to non-SCC, large pre-treatment tumor volume, and three or less cycles of concurrent chemotherapy based on multivariate analysis. Cold-type tumors had significantly worse prognoses than the other two types, whereas inflamed- and excluded-type tumors showed similar 5-year disease-specific survival (P < 0.001; 0% vs. 60.3% vs. 72.3%). Radiotherapy could overcome the inhibitory immune microenvironment that occurs in excluded type. Individualized combination therapy adapted to pre-treatment tumor immunity may be necessary to improve radiotherapy outcomes in cervical cancer.

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Acknowledgements

This work was supported by JSPS KAKENHI Grant Number 18K07760 and 18K07684.

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Authors and Affiliations

  1. Department of Radiology, Sapporo Medical University School of Medicine, S1 W16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan

    Masanori Someya, Takaaki Tsuchiya, Yuki Fukushima, Tomokazu Hasegawa, Masakazu Hori, Mio Kitagawa, Toshio Gocho, Shoh Mafune, Yutaro Ikeuchi & Koh-ichi Sakata

  2. Department of Pathology, Sapporo Medical University School of Medicine, Sapporo, Japan

    Yoshihiko Hirohashi & Toshihiko Torigoe

  3. Department of Obstetrics and Gynecology, Sapporo Medical University School of Medicine, Sapporo, Japan

    Masahiro Iwasaki, Motoki Matsuura & Tsuyoshi Saito

  4. Institute of Innovative Research Laboratory for Advanced Nuclear Energy, Tokyo Institute of Technology, N1-30 2-12-1 Ookayama, Meguro-ku, Tokyo, 152-8550, Japan

    Yoshihisa Matsumoto

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  1. Masanori Someya
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  2. Takaaki Tsuchiya
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Correspondence to Masanori Someya.

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Someya, M., Tsuchiya, T., Fukushima, Y. et al. Prediction of treatment response from the microenvironment of tumor immunity in cervical cancer patients treated with chemoradiotherapy. Med Mol Morphol 54, 245–252 (2021). https://doi.org/10.1007/s00795-021-00290-w

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  • DOI: https://doi.org/10.1007/s00795-021-00290-w

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