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Clinical and immune profiling for cancer of unknown primary site.
- Source :
-
Journal for ImmunoTherapy of Cancer . 9/13/2019, Vol. 7 Issue 1, pN.PAG-N.PAG. 1p. - Publication Year :
- 2019
-
Abstract
- Background: Immune checkpoint inhibitors (ICIs) confer a survival benefit in many cancer types. Given that the survival outcome for cancer of unknown primary site (CUP) remains poor, we investigated the potential of CUP for immunotherapy. Methods: A total of 164 patients with CUP (favorable subset, 34 patients; unfavorable subset, 130 patients) who were treated between January 2009 and March 2017 was identified from a review of medical records at Kindai University Hospital. They included 92 patients for whom pretreatment tumor tissue was available both for determination of programmed cell death–ligand 1 expression and tumor-infiltrating lymphocyte (TIL) density by immunohistochemistry (IHC) and for immune-related gene expression profiling (irGEP). The results of irGEP for CUP were compared with published data for ICI-treated solid cancers classified into progressive disease (PD) and non-PD subsets according to their best response to ICIs. Results: The median overall survival of all CUP patients was 29.3 months (95% confidence interval [CI], 15.7–not reached) and 7.1 months (95% CI, 5.0–9.4) for favorable and unfavorable subsets, respectively. IHC and irGEP revealed that pretreatment immune activity—including expression of immune checkpoint molecules—for CUP was similar to that for ICI-responsive malignancies (antitumor immune cell signatures: CUP versus PD, P = 0.002–0.067; CUP versus non-PD, P = 0.591–0.999), although VEGFA expression was associated with suppression of antitumor immunity in CUP (P = 0.008, false discovery rate = 0.010). In addition, one case of CUP in the unfavorable subset that was associated with prominent PD-L1 expression on TILs and showed a durable response to nivolumab is presented. Conclusions: The survival outcome of CUP remains unsatisfactory. However, our clinical and immune profiling of CUP has revealed a potential to benefit from immunotherapy, with ICIs thus being a potential option for CUP treatment. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CANCER of unknown primary origin
*GENE expression profiling
*FALSE discovery rate
Subjects
Details
- Language :
- English
- ISSN :
- 20511426
- Volume :
- 7
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal for ImmunoTherapy of Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 138611524
- Full Text :
- https://doi.org/10.1186/s40425-019-0720-z