Abstract 624: The role of draining lymph nodes in the post-transplant recurrence of liver cancer: Examining immune response using spatial proteomics

Hepatocellular Carcinoma (HCC) and Cholangiocarcinoma (CCA) are the predominant forms of liver cancer, with a devastating combined incidence of 40,000 cases per year in the United States. Despite many differences between the cancers, liver transplant has found great success in treating both over traditional methods. However, up to 35% of patients’ cancer still recur within five years. Given the risk and resource intensiveness of this treatment, it is critical to identify factors that influence recurrence in these cancers. Previous studies have found the micro-environments of HCC tumors tend to be immune-active while those of CCA tumors tend to be immunosuppressive. Increased immune activity at the tumor level is associated with better patient outcomes, but the role and impact of the regional immune response in liver cancer is not well understood. Liver draining lymph node tissue was collected from patients undergoing orthotopic liver transplant (OLT) for HCC, CCA, or other reasons (control). Nanostring GeoMx Digital Spatial Profiler (DSP) was used to measure immune marker levelsWe found increased immune activity in the LNs of patients with HCC compared to CCA, showing significantly higher levels of lymphocytes and immune activity markers, matching previous tumor microenvironment findings. Additionally, comparing recurrent and non-recurrent HCC or CCA samples, we see generally increased immune activity in non-recurrent lymph nodes, also identifying specific immune markers in both cancer types that correlate with cancer recurrence or non-recurrence. These also reveal patterns of activity specific to both cancer type and recurrence status. Overall, this study provides novel insights into the regional immune response in liver cancers and identifies candidate proteins to serve as predictors of recurrence in liver cancer. We suggest CD163, CD66b, CD8, and CD56 as markers to predict post-OLT HCC recurrence and CD163, CD66b, ID01, and OX40L as candidate markers to predict post-OLT CCA recurrence using LN samples. Further spatial analysis of this data may further characterize immune activity in these lymph nodes, and future studies focusing on identified differences in immune activity may reveal factors affecting liver cancer aggressiveness and recurrence. Citation Format: Peyton Hickman, Aubrey E. Thompson, Justin Nguyen. The role of draining lymph nodes in the post-transplant recurrence of liver cancer: Examining immune response using spatial proteomics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 624.