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Published on: June 13, 2019
Immune profiles of desmoplastic small round cell tumor and synovial sarcoma suggest different immunotherapeutic
Mary Frances Wedekind1,2, Kellie B Haworth3, Michael Arnold4,5
1Division of Hematology, Oncology, Blood and Marrow Transplant, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio.
Background:
Desmoplastic small round cell tumor (DSRCT) and synovial sarcoma are rare tumors with dismal outcomes requiring new therapeutic strategies. Immunotherapies have shown promise in several cancer types, but have not been evaluated in DSRCT and synovial sarcoma. Because the immune microenvironment can provide indications of the inflammatory nature of tumors, immunohistochemical staining is able to assess the tumor immune infiltrates in both tumor types.
Procedure:
Using tissue microarrays of DSRCT and synovial sarcoma tumor samples, we detected tumoral HLA-A/B/C, beta-2-microglobulin(B2M), and PD-L1 expression, and quantified tumor-infiltrating lymphocytes expressing CD4, CD8, CD56, CD45RO, or FOXP3 by immunohistochemistry. We used staining intensity on a scale of 0-3 and percentage of tumor stained to determine HLA, B2M, and PD-L1 scores. We calculated the cytotoxic T lymphocyte (CTL) target score as HLA score × B2M score/100.
Results:
In diagnostic samples, we found high HLA and CTL target scores and low PD-L1 expression with decreased scores in recurrence for both tumor types. We found an increase in CD56+ natural killer cells in DSRCT samples from diagnosis to recurrence.
Conclusions:
We found similar immunostimulatory profiles in DSRCT and synovial sarcoma. Our findings suggest that DSRCT and synovial sarcoma may be amenable to immunotherapies, albeit there was significant heterogeneity. Interestingly, HLA and CTL target scores decreased at recurrence, possibly reflecting immunoevasion. Our findings suggest both tumor types may be amendable to CTL-based therapies at diagnosis but less so at relapse. Our results support further investigation into the prognostic and predictive value of these findings in a larger dataset.
Insights
Desmoplastic small round cell tumors (DSRCT) and synovial sarcoma show similar immune profiles, suggesting potential for immunotherapy. However, immune evasion may occur at recurrence, impacting treatment effectiveness.
Area of Science:
- Oncology
- Immunology
- Pathology
Background:
- Desmoplastic small round cell tumor (DSRCT) and synovial sarcoma are rare cancers with poor prognoses.
- New therapeutic strategies, including immunotherapy, are needed for these tumors.
- The tumor immune microenvironment, assessed by immunohistochemistry, can indicate tumor inflammation and guide treatment strategies.
Purpose of the Study:
- To evaluate the potential of DSRCT and synovial sarcoma for immunotherapy.
- To assess tumor immune infiltrates and expression of immune markers in DSRCT and synovial sarcoma.
- To investigate changes in immune profiles from diagnosis to recurrence.
Main Methods:
- Tissue microarrays of DSRCT and synovial sarcoma samples were analyzed.
- Immunohistochemistry was used to detect tumoral HLA-A/B/C, beta-2-microglobulin (B2M), and PD-L1 expression.
- Tumor-infiltrating lymphocytes (CD4, CD8, CD56, CD45RO, FOXP3) and cytotoxic T lymphocyte (CTL) target scores were quantified.
Main Results:
- Both DSRCT and synovial sarcoma exhibited high HLA and CTL target scores with low PD-L1 expression at diagnosis.
- Scores for HLA and CTL targets decreased at recurrence, suggesting immunoevasion.
- An increase in CD56+ natural killer cells was observed in DSRCT from diagnosis to recurrence.
Conclusions:
- DSRCT and synovial sarcoma share similar immunostimulatory profiles, indicating potential amenability to immunotherapy.
- Heterogeneity exists within these tumor types, potentially impacting treatment response.
- CTL-based therapies may be more effective at diagnosis than at relapse due to immunoevasion.
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