Immune-Related Pathological Features and Predictive Score in Intrahepatic Cholangiocarcinoma Treated With Combined...

Area of Science:

• Oncology
• Immunotherapy
• Pathology

Background:

• Immune checkpoint inhibitor (ICI) therapy is increasingly used for unresectable intrahepatic cholangiocarcinoma (iCCA).
• Predictive biomarkers for treatment response and survival in iCCA patients receiving ICI therapy are lacking.
• Immune-related pathological features (irPF) in pre-treatment biopsies may offer predictive value.

Purpose of the Study:

• To assess irPF in pre-treatment biopsies of iCCA patients undergoing ICI-based conversion therapy.
• To develop a predictive scoring system (iTPS) for oncological outcomes.
• To evaluate the correlation between irPF and recurrence-free survival (RFS) and overall survival (OS).

Main Methods:

• Evaluation of 13 irPF in H&E stained biopsy slides from 95 iCCA patients.
• Cox regression analysis to determine the association between irPF and survival outcomes.
• Development of a binary iTPS scheme using significant irPF (immature fibrosis, tumor-infiltrating lymphocytes, lymphoid aggregate, hemosiderin).

Main Results:

• The developed binary iTPS scheme demonstrated significant predictive capability.
• Patients with a low iTPS showed significantly better RFS (HR: 1.83; P = 0.04).
• Patients with a low iTPS exhibited significantly better OS (HR: 12.9; P < 0.001).

Conclusions:

• An iTPS scheme was successfully developed using routine H&E stained pre-treatment biopsy slides.
• The iTPS can effectively predict RFS and OS in iCCA patients receiving combined ICI-based conversion therapy.
• iTPS shows promise as a predictive biomarker for iCCA, offering insights into the tumor immune microenvironment during immunotherapy.