Immunohistochemical scoring of CD38 in the tumor microenvironment predicts responsiveness to anti-PD-1/PD-L1 immunotherapy in hepatocellular carcinoma

Introduction Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-associated mortality globally. Immune-checkpoint blockade (ICB) is one of the systemic therapy options for HCC. However, response rates remain low, necessitating robust predictive biomarkers. In the present study, we e...

Full description

Saved in:
Bibliographic Details
Main Authors: Valerie Chew, Tony Kiat Hon Lim, David Tai, Su Pin Choo, Joe Yeong, Jeffrey Chun Tatt Lim, Bernett Lee, Huihua Li, Sahil Saraf, Han Chong Toh, Benedict Tan, Harry Ho Man Ng, Ren Yuan Lee, Siting Goh, Isabel Shu Ying Tay, Xinru Lim, Sherlly Lim, Bijin Au, Josh Jie Hua Loh, John Edward Connolly, Tracy Loh, Wei Qiang Leow, Joycelyn Jie Xin Lee, Fabio Malavasi, Ser Yee Lee, Pierce Chow, Evan W Newell
Format: Article
Language:English
Published: BMJ Publishing Group 2020-10-01
Series:Journal for ImmunoTherapy of Cancer
Online Access:https://jitc.bmj.com/content/8/2/e000987.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846172593426530304
author Valerie Chew
Tony Kiat Hon Lim
David Tai
Su Pin Choo
Joe Yeong
Jeffrey Chun Tatt Lim
Bernett Lee
Huihua Li
Sahil Saraf
Han Chong Toh
Benedict Tan
Harry Ho Man Ng
Ren Yuan Lee
Siting Goh
Isabel Shu Ying Tay
Xinru Lim
Sherlly Lim
Bijin Au
Josh Jie Hua Loh
John Edward Connolly
Tracy Loh
Wei Qiang Leow
Joycelyn Jie Xin Lee
Fabio Malavasi
Ser Yee Lee
Pierce Chow
Evan W Newell
author_facet Valerie Chew
Tony Kiat Hon Lim
David Tai
Su Pin Choo
Joe Yeong
Jeffrey Chun Tatt Lim
Bernett Lee
Huihua Li
Sahil Saraf
Han Chong Toh
Benedict Tan
Harry Ho Man Ng
Ren Yuan Lee
Siting Goh
Isabel Shu Ying Tay
Xinru Lim
Sherlly Lim
Bijin Au
Josh Jie Hua Loh
John Edward Connolly
Tracy Loh
Wei Qiang Leow
Joycelyn Jie Xin Lee
Fabio Malavasi
Ser Yee Lee
Pierce Chow
Evan W Newell
author_sort Valerie Chew
collection DOAJ
description Introduction Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-associated mortality globally. Immune-checkpoint blockade (ICB) is one of the systemic therapy options for HCC. However, response rates remain low, necessitating robust predictive biomarkers. In the present study, we examined the expression of CD38, a molecule involved in the immunosuppressive adenosinergic pathway, on immune cells present in the tumor microenvironment. We then investigated the association between CD38 and ICB treatment outcomes in advanced HCC.Methods Clinically annotated samples from 49 patients with advanced HCC treated with ICB were analyzed for CD38 expression using immunohistochemistry (IHC), multiplex immunohistochemistry/immunofluorescence (mIHC/IF) and multiplex cytokine analysis.Results IHC and mIHC/IF analyses revealed that higher intratumoral CD38+ cell proportion was strongly associated with improved response to ICB. The overall response rates to ICB was significantly higher among patients with high proportion of total CD38+cells compared with patients with low proportion (43.5% vs 3.9%, p=0.019). Higher responses seen among patients with a high intratumoral CD38+cell proportion translated to a longer median progression-free survival (mPFS, 8.21 months vs 1.64 months, p=0.0065) and median overall survival (mOS, 19.06 months vs 9.59 months, p=0.0295). Patients with high CD38+CD68+macrophage density had a better mOS of 34.43 months compared with 9.66 months in patients with low CD38+CD68+ macrophage density. CD38hi macrophages produce more interferon γ (IFN-γ) and related cytokines, which may explain its predictive value when treated with ICB.Conclusions A high proportion of CD38+ cells, determined by IHC, predicts response to ICB and is associated with superior mPFS and OS in advanced HCC.
format Article
id doaj-art-63bba1dbcae64136851847771b46dfaf
institution Kabale University
issn 2051-1426
language English
publishDate 2020-10-01
publisher BMJ Publishing Group
record_format Article
series Journal for ImmunoTherapy of Cancer
spelling doaj-art-63bba1dbcae64136851847771b46dfaf2024-11-09T23:50:08ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262020-10-018210.1136/jitc-2020-000987Immunohistochemical scoring of CD38 in the tumor microenvironment predicts responsiveness to anti-PD-1/PD-L1 immunotherapy in hepatocellular carcinomaValerie Chew0Tony Kiat Hon Lim1David Tai2Su Pin Choo3Joe Yeong4Jeffrey Chun Tatt Lim5Bernett Lee6Huihua Li7Sahil Saraf8Han Chong Toh9Benedict Tan10Harry Ho Man Ng11Ren Yuan Lee12Siting Goh13Isabel Shu Ying Tay14Xinru Lim15Sherlly Lim16Bijin Au17Josh Jie Hua Loh18John Edward Connolly19Tracy Loh20Wei Qiang Leow21Joycelyn Jie Xin Lee22Fabio Malavasi23Ser Yee Lee24Pierce Chow25Evan W Newell26Translational Immunology Institute (TII), SingHealth-DukeNUS Academic Medical Centre, Singapore, Singapore2 Department of Pathology, Singapore General Hospital, Singapore10 Division of Medical Oncology, National Cancer Centre Singapore, SingaporeDivision of Medical Oncology, National Cancer Centre Singapore, Singapore2 Division of Pathology, Singapore General Hospital, Singapore13 Institute of Molecular and Cell Biology, Integrative Biology for Theranostics Lab, Agency for Science Technology and Research (A*STAR), Singapore5Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore4 Center for Quantitative Medicine, Duke-NUS Medical School, Singapore2 Division of Pathology, Singapore General Hospital, Singapore8National Cancer Centre Singapore, Singapore, SingaporeExercise is Medicine Singapore, Singapore1 Duke-NUS Medical School, Singapore2 Division of Pathology, Singapore General Hospital, Singapore2 Division of Pathology, Singapore General Hospital, Singapore4 Temasek Polytechnic, Singapore5 Institute of Molecular Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore1 Institute of Molecular and Cell Biology, Agency of Science, Technology and Research (A*STAR), Singapore5 Institute of Molecular Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore2 Division of Pathology, Singapore General Hospital, Singapore5 Institute of Molecular Cell Biology (IMCB), Agency of Science, Technology and Research (A*STAR), Singapore2 Division of Pathology, Singapore General Hospital, Singapore2 Division of Pathology, Singapore General Hospital, Singapore10 Division of Medical Oncology, National Cancer Centre Singapore, Singapore11 Laboratory of Immunogenetics and CeRMS, Department of Medical Sciences, University of Torino, Torino, Italy1 Duke-NUS Medical School, SingaporeSingHeath Duke-NUS Global Health Institute, Singapore6 Singapore Immunology Network (SIgN), Agency of Science, Technology and Research (A*STAR), SingaporeIntroduction Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-associated mortality globally. Immune-checkpoint blockade (ICB) is one of the systemic therapy options for HCC. However, response rates remain low, necessitating robust predictive biomarkers. In the present study, we examined the expression of CD38, a molecule involved in the immunosuppressive adenosinergic pathway, on immune cells present in the tumor microenvironment. We then investigated the association between CD38 and ICB treatment outcomes in advanced HCC.Methods Clinically annotated samples from 49 patients with advanced HCC treated with ICB were analyzed for CD38 expression using immunohistochemistry (IHC), multiplex immunohistochemistry/immunofluorescence (mIHC/IF) and multiplex cytokine analysis.Results IHC and mIHC/IF analyses revealed that higher intratumoral CD38+ cell proportion was strongly associated with improved response to ICB. The overall response rates to ICB was significantly higher among patients with high proportion of total CD38+cells compared with patients with low proportion (43.5% vs 3.9%, p=0.019). Higher responses seen among patients with a high intratumoral CD38+cell proportion translated to a longer median progression-free survival (mPFS, 8.21 months vs 1.64 months, p=0.0065) and median overall survival (mOS, 19.06 months vs 9.59 months, p=0.0295). Patients with high CD38+CD68+macrophage density had a better mOS of 34.43 months compared with 9.66 months in patients with low CD38+CD68+ macrophage density. CD38hi macrophages produce more interferon γ (IFN-γ) and related cytokines, which may explain its predictive value when treated with ICB.Conclusions A high proportion of CD38+ cells, determined by IHC, predicts response to ICB and is associated with superior mPFS and OS in advanced HCC.https://jitc.bmj.com/content/8/2/e000987.full
spellingShingle Valerie Chew
Tony Kiat Hon Lim
David Tai
Su Pin Choo
Joe Yeong
Jeffrey Chun Tatt Lim
Bernett Lee
Huihua Li
Sahil Saraf
Han Chong Toh
Benedict Tan
Harry Ho Man Ng
Ren Yuan Lee
Siting Goh
Isabel Shu Ying Tay
Xinru Lim
Sherlly Lim
Bijin Au
Josh Jie Hua Loh
John Edward Connolly
Tracy Loh
Wei Qiang Leow
Joycelyn Jie Xin Lee
Fabio Malavasi
Ser Yee Lee
Pierce Chow
Evan W Newell
Immunohistochemical scoring of CD38 in the tumor microenvironment predicts responsiveness to anti-PD-1/PD-L1 immunotherapy in hepatocellular carcinoma
Journal for ImmunoTherapy of Cancer
title Immunohistochemical scoring of CD38 in the tumor microenvironment predicts responsiveness to anti-PD-1/PD-L1 immunotherapy in hepatocellular carcinoma
title_full Immunohistochemical scoring of CD38 in the tumor microenvironment predicts responsiveness to anti-PD-1/PD-L1 immunotherapy in hepatocellular carcinoma
title_fullStr Immunohistochemical scoring of CD38 in the tumor microenvironment predicts responsiveness to anti-PD-1/PD-L1 immunotherapy in hepatocellular carcinoma
title_full_unstemmed Immunohistochemical scoring of CD38 in the tumor microenvironment predicts responsiveness to anti-PD-1/PD-L1 immunotherapy in hepatocellular carcinoma
title_short Immunohistochemical scoring of CD38 in the tumor microenvironment predicts responsiveness to anti-PD-1/PD-L1 immunotherapy in hepatocellular carcinoma
title_sort immunohistochemical scoring of cd38 in the tumor microenvironment predicts responsiveness to anti pd 1 pd l1 immunotherapy in hepatocellular carcinoma
url https://jitc.bmj.com/content/8/2/e000987.full
work_keys_str_mv AT valeriechew immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT tonykiathonlim immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT davidtai immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT supinchoo immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT joeyeong immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT jeffreychuntattlim immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT bernettlee immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT huihuali immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT sahilsaraf immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT hanchongtoh immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT benedicttan immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT harryhomanng immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT renyuanlee immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT sitinggoh immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT isabelshuyingtay immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT xinrulim immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT sherllylim immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT bijinau immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT joshjiehualoh immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT johnedwardconnolly immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT tracyloh immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT weiqiangleow immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT joycelynjiexinlee immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT fabiomalavasi immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT seryeelee immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT piercechow immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma
AT evanwnewell immunohistochemicalscoringofcd38inthetumormicroenvironmentpredictsresponsivenesstoantipd1pdl1immunotherapyinhepatocellularcarcinoma