Prognostic Value of the Neo-Immunoscore in Renal Cell Carcinoma

Abstract

Objective: This study evaluated the prognostic value of the newly-built Immunoscore (neo-Immunoscore) in patients with renal cell carcinoma (RCC). Methods: Eighty-two patients with RCC were enrolled in this study. Their 3- and 5-year survival rates and overall survival (OS) were evaluated. The clinicopathologic data of the 82 patients were collected and analyzed. CD3, CD4, CD8, CD45RO, Foxp3, tumor necrosis factor receptor type II (TNFR2), programmed death ligand-1 (PD-L1), CD68, programmed death-1 (PD-1), cytokeratin (CK), and indoleamine 2,3-dioxygenase (IDO) were separated into two panels and stained using multiplex fluorescent immunohistochemistry methods. An immunologic prediction model of RCC patients, the neo-Immunoscore (neo-IS), was constructed using a Cox regression model. For the prognostic prediction of RCC, the neo-IS with the immunoscore (IS) proposed by the Society for Immunotherapy of Cancer (SITC) were compared by receiver operator characteristic (ROC) curve analysis. Survivals between the neo-IS low and neo-IS high groups were analyzed using the Kaplan–Meier method. Multivariate Cox regression survival analysis was applied to analyze independent indicators. Results: The Cox regression model allowed the establishment of a neo-IS based on three features: CD , CD4 + Foxp3 + CD45RO , and CD8 + PD- . Compared to that of the IS proposed by the SITC, the neo-IS obtained a better prediction. The 3- and 5-year survival rates in neo-IS high RCC patients were significantly higher than those in neo-IS low RCC patients (94.7 vs. 77.4%, P = 0.035 and 94.7 vs. 64.5%, P = 0.002, respectively). The OS in the neo-IS low group was significantly shorter than that in the neo-IS high group (73 vs. 97 months, P = 0.000). In comparisons of the neo-IS with clinical pathological factors, we found that the risk stratification and neo-IS were independent factors for the prognosis of patients with RCC. Moreover, the OS rate of neo-IS high RCC patients with low- and intermediate- risk was higher than that of neo-IS low patients. Conclusion: The newly-constructed IS model more precisely predicted the survival of patients with RCC and may supplement the prognostic value of risk stratification.

Immune Checkpoint Inhibitors for Genitourinary Cancers: Treatment Indications, Investigational Approaches and Biomarkers

“…In one study in RCC, CD8+ T cell quantification on anti-PD-1 treated RCC samples found a majority of samples (73%) were infiltrated; however, infiltration did not correlate with PFS [69]. In another study, an 11-marker multiplex IF panel-based prognostic score associated with survival of RCC patients, particularly the density of T cell marker CD3-positive cell populations [159]. Interestingly, spatial immune profiling of nephrectomy samples revealed patients with excluded TME had reduced burden of metastatic disease and improved overall survival versus T cell-inflamed TME [160].…”

Immuno-Oncological Biomarkers for Squamous Cell Cancer of the Head and Neck: Current State of the Art and Future Perspectives

“…Several attempts have been made to develop standardized methods for TIL assessment. For instance, the Immunoscore is a method for (semi-) quantification of CD3 + and CD8 + infiltrating T cells introduced in renal cell carcinoma and colorectal cancer but has not been utilized in SCCHN as a potential diagnostic or prognostic biomarker [ 54 , 75 , 76 , 77 , 78 ]. Recently, the international immunology biomarker working group (IBWG) has designed a guideline-based protocol to assess (stromal and intratumoral) TILs on single slide haematoxilin-eosin (HE) stained sections in several types of solid carcinoma, including SCCHN ( Figure 2 A,B) [ 79 , 80 , 81 ].…”