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Deutsch JS, Lipson EJ, Danilova L, Topalian SL, Jedrych J, Baraban E, Ged Y, Singla N, Choueiri TK, Gupta S, Motzer RJ, McDermott D, Signoretti S, Atkins M, Taube JM. Combinatorial biomarker for predicting outcomes to anti-PD-1 therapy in patients with metastatic clear cell renal cell carcinoma. Cell Rep Med 2023; 4:100947. [PMID: 36812889 PMCID: PMC9975323 DOI: 10.1016/j.xcrm.2023.100947] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 11/02/2022] [Accepted: 01/23/2023] [Indexed: 02/24/2023]
Abstract
With a rapidly developing immunotherapeutic landscape for patients with metastatic clear cell renal cell carcinoma, biomarkers of efficacy are highly desirable to guide treatment strategy. Hematoxylin and eosin (H&E)-stained slides are inexpensive and widely available in pathology laboratories, including in resource-poor settings. Here, H&E scoring of tumor-infiltrating immune cells (TILplus) in pre-treatment tumor specimens using light microscopy is associated with improved overall survival (OS) in three independent cohorts of patients receiving immune checkpoint blockade. Necrosis score alone does not associate with OS; however, necrosis modifies the predictive effect of TILplus, a finding that has broad translational relevance for tissue-based biomarker development. PBRM1 mutational status is combined with H&E scores to further refine outcome predictions (OS, p = 0.007, and objective response, p = 0.04). These findings bring H&E assessment to the fore for biomarker development in future prospective, randomized trials, and emerging multi-omics classifiers.
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Affiliation(s)
| | - Evan J Lipson
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA; The Bloomberg∼Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Ludmila Danilova
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA; The Bloomberg∼Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Suzanne L Topalian
- Department of Surgery, Johns Hopkins University, Baltimore, MD, USA; The Bloomberg∼Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Jaroslaw Jedrych
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA; Department of Dermatology, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Ezra Baraban
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Yasser Ged
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Nirmish Singla
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Toni K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Robert J Motzer
- Department of Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David McDermott
- Department of Hematology/Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Sabina Signoretti
- Department of Pathology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Michael Atkins
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Janis M Taube
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA; Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA; Department of Dermatology, Johns Hopkins University, Baltimore, MD 21287, USA; The Bloomberg∼Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University, Baltimore, MD 21287, USA.
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