Detailed spatial immunophenotyping of primary melanomas reveals immune cell subpopulations associated with patient outcome

Detailed spatial immunophenotyping of primary melanomas reveals immune cell subpopulations associated with patient outcome.

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Item Type: Article
Official URL: https://doi.org/10.3389/fimmu.2022.979993
Journal or Publication Title: Frontiers in Immunology
Volume: 13
Date: 8 August 2022
Divisions: Human Viral and Cancer Immunology
Depositing User: General Admin
Identification Number: 10.3389/fimmu.2022.979993
ISSN: 1664-3224
Date Deposited: 08 Jan 2023 22:45
Abstract:

While the tumor immune microenvironment (TIME) of metastatic melanoma has been well characterized, the primary melanoma TIME is comparatively poorly understood. Additionally, although the association of tumor-infiltrating lymphocytes with primary melanoma patient outcome has been known for decades, it is not considered in the current AJCC melanoma staging system. Detailed immune phenotyping of advanced melanoma has revealed multiple immune biomarkers, including the presence of CD8+ T-cells, for predicting response to immunotherapies. However, in primary melanomas, immune biomarkers are lacking and CD8+ T-cells have yet to be extensively characterized. As recent studies combining immune features and clinicopathologic characteristics have created more accurate predictive models, this study sought to characterize the TIME of primary melanomas and identify predictors of patient outcome. We first phenotyped CD8+ T cells in fresh stage II primary melanomas using flow cytometry (n = 6), identifying a CD39+ tumor-resident CD8+ T-cell subset enriched for PD-1 expression. We then performed Opal multiplex immunohistochemistry and quantitative pathology-based immune profiling of CD8+ T-cell subsets, along with B cells, NK cells, Langerhans cells and Class I MHC expression in stage II primary melanoma specimens from patients with long-term follow-up (n = 66), comparing patients based on their recurrence status at 5 years after primary diagnosis. A CD39+CD103+PD-1- CD8+ T-cell population (P2) comprised a significantly higher proportion of intratumoral and stromal CD8+ T-cells in patients with recurrence-free survival (RFS) ≥5 years vs those with RFS <5 years (p = 0.013). Similarly, intratumoral B cells (p = 0.044) and a significantly higher B cell density at the tumor/stromal interface were associated with RFS. Both P2 and B cells localized in significantly closer proximity to melanoma cells in patients who remained recurrence-free (P2 p = 0.0139, B cell p = 0.0049). Our results highlight how characterizing the TIME in primary melanomas may provide new insights into how the complex interplay of the immune system and tumor can modify the disease outcomes. Furthermore, in the context of current clinical trials of adjuvant anti-PD-1 therapies in high-risk stage II primary melanoma, assessment of B cells and P2 could identify patients at risk of recurrence and aid in long-term treatment decisions at the point of primary melanoma diagnosis.

Keywords: Clinicopathological features; T cell phenotypes; immunophenotyping; primary melanoma; spatial pathology.

Creators:
Creators
Email
Attrill, Grace H.
UNSPECIFIED
Lee, Hansol
UNSPECIFIED
Tasker, Annie T.
UNSPECIFIED
Adegoke, Nurudeen A.
UNSPECIFIED
Ferguson, Angela L.
UNSPECIFIED
da Silva, Ines Pires
UNSPECIFIED
Saw, Robyn P. M.
UNSPECIFIED
Thompson, John F.
UNSPECIFIED
Palendira, Umaimainthan
UNSPECIFIED
Long, Georgina V.
UNSPECIFIED
Ferguson, Peter M.
UNSPECIFIED
Scolyer, Richard A.
UNSPECIFIED
Wilmott, James S.
UNSPECIFIED
Last Modified: 08 Jan 2023 22:45
URI: https://eprints.centenary.org.au/id/eprint/1295

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