Recurrent Oropharyngeal Squamous Cell Carcinomas Maintain Anti-tumor Immunity and Multinucleation Levels Following Completion of Radiation

Authors

Patricia Castro
Germán Corredor
Can Koyuncu
Luke A Nordstrom
Michelle Tiji
Taylor Leavitt
James S Lewis
Anant Madabhushi
Mitchell J Frederick
Vlad C Sandulache

Publication Date

12-1-2023

Journal

Head and Neck Pathology

DOI

10.1007/s12105-023-01597-z

PMID

37995073

PMCID

PMC10739687

PubMedCentral® Posted Date

11-23-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Squamous Cell Carcinoma of Head and Neck, Oropharyngeal Neoplasms, Lymphocytes, Tumor-Infiltrating, Head and Neck Neoplasms, Prognosis, Tumor Microenvironment, Oropharyngeal cancer, Multinucleation, Tumor infiltrating lymphocytes, Recurrence

Abstract

OBJECTIVE: Oropharyngeal squamous cell carcinoma (OPSCC) recurrence is almost universally fatal. Development of effective therapeutic options requires an improved understanding of recurrent OPSCC biology.

METHODS: We analyzed paired primary-recurrent OPSCC from Veterans treated at the Michael E. DeBakey Veterans Affairs Medical Center between 2000 and 2020 who received curative intent radiation-based treatment (with or without chemotherapy). Patient tumors were analyzed using standard immunohistochemistry and automated imaging of infiltrating lymphocytes and multinucleated tumor cells coupled to machine learning algorithms.

RESULTS: Primary and recurrent tumors demonstrated high concordance via p16 and p53 immunohistochemistry, with comparable levels of multinucleation. In contrast, recurrent tumors demonstrated significantly higher levels of CD8+ tumor infiltrating lymphocytes (p

CONCLUSION: Exposure to chemo-radiation and recurrence following treatment preserves critical features of intrinsic tumor biology and the tumor immune microenvironment suggesting that novel treatment regimens may be as effective in the salvage setting as in the definitive intent setting.