Prognostic influence of tumor microenvironment after hypofractionated radiation and surgery for mesothelioma

Cytotoxic CD8+ tumor infiltrating lymphocytes (TILs) can contribute to the benefit of hypofractionated radiation, but programmed cell death pathways (programmed cell death 1 and programmed cell death ligand 1 [PD-1/PD-L1]) may provide a mechanism of tumor immune escape. We therefore reviewed the inf...

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Bibliographic Details
Published in:The Journal of thoracic and cardiovascular surgery 2020-05, Vol.159 (5), p.2082-2091.e1
Main Authors: de Perrot, Marc, Wu, Licun, Cabanero, Michael, Perentes, J. Yannis, McKee, Trevor D., Donahoe, Laura, Bradbury, Penelope, Kohno, Mikihiro, Chan, Mei-Lin, Murakami, Junichi, Keshavjee, Shaf, Tsao, Ming-Sound, Cho, B. C. John
Format: Article
Language:English
Subjects:
mesothelioma
radiation
surgery
tumor immune microenvironment
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Summary:Cytotoxic CD8+ tumor infiltrating lymphocytes (TILs) can contribute to the benefit of hypofractionated radiation, but programmed cell death pathways (programmed cell death 1 and programmed cell death ligand 1 [PD-1/PD-L1]) may provide a mechanism of tumor immune escape. We therefore reviewed the influence of PD-1/PD-L1 and CD8+ TILs on survival after accelerated hypofractionated hemithoracic radiation followed by extrapleural pneumonectomy for malignant pleural mesothelioma (MPM). Sixty-nine consecutive patients undergoing the protocol of Surgery for Mesothelioma after Radiation Therapy (SMART) between November 2008 and February 2016 were analyzed for the presence of PD-L1 on tumor cells, PD-1 on inflammatory cells, and CD8+ TILs. Comparison was made with a cohort of patients undergoing extrapleural pneumonectomy after induction chemotherapy (n = 14) and no induction (n = 2) between March 2005 and October 2008. PD-L1 expression on tumor cells ≥1% was considered positive. CD8+ TILs and PD-1 expression were scored as a percentage of positive cells. PD-L1 was negative in 75% of MPM after completion of SMART. CD8+ TILs ranged between 0.24% and 8.47% (median 2%). CD8+ TILs ≥2% was associated with significantly better survival in epithelioid MPM (median survival 3.7 years vs 2.3 years in CD8+ TILs
ISSN:0022-5223
1097-685X
DOI:10.1016/j.jtcvs.2019.10.122