The advent of immune checkpoint inhibitor therapy has proven beneficial in a subset of high-grade urothelial carcinomas (HGUC) of the bladder. Although treatment selection is currently largely determined by programmed death-ligand 1 (PD-L1) status, multiple factors in the immune system may modulate the host immune response to HGUC and immunotherapy.
In this pilot study, we used a transcriptomic approach to identify the immune milieu associated with PD-L1 expression to enhance our understanding of the HGUC immune evasion network.
The immune transcriptome of 40 HGUC cystectomy cases was profiled using the NanoString nCounter Human V.1.1 PanCancer Panel. All cases were assessed for associated PD-L1 status (SP263) using whole tissue sections. PD-L1 status was determined as high or low using 25% tumour and/or immune cell staining.
The most significantly differentially expressed gene was PD-L1 messenger RNA (CD274), which strongly correlated with protein expression (r=0.720, p<0.001). The sensitivity, specificity, positive and negative predictive values of CD274 for PD-L1 expression were 85%, 96%, 92% and 93%, respectively. The PD-L1 associated gene signature also included complement components C1QA and CD46 and NOD2 (innate immune system), proinflammatory cytokines CXCL14, CXCL16, CCL3, CCL3L1 and OSM along with the immune response mediator SMAD3, among others. Pathway analysis determined enrichment of these genes in interleukin-10 production, lymphocyte chemotaxis and aberrant IFNγ, NF-κB and ERK signalling networks.
We report key genes and pathways in the immune transcriptome and their association with PD-L1 status, which may be involved in immune evasion of HGUC and warrants further investigation.
Journal of clinical pathology. 2020 May 29 [Epub ahead of print]
Ekaterina Olkhov-Mitsel, Anjelica Hodgson, Stanley K Liu, Danny Vesprini, Jane Bayani, John Bartlett, Bin Xu, Michelle R Downes
Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada., Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada., Diagnostic Development, Ontario Institute for Cancer Research, Toronto, Ontario, Canada., Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA., Pathology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/32471889