Comparison of Tumor Microenvironments between Primary Tumors and Lymph Node Metastases in Head and Neck Squamous Cell Carcinoma and Their Predictive Role in Immune Checkpoint Inhibitor Treatment
Authors:
- Dong Hyun KimDKDong Hyun Kim
- Jong Seok AhnJAJong Seok Ahn
- Mingu KangMKMingu Kang
- Gahee ParkGPGahee Park
- Yoojoo LimYLYoojoo Lim
- Soohyun HwangSHSoohyun Hwang
- Chan-Young OckCOChan-Young Ock
- Jiwon KohJKJiwon Koh
- Eun-Jae ChungECEun-Jae Chung
- Seong-Keun KwonSKSeong-Keun Kwon
- Yoon Kyung JeonYJYoon Kyung Jeon
- Kyeong Cheon JungKJKyeong Cheon Jung
Open Access
Abstract
The relationship between tumor microenvironments (TMEs) of regional lymph node metastases (LNMs) and primary tumors in head and neck squamous cell carcinoma (HNSCC) remains unclear. This study compared tumor-infiltrating lymphocytes (TILs) and the immune phenotype (IP), characterized by spatial TIL distribution, between primary tumors and LNMs. Twenty-one HNSCC patients with regional LNM who received immune checkpoint inhibitors (ICIs) were included. A paired comparative analysis of TIL densities and IP between primary tumors and LNMs revealed no significant difference or correlation between TIL densities in primary tumors and LNMs. Their IPs were discordant in 12 patients (57.1%). Patients with high intratumoral TIL exhibited longer progression-free survival (PFS) than those with low intratumoral TIL in both primary tumors (median, 5.2 vs. 1.3 months, p = 0.003) and LNMs (median, 30.2 vs. 1.3 months, p = 0.012). Patients with inflamed IP exhibited longer PFS than those with non-inflamed IP in both primary tumors (median, 4.5 vs. 1.3 months, p = 0.043) and LNMs (median, 4.1 vs. 1.3 months, p = 0.037). Given the lack of correlation in TIL densities, the discrepancies in IP, and the predictive value of both TMEs, evaluating the TMEs of both primary tumors and LNMs may be beneficial for the precise use of ICIs in HNSCC. There was a significant discordance between the TME of primary tumors and LNMs, with implications in survival outcomes. Therefore, evaluating the TME of both the primary tumor and LNM could be beneficial for the precise use of ICIs in HNSCC.Keywords
Funding Information
- National Research Foundation (NRF) funded by the Korean government (MSIT) (RS-2023-00261820)
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