Evaluation of the Immune Microenvironment in Sinonasal Undifferentiated Carcinoma and Its Association with Patients’ Survival

Background: Sinonasal undifferentiated carcinoma (SNUC) is a rare, highly aggressive cancer that arises in the nasal cavity and paranasal sinuses. Despite aggressive multimodal therapy the prognosis remains poor. To better manage patients with SNUC, identification of survival predictors and new therapeutic options for SNUC treatments, including immunotherapy are crucial. The aim of this study was to evaluate the signature of the tumor immune microenvironment and analyze its correlation with clinical outcomes in SNUC.

Materials and Methods: Tumor samples from 14 previously untreated patients with confirmed diagnosis of SNUC were included in this study. All the patients were treated at the University of Texas MD Anderson Cancer Center, and the median follow-up period was 32.2 months (range: 8.1–176.2 months). Opal 7-color multiplex immunofluorescence for pan-cytokeratin, CD3, CD8, PD-L1, CD68, CD56/NCAM (NK cell marker), and DAPI was performed. Tissue identification, marker detection and data extraction were done using Visiopharm. Expression of each marker versus overall survival (OS), response to induction chemotherapy, and disease recurrence were assessed by Wilcoxon test, and the survival rate differences were calculated using Log-Rank test.

Results: CD3+CD8+ double positive expression, which is a cytotoxic T-lymphocyte marker, in stroma was found to be associated with OS rates; patients with higher CD3+CD8+ expression in stroma had significantly better OS (p = 0.0029).

Conclusions: Our study showed that high expression of CD3+CD8+ in stroma was associated with better survival rate in patients with SNUC. Investigating this cell population before starting treatment might be important to manage patients with SNUC.

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Artikel online veröffentlicht:
01. Februar 2023