Intraepithelial tumor-infiltrating lymphocytes shape loco-regional PET/CT spread of locally advanced cervical cancer.

cervical cancer;

 lymph nodes.

Alejandra MartinezT2i Team’s – Anti-tumour immunity and immunotherapy

Data suggest an association between positron emission tomography/CT (PET/CT) metabolic metrics and tumor microenvironment in several malignancies, and a potential role of PET/CT to monitor response to immunotherapy.

The main objective was to evaluate the correlation between tumor loco-regional extension and tumor-infiltrating lymphocyte infiltration in locally advanced cervical cancer prior to concurrent chemo-radiotherapy. The secondary objective was to assess the association between tumor-infiltrating lymphocytes and PET/CT metabolic metrics.

Eighty-six patients with locally advanced cervical cancer and negative para-aortic extensions on PET/CT were included. Two senior nuclear medicine physicians specializing in gynecologic oncology reviewed all PET/CT exams, and extracted tumor maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis, as well as pelvic lymph node involvement. One senior gynecologic oncology pathologist assessed intraepithelial tumor-infiltrating lymphocytes and stromal tumor-infiltrating lymphocytes. Intraepithelial tumor-infiltrating lymphocytes were categorized following previous studies as < 1% and > 1%. The cut-off for stromal tumor-infiltrating lymphocytes was chosen empirically: intermediate < 60% and high > 60%.

Intraepithelial tumor-infiltrating lymphocytes were not significantly associated with tumor metabolic metrics. Intraepithelial tumor-infiltrating lymphocytes were not significantly associated with maximum standard uptake value (p=0.16), or metabolic tumor volume (p=0.19). Tumors with < 1% intraepithelial tumor-infiltrating lymphocytes score were associated with a higher MRI tumor size (≥ median) (63.3% vs 39.3%, p=0.04). Patients with pelvic lymph node uptake were significantly more frequent in patients with high stromal tumor-infiltrating lymphocytes score (≥ 60%) (61.5% vs 31.7%, p=0.009).

Poor or absent intraepithelial tumor-infiltrating lymphocytes were associated with more advanced disease at diagnosis and larger tumor size. Tumor-infiltrating lymphocytes were not associated with tumor metabolic activity. Intraepithelial and stroma tumor-infiltrating lymphocytes are not redundant and should be assessed separately. Further work is needed to evaluate the association between tumor metabolic profile and immune populations, including different T-cell subtypes for patient selection for immunotherapy strategies.

 

Discover the published article

Int J Gynecol Cancer. 2024 Apr 1;34(4):490-496.doi: 10.1136/ijgc-2023-004677.
Intraepithelial tumor-infiltrating lymphocytes shape loco-regional PET/CT spread of locally advanced cervical cancer
Mathilde Del, Claire Illac, Mathilde Morisseau, Martina Aida Angeles, Anne Ducassou, Sarah Betrian, Guillaume Bataillon, Gwenael Ferron, Elodie Chantalat, Erwan Gabiache, Alejandra Martinez

Centre de Recherches en Cancérologie de Toulouse

Centre de Recherches contre le Cancer de Toulouse (Oncopole)

Toulouse - FR

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