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Berghoff AS, Kiesel B, Widhalm G, Rajky O, Ricken G, Wöhrer A, Dieckmann K, Filipits M, Brandstetter A, Weller M, Kurscheid S, Hegi ME, Zielinski CC, Marosi C, Hainfellner JA, Preusser M, Wick W. Programmed death ligand 1 expression and tumor-infiltrating lymphocytes in glioblastoma. Neuro Oncol 2014; 17:1064-75. [PMID: 25355681 DOI: 10.1093/neuonc/nou307] [Citation(s) in RCA: 423] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 10/04/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitors targeting programmed cell death 1 (PD1) or its ligand (PD-L1) showed activity in several cancer types. METHODS We performed immunohistochemistry for CD3, CD8, CD20, HLA-DR, phosphatase and tensin homolog (PTEN), PD-1, and PD-L1 and pyrosequencing for assessment of the O6-methylguanine-methyltransferase (MGMT) promoter methylation status in 135 glioblastoma specimens (117 initial resection, 18 first local recurrence). PD-L1 gene expression was analyzed in 446 cases from The Cancer Genome Atlas. RESULTS Diffuse/fibrillary PD-L1 expression of variable extent, with or without interspersed epithelioid tumor cells with membranous PD-L1 expression, was observed in 103 of 117 (88.0%) newly diagnosed and 13 of 18 (72.2%) recurrent glioblastoma specimens. Sparse-to-moderate density of tumor-infiltrating lymphocytes (TILs) was found in 85 of 117 (72.6%) specimens (CD3+ 78/117, 66.7%; CD8+ 52/117, 44.4%; CD20+ 27/117, 23.1%; PD1+ 34/117, 29.1%). PD1+ TIL density correlated positively with CD3+ (P < .001), CD8+ (P < .001), CD20+ TIL density (P < .001), and PTEN expression (P = .035). Enrichment of specimens with low PD-L1 gene expression levels was observed in the proneural and G-CIMP glioblastoma subtypes and in specimens with high PD-L1 gene expression in the mesenchymal subtype (P = 5.966e-10). No significant differences in PD-L1 expression or TIL density between initial and recurrent glioblastoma specimens or correlation of PD-L1 expression or TIL density with patient age or outcome were evident. CONCLUSION TILs and PD-L1 expression are detectable in the majority of glioblastoma samples but are not related to outcome. Because the target is present, a clinical study with specific immune checkpoint inhibitors seems to be warranted in glioblastoma.
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Affiliation(s)
- Anna Sophie Berghoff
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Barbara Kiesel
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Georg Widhalm
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Orsolya Rajky
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Gerda Ricken
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Adelheid Wöhrer
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Karin Dieckmann
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Martin Filipits
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Anita Brandstetter
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Michael Weller
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Sebastian Kurscheid
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Monika E Hegi
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Christoph C Zielinski
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Christine Marosi
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Johannes A Hainfellner
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Matthias Preusser
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
| | - Wolfgang Wick
- Institute of Neurology, Medical University of Vienna, Vienna, Austria (A.S.B., G.R., A.W., J.A.H.); Department of Medicine I, Medical University of Vienna, Vienna, Austria (A.S.B., O.R., M.F., A.B., C.C.Z., C.M., M.P.); Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria (A.S.B., B.K., G.W., O.R., G.R., A.W., K.D., M.F., A.B., C.C.Z., C.M., J.A.H., M.P.); Department of Neurosurgery, Medical University of Vienna, Vienna, Austria (B.K., G.W.); Department of Radiotherapy, Medical University of Vienna, Vienna, Austria (K.D.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Laboratory of Brain Tumor Biology and Genetics, Service of Neurosurgery, Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Lausanne, Switzerland (S.K., M.E.H.); Neurology Clinic and National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany (W.W.); Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany (W.W.)
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