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Tai SB, Lee ECY, Lim BY, Kannan B, Lee JY, Guo Z, Ko TK, Ng CCY, Teh BT, Chan JY. Tumor-Infiltrating Mast Cells in Angiosarcoma Correlate With Immuno-Oncology Pathways and Adverse Clinical Outcomes. J Transl Med 2024; 104:100323. [PMID: 38218317 DOI: 10.1016/j.labinv.2024.100323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/15/2024] Open
Abstract
Recent studies have described several molecular subtypes and deregulation of immuno-oncologic signaling pathways in angiosarcoma. Interestingly, mast cells were enriched in subsets of angiosarcoma, although their significance remains unknown. In this study, we aim to verify this observation using immunohistochemistry (H scores) and NanoString transcriptomic profiling and explore the association between mast cells with clinical and biological features. In the study cohort (N = 60), H scores showed a significant moderate correlation with NanoString mast cell scores (r = 0.525; P < .001). Both H score and NanoString mast cell scores showed a significant positive correlation (P < .05) with head and neck location, nonepithelioid morphology, and lower tumor grade. Mast cell enrichment significantly correlated with higher NanoString regulatory T-cell scores (H score, r = 0.32; P = .01; NanoString mast cell score, r = 0.27; P = .04). NanoString mast cell scores positively correlated with signaling pathways relating to antigen presentation (r = 0.264; P = .0414) and negatively correlated with apoptosis (r = -0.366; P = .0040), DNA damage repair (r = -0.348; P = .0064), and cell proliferation (r = -0.542; P < .001). Interestingly, in the metastatic setting, patients with mast cell-enriched angiosarcoma showed poorer progression-free survival (median, 0.2 vs 0.4 years; hazard ratio = 3.05; P = .0489) along with a trend toward worse overall survival (median, 0.2 vs 0.6 years; hazard ratio, 2.86; P = .0574) compared with patients with mast cell-poor angiosarcoma. In conclusion, we demonstrated the presence of mast cells in human angiosarcoma and provided initial evidence of their potential clinical and biological significance. Future research will be required to elucidate their specific roles and mechanisms, which may uncover novel avenues for therapeutic intervention.
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Affiliation(s)
- Sarah Beishan Tai
- Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore; Cancer Discovery Hub, National Cancer Centre Singapore, Singapore.
| | | | - Boon Yee Lim
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore
| | - Bavani Kannan
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore
| | - Jing Yi Lee
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore
| | - Zexi Guo
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore
| | - Tun Kiat Ko
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore
| | | | - Bin Tean Teh
- Laboratory of Cancer Epigenome, National Cancer Centre Singapore, Singapore; Duke-NUS Medical School, Singapore
| | - Jason Yongsheng Chan
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore; Duke-NUS Medical School, Singapore; Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
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2
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Loh JW, Lee JY, Lim AH, Guan P, Lim BY, Kannan B, Lee ECY, Gu NX, Ko TK, Ng CCY, Lim JCT, Yeong J, Lim JQ, Ong CK, Teh BT, Chan JY. Spatial transcriptomics reveal topological immune landscapes of Asian head and neck angiosarcoma. Commun Biol 2023; 6:461. [PMID: 37106027 PMCID: PMC10140281 DOI: 10.1038/s42003-023-04856-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/20/2023] [Indexed: 04/29/2023] Open
Abstract
Angiosarcomas are rare malignant tumors of the endothelium, arising commonly from the head and neck region (AS-HN) and recently associated with ultraviolet (UV) exposure and human herpesvirus-7 infection. We examined 81 cases of angiosarcomas, including 47 cases of AS-HN, integrating information from whole genome sequencing, gene expression profiling and spatial transcriptomics (10X Visium). In the AS-HN cohort, we observed recurrent somatic mutations in CSMD3 (18%), LRP1B (18%), MUC16 (18%), POT1 (16%) and TP53 (16%). UV-positive AS-HN harbored significantly higher tumor mutation burden than UV-negative cases (p = 0.0294). NanoString profiling identified three clusters with distinct tumor inflammation signature scores (p < 0.001). Spatial transcriptomics revealed topological profiles of the tumor microenvironment, identifying dominant but tumor-excluded inflammatory signals in immune-hot cases and immune foci even in otherwise immune-cold cases. In conclusion, spatial transcriptomics reveal the tumor immune landscape of angiosarcoma, and in combination with multi-omic information, may improve implementation of treatment strategies.
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Affiliation(s)
- Jui Wan Loh
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore, Singapore
| | - Jing Yi Lee
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore, Singapore
| | - Abner Herbert Lim
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Peiyong Guan
- Genome Institute of Singapore, Agency of Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Boon Yee Lim
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore, Singapore
| | - Bavani Kannan
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Ning Xin Gu
- MGI Tech Singapore PTE LTD, Singapore, Singapore
| | - Tun Kiat Ko
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Jeffrey Chun Tatt Lim
- Institute of Molecular and Cell Biology, Agency of Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Joe Yeong
- Institute of Molecular and Cell Biology, Agency of Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Jing Quan Lim
- Lymphoma Genomic Translational Research Laboratory, Division of Cellular and Molecular Research, National Cancer Centre Singapore, Singapore, Singapore
| | - Choon Kiat Ong
- Lymphoma Genomic Translational Research Laboratory, Division of Cellular and Molecular Research, National Cancer Centre Singapore, Singapore, Singapore
- Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, Singapore, Singapore
| | - Bin Tean Teh
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, Singapore, Singapore.
- Institute of Molecular and Cell Biology, Agency of Science, Technology and Research (ASTAR), Singapore, Singapore.
- Program in Cancer and Stem Cell Biology, Duke-NUS Medical School, Singapore, Singapore.
| | - Jason Yongsheng Chan
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore, Singapore.
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
- Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
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Guan L, Palmeri M, Groisberg R. Cutaneous angiosarcoma: A review of current evidence for treatment with checkpoint inhibitors. Front Med (Lausanne) 2023; 10:1090168. [PMID: 36993810 PMCID: PMC10040781 DOI: 10.3389/fmed.2023.1090168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 02/21/2023] [Indexed: 03/14/2023] Open
Abstract
Cutaneous angiosarcoma (cAS) is a rare and aggressive subtype of soft tissue sarcoma with poor prognosis and suboptimal treatment options. Clinical presentation is variable, but cAS often arises from the head and neck. The most widely accepted current approach, surgical excision with adjuvant radiotherapy, is associated with high recurrence rates and can leave patients with profound disfigurement. Chemotherapy and targeted therapy alternatives have had limited success. Thus, there is a significant unmet need to address the absence of durable treatments for advanced and metastatic cAS. Like melanoma and cutaneous squamous cell carcinoma, tumor types with known response to immunotherapy, cAS harbors immune biomarkers, such as tumor mutational burden high (TMB-H), PD-L1 positivity, ultraviolet signature expression, and tertiary lymphoid structures. While data on the use and efficacy of immunotherapy in cAS is limited, the biomarkers suggest a promising advancement in future treatment options. This review aims to summarize and discuss current data from case reports, case series, retrospective studies and clinical trials regarding immunotherapy treatment and outcomes for cAS.
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Lee JY, Kannan B, Lim BY, Li Z, Lim AH, Loh JW, Ko TK, Ng CCY, Chan JY. The Multi-Dimensional Biomarker Landscape in Cancer Immunotherapy. Int J Mol Sci 2022; 23:7839. [PMID: 35887186 PMCID: PMC9323480 DOI: 10.3390/ijms23147839] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/10/2022] [Accepted: 07/14/2022] [Indexed: 02/04/2023] Open
Abstract
The field of immuno-oncology is now at the forefront of cancer care and is rapidly evolving. The immune checkpoint blockade has been demonstrated to restore antitumor responses in several cancer types. However, durable responses can be observed only in a subset of patients, highlighting the importance of investigating the tumor microenvironment (TME) and cellular heterogeneity to define the phenotypes that contribute to resistance as opposed to those that confer susceptibility to immune surveillance and immunotherapy. In this review, we summarize how some of the most widely used conventional technologies and biomarkers may be useful for the purpose of predicting immunotherapy outcomes in patients, and discuss their shortcomings. We also provide an overview of how emerging single-cell spatial omics may be applied to further advance our understanding of the interactions within the TME, and how these technologies help to deliver important new insights into biomarker discovery to improve the prediction of patient response.
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Affiliation(s)
- Jing Yi Lee
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.L.); (B.K.); (B.Y.L.); (Z.L.); (A.H.L.); (J.W.L.); (T.K.K.); (C.C.-Y.N.)
| | - Bavani Kannan
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.L.); (B.K.); (B.Y.L.); (Z.L.); (A.H.L.); (J.W.L.); (T.K.K.); (C.C.-Y.N.)
| | - Boon Yee Lim
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.L.); (B.K.); (B.Y.L.); (Z.L.); (A.H.L.); (J.W.L.); (T.K.K.); (C.C.-Y.N.)
| | - Zhimei Li
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.L.); (B.K.); (B.Y.L.); (Z.L.); (A.H.L.); (J.W.L.); (T.K.K.); (C.C.-Y.N.)
| | - Abner Herbert Lim
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.L.); (B.K.); (B.Y.L.); (Z.L.); (A.H.L.); (J.W.L.); (T.K.K.); (C.C.-Y.N.)
| | - Jui Wan Loh
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.L.); (B.K.); (B.Y.L.); (Z.L.); (A.H.L.); (J.W.L.); (T.K.K.); (C.C.-Y.N.)
| | - Tun Kiat Ko
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.L.); (B.K.); (B.Y.L.); (Z.L.); (A.H.L.); (J.W.L.); (T.K.K.); (C.C.-Y.N.)
| | - Cedric Chuan-Young Ng
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.L.); (B.K.); (B.Y.L.); (Z.L.); (A.H.L.); (J.W.L.); (T.K.K.); (C.C.-Y.N.)
| | - Jason Yongsheng Chan
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.L.); (B.K.); (B.Y.L.); (Z.L.); (A.H.L.); (J.W.L.); (T.K.K.); (C.C.-Y.N.)
- Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore
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Towards precision oncology in angiosarcomas using next generation "omic" technologies. Oncotarget 2021; 12:1953-1955. [PMID: 34548911 PMCID: PMC8448512 DOI: 10.18632/oncotarget.27996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/10/2021] [Indexed: 11/25/2022] Open
Abstract
Angiosarcomas are a group of aggressive tumors of vascular origin. Although thought to be a rare cancer constituting just 1–2% of all soft tissue sarcomas, recent observations suggest that angiosarcomas are more common amongst Asian populations as compared to the West, suggesting the possibility of distinct genetic or environmental triggers influencing its pathogenesis. Advances in genomic sequencing efforts have led to the discovery of ultraviolet mutation signatures and high tumor mutation burden as common features of angiosarcoma of the head and neck. In addition, multi-omic analyses integrated with clinical data identified 3 subtypes characterized by distinctive etiological and biological phenotypes, with potential implications on precision therapy. The systemic and local immune milieu, as well as the presence of “giant” tumor cells, was also recently demonstrated to influence clinical behavior and patient outcomes, further highlighting complexities of this disease. Improvements in next generation “omic”-based technologies are expected to improve our understanding of angiosarcoma and guide the development of precision oncology in this rare cancer.
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Missale F, Bugatti M, Mattavelli D, Lonardi S, Lombardi D, Nicolai P, Piazza C, Battocchio S, Bozzola AM, Calza S, Vermi W. Metavariables Resuming Host Immune Features and Nodal Involvement Are Associated with Oncological Outcomes in Oral Cavity Squamous Cell Carcinoma. Cells 2021; 10:2203. [PMID: 34571850 PMCID: PMC8472482 DOI: 10.3390/cells10092203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 11/16/2022] Open
Abstract
Oral cavity squamous cell carcinoma (OSCC) is a common head and neck cancer characterized by a poor prognosis associated with locoregional or distant failure. Among the predictors of prognosis, a dense infiltration of adaptive immune cells is protective and associated with improved clinical outcomes. However, few tools are available to integrate immune contexture variables into clinical settings. By using digital microscopy analysis of a large retrospective OSCC cohort (n = 182), we explored the clinical significance of tumor-infiltrating CD8+ T-cells. To this end, CD8+ T-cells counts were combined with well-established clinical variables and peripheral blood immune cell parameters. Through variable clustering, five metavariables (MV) were obtained and included descriptors of nodal (NODALMV) and primary tumor (TUMORMV) involvement, the frequency of myeloid (MYELOIDMV) or lymphoid (LYMPHOIDMV) peripheral blood immune cell populations, and the density of tumor-infiltrating CD8+ T-cells (TI-CD8MV). The clinical relevance of the MV was evaluated in the multivariable survival models. The NODALMV was significantly associated with all tested outcomes (p < 0.001), the LYMPHOIDMV showed a significant association with the overall, disease-specific and distant recurrence-free survival (p < 0.05) and the MYELOIDMV with the locoregional control only (p < 0.001). Finally, TI-CD8MV was associated with distant recurrence-free survival (p = 0.029). Notably, the performance in terms of survival prediction of the combined effect of NODALMV and immune metavariables (LYMPHOIDMV, MYELOIDMV and TI-CD8MV) was superior to the TNM stage for most of the outcomes analyzed. These findings indicate that the analysis of the baseline host immune features are promising tools to complement clinical features, in stratifying the risk of recurrences.
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Affiliation(s)
- Francesco Missale
- Department of Molecular and Translational Medicine, University of Brescia, 25125 Brescia, Italy
- Department of Head & Neck Oncology & Surgery Otorhinolaryngology, Antoni Van Leeuwenhoek, Nederlands Kanker Instituut, 1066 Amsterdam, The Netherlands
| | - Mattia Bugatti
- Unit of Pathology, ASST Spedali Civili di Brescia, 25100 Brescia, Italy; (M.B.); (S.L.); (S.B.); (A.M.B.)
| | - Davide Mattavelli
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25123 Brescia, Italy; (D.M.); (D.L.); (C.P.)
| | - Silvia Lonardi
- Unit of Pathology, ASST Spedali Civili di Brescia, 25100 Brescia, Italy; (M.B.); (S.L.); (S.B.); (A.M.B.)
| | - Davide Lombardi
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25123 Brescia, Italy; (D.M.); (D.L.); (C.P.)
| | - Piero Nicolai
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, Via Giustiniani, 2-35128 Padua, Italy;
| | - Cesare Piazza
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25123 Brescia, Italy; (D.M.); (D.L.); (C.P.)
| | - Simonetta Battocchio
- Unit of Pathology, ASST Spedali Civili di Brescia, 25100 Brescia, Italy; (M.B.); (S.L.); (S.B.); (A.M.B.)
| | - Anna Maria Bozzola
- Unit of Pathology, ASST Spedali Civili di Brescia, 25100 Brescia, Italy; (M.B.); (S.L.); (S.B.); (A.M.B.)
| | - Stefano Calza
- Unit of Biostatistics, Department of Molecular and Translational Medicine, University of Brescia, 25125 Brescia, Italy;
- BDbiomed, Big and Open Data Innovation Laboratory, University of Brescia, 25125 Brescia, Italy
| | - William Vermi
- Department of Molecular and Translational Medicine, University of Brescia, 25125 Brescia, Italy
- Unit of Pathology, ASST Spedali Civili di Brescia, 25100 Brescia, Italy; (M.B.); (S.L.); (S.B.); (A.M.B.)
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63130, USA
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