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Blake EA, Ross MS, Ross ME, Matsuo K, Silverstein ET, Torno LR, Bhargava R, Post MD, Da Silva DM, Taylor S, Walia S, Roman L, McEachron TA. Immunohistochemical analysis of glassy cell carcinoma of the cervix reveals robust lymphocyte infiltrate and the expression of targetable inhibitory immune checkpoints. Arch Gynecol Obstet 2021; 305:439-447. [PMID: 34392396 DOI: 10.1007/s00404-021-06164-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/27/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To validate our previous findings of high-level EGFR expression in GCCC using an expanded cohort of specimens and to further examine the molecular and cellular features of this aggressive malignancy to identify potentially actionable therapeutic targets. METHODS The SEER database was queried to obtain the epidemiological data regarding the current national survival trends for GCCC. Immunohistochemistry (IHC) was used to examine the expression of EGFR, PD-1, and PD-L1. CiberSort analysis was used to analyze a previously published RNA-sequencing dataset obtained from a single patient diagnosed with GCCC. RESULTS In comparison to squamous cell carcinomas and adenocarcinoma/adenosquamous carcinomas, GCCC was observed in younger patients (p < 0.001) and demonstrated inferior survival (p < 0.001). All (100%) of the specimens (8/8) exhibited immunoreactivity when stained for CD3ε (T-cell marker), EGFR, PD-1, and PD-L1 whereas CTLA4 expression was not detected. Analysis of RNA-sequencing data revealed that cetuximab and erlotinib altered the chemokine profile, lymphocyte abundance, and expression of inhibitory immune checkpoints in a single patient when combined with cytotoxic chemotherapy in a single patient. CONCLUSIONS The data from this descriptive study suggests that immune checkpoint blockade, whether single agent or in combination, may be a suitable therapeutic option for a disease for which targeted approaches do not currently exist.
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Affiliation(s)
- Erin A Blake
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
- Department of Gynecologic Oncology, University of Southern California, 2020 Zonal Ave., Room 522, Los Angeles, CA, 90033, USA.
| | - Malcolm S Ross
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Megan E Ross
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Emily T Silverstein
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Lilibeth R Torno
- Hyundai Cancer Genomics Center, Children's Hospital of Orange County, Orange, CA, USA
- Department of Pediatrics, School of Medicine, University of California-Irvine, Orange, CA, USA
| | - Rohit Bhargava
- Division of Pathology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Miriam D Post
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Diane M Da Silva
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Sarah Taylor
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Saloni Walia
- Department of Laboratory Medicine and Pathology, Department of Gynecologic Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lynda Roman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Troy A McEachron
- Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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