Immune infiltration and PD-L1 expression in the tumor microenvironment are prognostic in osteosarcoma

Sci Rep. 2016 Jul 26:6:30093. doi: 10.1038/srep30093.

Abstract

Osteosarcoma patient survival has remained stagnant for 30 years. Novel therapeutic approaches are needed to improve outcomes. We examined the expression of Programmed Death Ligand 1 (PD-L1) and defined the tumor immune microenvironment to assess the prognostic utility in osteosarcoma. PD-L1 expression in osteosarcoma was examined in two patient cohorts using immunohistochemistry (IHC) (n = 48, n = 59) and expression was validated using quantitative real time PCR (n = 21) and western blotting (n = 9). IHC was used to determine the presence of tumor infiltrating lymphocytes and antigen-presenting cells (APCs) in the tumor. Expression of PD-L1 was correlated with immune cell infiltration and event-free-survival (EFS). The 25% of primary osteosarcoma tumors that express PD-L1 were more likely to contain cells that express PD-1 than PD-L1 negative tumors (91.7% vs 47.2%, p = 0.002). Expression of PD-L1 was significantly associated with the presence of T cells, dendritic cells, and natural killer cells. Although all immune cell types examined were present in osteosarcoma samples, only infiltration by dendritic cells (28.3% vs. 83.9%, p = 0.001) and macrophages (45.5% vs. 84.4%, p = 0.031) were associated with worse five-year-EFS. PD-L1 expression was significantly associated with poorer five-year-EFS (25.0%. vs. 69.4%, p = 0.014). Further studies in osteosarcoma are needed to determine if targeting the PD-L1:PD-1 axis improves survival.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • B7-H1 Antigen / biosynthesis*
  • Biomarkers, Tumor / immunology
  • Breast Neoplasms / immunology
  • Breast Neoplasms / pathology
  • CD8-Positive T-Lymphocytes / immunology*
  • Cell Line, Tumor
  • Dendritic Cells / immunology*
  • Humans
  • Killer Cells, Natural / immunology
  • Lymphocytes, Tumor-Infiltrating / immunology*
  • MCF-7 Cells
  • Macrophages / immunology
  • Osteosarcoma / immunology*
  • Osteosarcoma / mortality
  • Osteosarcoma / pathology*
  • Prognosis
  • Tumor Microenvironment / immunology*

Substances

  • B7-H1 Antigen
  • Biomarkers, Tumor
  • CD274 protein, human