Computational image features of immune architecture is associated with clinical benefit and survival in gynecological cancers across treatment modalities.


Journal

Journal for immunotherapy of cancer
ISSN: 2051-1426
Titre abrégé: J Immunother Cancer
Pays: England
ID NLM: 101620585

Informations de publication

Date de publication:
02 2022
Historique:
accepted: 03 01 2022
entrez: 4 2 2022
pubmed: 5 2 2022
medline: 24 3 2022
Statut: ppublish

Résumé

We present a computational approach (ArcTIL) for quantitative characterization of the architecture of tumor-infiltrating lymphocytes (TILs) and their interplay with cancer cells from digitized H&E-stained histology whole slide images and evaluate its prognostic role in three different gynecological cancer (GC) types and across three different treatment types (platinum, radiation and immunotherapy). In this retrospective study, we included 926 patients with GC diagnosed with ovarian cancer (OC), cervical cancer, and endometrial cancer with available digitized diagnostic histology slides and survival outcome information. ArcTIL features quantifying architecture and spatial interplay between immune cells and the rest of nucleated cells (mostly comprised cancer cells) were extracted from the cell cluster graphs of nuclei within the tumor epithelial nests, surrounding stroma and invasive tumor front compartments on H&E-stained slides. A Cox proportional hazards model, incorporating ArcTIL features was fit on the OC training cohort (N=51), yielding an ArcTIL signature. A unique threshold learned from the training set stratified the patients into a low and high-risk group. The seven feature ArcTIL classifier was found to significantly correlate with overall survival in chemotherapy and radiotherapy-treated validation cohorts and progression-free survival in an immunotherapy-treated validation cohort. ArcTIL features relating to increased density of TILs in the epithelium and invasive tumor front were found to be associated with better survival outcomes when compared with those patients with an increased TIL density in the stroma. A statistically significant association was found between the ArcTIL signature and signaling pathways for blood vessel morphogenesis, vasculature development, regulation of cell differentiation, cell-substrate adhesion, biological adhesion, regulation of vasculature development, and angiogenesis. This study reveals that computationally-derived features from the spatial architecture of TILs and tumor cells are prognostic in GCs treated with chemotherapy, radiotherapy, and checkpoint blockade and are closely associated with central biological processes that impact tumor progression. These findings could aid in identifying therapy-refractory patients and further enable personalized treatment decision-making.

Sections du résumé

BACKGROUND
We present a computational approach (ArcTIL) for quantitative characterization of the architecture of tumor-infiltrating lymphocytes (TILs) and their interplay with cancer cells from digitized H&E-stained histology whole slide images and evaluate its prognostic role in three different gynecological cancer (GC) types and across three different treatment types (platinum, radiation and immunotherapy).
METHODS
In this retrospective study, we included 926 patients with GC diagnosed with ovarian cancer (OC), cervical cancer, and endometrial cancer with available digitized diagnostic histology slides and survival outcome information. ArcTIL features quantifying architecture and spatial interplay between immune cells and the rest of nucleated cells (mostly comprised cancer cells) were extracted from the cell cluster graphs of nuclei within the tumor epithelial nests, surrounding stroma and invasive tumor front compartments on H&E-stained slides. A Cox proportional hazards model, incorporating ArcTIL features was fit on the OC training cohort (N=51), yielding an ArcTIL signature. A unique threshold learned from the training set stratified the patients into a low and high-risk group.
RESULTS
The seven feature ArcTIL classifier was found to significantly correlate with overall survival in chemotherapy and radiotherapy-treated validation cohorts and progression-free survival in an immunotherapy-treated validation cohort. ArcTIL features relating to increased density of TILs in the epithelium and invasive tumor front were found to be associated with better survival outcomes when compared with those patients with an increased TIL density in the stroma. A statistically significant association was found between the ArcTIL signature and signaling pathways for blood vessel morphogenesis, vasculature development, regulation of cell differentiation, cell-substrate adhesion, biological adhesion, regulation of vasculature development, and angiogenesis.
CONCLUSIONS
This study reveals that computationally-derived features from the spatial architecture of TILs and tumor cells are prognostic in GCs treated with chemotherapy, radiotherapy, and checkpoint blockade and are closely associated with central biological processes that impact tumor progression. These findings could aid in identifying therapy-refractory patients and further enable personalized treatment decision-making.

Identifiants

pubmed: 35115363
pii: jitc-2021-003833
doi: 10.1136/jitc-2021-003833
pmc: PMC8814810
pii:
doi:

Substances chimiques

Biomarkers, Tumor 0

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : NCATS NIH HHS
ID : UL1 TR002548
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA216579
Pays : United States
Organisme : NCI NIH HHS
ID : K12 CA076917
Pays : United States
Organisme : NCRR NIH HHS
ID : C06 RR012463
Pays : United States
Organisme : NCI NIH HHS
ID : U24 CA199374
Pays : United States
Organisme : NIBIB NIH HHS
ID : R43 EB028736
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA239055
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA249992
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA220581
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA202752
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA208236
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA248226
Pays : United States
Organisme : BLRD VA
ID : I01 BX004121
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA257612
Pays : United States
Organisme : NCI NIH HHS
ID : U54 CA254566
Pays : United States

Commentaires et corrections

Type : ErratumIn

Informations de copyright

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: AM is an equity holder in Elucid Bioimaging and in Inspirata. In addition, he has served as a scientific advisory board member for Inspirata, AstraZeneca, Bristol Meyers Squibb and Merck. Currently he serves on the advisory board of Aiforia and currently consults for Caris, Roche and Aiforia. He also has sponsored research agreements with Philips, AstraZeneca, Boehringer Ingelheim and Bristol Meyers Squibb. His technology has been licensed to Elucid Bioimaging. He is also involved in a NIH U24 grant with PathCore, and three different R01 grants with Inspirata. Other authors declare no potential conflicts of interest.

Références

Cancer Cell Int. 2020 Aug 05;20:373
pubmed: 32774167
Nat Mach Intell. 2019 May;1(5):206-215
pubmed: 35603010
Int J Radiat Oncol Biol Phys. 2001 Feb 1;49(2):547-54
pubmed: 11173153
Int J Gynecol Pathol. 2004 Jan;23(1):41-4
pubmed: 14668549
Cancer Biomark. 2010;9(1-6):287-305
pubmed: 22112481
J Pathol Inform. 2016 Jul 26;7:29
pubmed: 27563488
Laryngoscope. 2020 Apr;130(4):930-938
pubmed: 31070246
J Natl Cancer Inst. 2004 Nov 17;96(22):1659-68
pubmed: 15547178
J Natl Cancer Inst. 2006 Nov 15;98(22):1655-63
pubmed: 17105988
J Clin Oncol. 2014 May 1;32(13):1302-8
pubmed: 24637997
Hum Pathol. 2018 Oct;80:47-54
pubmed: 29883779
Clin Cancer Res. 2019 Mar 1;25(5):1449-1451
pubmed: 30567833
Clin Cancer Res. 2016 Jun 15;22(12):3025-36
pubmed: 27306793
Clin Cancer Res. 2019 Mar 1;25(5):1526-1534
pubmed: 30201760
Onco Targets Ther. 2020 Aug 12;13:8037-8047
pubmed: 32884290
Nat Med. 2020 Jul;26(7):1054-1062
pubmed: 32461698
Nature. 2011 Jun 29;474(7353):609-15
pubmed: 21720365
J R Soc Interface. 2018 Apr;15(141):
pubmed: 29618526
PLoS One. 2013 Jul 29;8(7):e70221
pubmed: 23922958
Cancer Immunol Immunother. 2020 Mar;69(3):325-342
pubmed: 31901949
Bioinformatics. 2011 Jun 15;27(12):1739-40
pubmed: 21546393
Clin Cancer Res. 2016 Feb 1;22(3):714-24
pubmed: 26384738
Eur J Gynaecol Oncol. 2010;31(2):139-44
pubmed: 20527227
Hum Vaccin Immunother. 2012 Sep;8(9):1179-91
pubmed: 22906947
J Chiropr Med. 2016 Jun;15(2):155-63
pubmed: 27330520
Oncol Lett. 2018 Apr;15(4):4351-4357
pubmed: 29541203
CA Cancer J Clin. 2020 Jan;70(1):7-30
pubmed: 31912902
Adv Anat Pathol. 2017 Nov;24(6):311-335
pubmed: 28777143
Cell. 2017 Aug 24;170(5):927-938.e20
pubmed: 28841418
Cancer Immunol Immunother. 2012 Oct;61(10):1849-56
pubmed: 22456757
Oncogene. 2008 Oct 6;27(45):5904-12
pubmed: 18836471
Nat Genet. 2000 May;25(1):25-9
pubmed: 10802651
Cancer. 1999 Oct 15;86(8):1537-43
pubmed: 10526283
PLoS One. 2017 Feb 6;12(2):e0170634
pubmed: 28166544
J Natl Cancer Inst. 2015 Feb 03;107(3):
pubmed: 25650315
Clin Cancer Res. 2019 Nov 15;25(22):6731-6741
pubmed: 31515462
JAMA Oncol. 2017 Dec 1;3(12):e173290
pubmed: 29049607
Clin Exp Metastasis. 1993 Jul;11(4):295-305
pubmed: 8319378
Proc Natl Acad Sci U S A. 2005 Oct 25;102(43):15545-50
pubmed: 16199517
Oncoimmunology. 2015 Jun 9;5(1):e1057388
pubmed: 26942067
BMC Cancer. 2018 May 30;18(1):610
pubmed: 29848291
Cancer Manag Res. 2019 Jul 23;11:6815-6827
pubmed: 31440080
Natl Med J India. 2003 May-Jun;16(3):150-1
pubmed: 12929858
Nat Rev Cancer. 2007 Aug;7(8):573-84
pubmed: 17625587
Int Sch Res Notices. 2014 Oct 29;2014:953509
pubmed: 27382614
Cancer Res. 2001 Jul 1;61(13):5132-6
pubmed: 11431351
Onco Targets Ther. 2016 Mar 31;9:1875-88
pubmed: 27099519
J Immunother Cancer. 2018 Mar 6;6(1):20
pubmed: 29510739
Int J Gynecol Cancer. 2013 Oct;23(8):1376-82
pubmed: 24257551
Nucleic Acids Res. 2017 Jan 4;45(D1):D331-D338
pubmed: 27899567
JCO Clin Cancer Inform. 2019 Apr;3:1-7
pubmed: 30990737
Cell Rep. 2018 Apr 3;23(1):181-193.e7
pubmed: 29617659
CA Cancer J Clin. 2018 Nov;68(6):394-424
pubmed: 30207593
J Cell Sci. 2016 Aug 1;129(15):2881-6
pubmed: 27505426
Gynecol Oncol. 2019 May;153(2):217-222
pubmed: 30803719
Aging (Albany NY). 2019 Nov 18;11(22):10154-10166
pubmed: 31740624
J Immunother Cancer. 2020 May;8(1):
pubmed: 32414858
Oncotarget. 2016 Jul 12;7(28):44288-44298
pubmed: 27329588
Stat Med. 1997 Feb 28;16(4):385-95
pubmed: 9044528
J Clin Oncol. 2015 Dec 1;33(34):4015-22
pubmed: 26351349

Auteurs

Sepideh Azarianpour (S)

Center for Computational Imaging and Personalized Diagnostics, Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA.

Germán Corredor (G)

Center for Computational Imaging and Personalized Diagnostics, Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA.
Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA.

Kaustav Bera (K)

Center for Computational Imaging and Personalized Diagnostics, Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA.

Patrick Leo (P)

Center for Computational Imaging and Personalized Diagnostics, Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA.

Pingfu Fu (P)

Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA.

Paula Toro (P)

Department of Pathology, Cleveland Clinic, Cleveland, Ohio, USA.

Amy Joehlin-Price (A)

Department of Pathology, Cleveland Clinic, Cleveland, Ohio, USA.

Mojgan Mokhtari (M)

Center for Computational Imaging and Personalized Diagnostics, Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA.
School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of).

Haider Mahdi (H)

Magee Women's Hospital and Magee Women's Research Institute, University of Pittsburgh Medical Center, Pittsburgh, Ohio, USA.

Anant Madabhushi (A)

Center for Computational Imaging and Personalized Diagnostics, Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA anant.madabhushi@case.edu.
Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA.

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