High immunoscore is associated with good response to neo-adjuvant chemotherapy and prolonged survival in advanced head and neck cancer patients

Abstract Background The presence of high levels of tumor immune infiltrate has been recognized to be associated with better prognosis in Head and Neck cancer (HN HR, hazard ratio; ORR, objective response rate; OS, overall survival; PFS, progression-free survival; SOC, standard of care; TPS, tumor proportion score. Sensitivity, specificity, N (prevalence), and ORR are for the pembrolizumab arm. Odds ratio, PFS HR, and OS HR compare pembrolizumab and SOC. Methods This retrospective ongoing study evaluated the Immunoscore in 110 patients with advanced laryngeal (n = 57) or hypopharyngeal (n = 53) cancers who received neo-adjuvant chemotherapy in the setting of an organ preservation protocol. Good responders (tumor reduction > 50%) were subsequently treated by radiation/chemoradiation, whereas non-responders were subjected to surgery followed by post-operative radiation/chemoradiation. Pre-treatment tumor samples were immune-stained for T-cell (CD3, CD8) markers and quantitative analysis of the immune cells was carried out in different tumor locations using a computer-assisted image analysis. Results 60% of patients were good responders. Densities of T cell infiltration were significantly higher for Hypopharyngeal cancer patients compared to those with laryngeal cancer. ( P  Conclusions The results of this ongoing study show a significant prognostic and potentially predictive role of Immunoscore in HN Travel / Accommodation / Expenses: BMS. B. Mlecnik: Licensing / Royalties: HalioDx. F. Hermitte: Shareholder / Stockholder / Stock options, Full / Part-time employment, Officer / Board of Directors: HalioDx. C. Even: Advisory / Consultancy: MSD; Advisory / Consultancy, Travel / Accommodation / Expenses: BMS; Advisory / Consultancy, Travel / Accommodation / Expenses: Merck Serono; Advisory / Consultancy: Innate Pharma; Advisory / Consultancy, Travel / Accommodation / Expenses: AstraZeneca. J. Galon: Advisory / Consultancy, Research grant / Funding (institution), Shareholder / Stockholder / Stock options: HalioDx; Honoraria (self): AstraZeneca; Honoraria (self): Novartis; Honoraria (self): Merck Serono; Honoraria (self): MSD; Honoraria (self): BMS; Honoraria (self): Sanofi; Honoraria (self): Gilead; Advisory / Consultancy, Research grant / Funding (institution): IOBiotech; Advisory / Consultancy: Illumina; Advisory / Consultancy: Northwest Biotherapeutics; Advisory / Consultancy: Actelion; Advisory / Consultancy: Amgen; Research grant / Funding (institution): Perkin-Helmer; Research grant / Funding (institution): MedImmune; Research grant / Funding (institution): Janssen; Research grant / Funding (institution): Imcheck; Licensing / Royalties: Inserm. All other authors have declared no conflicts of interest.