Relationship Between Tumor Infiltrating Immune Cells And Tumor Draining Lymph Nodes Among Patients With Esophageal Cancer

Results from the UK MRC OE02 Trial

At the 2023 World Congress on Gastrointestinal Cancers, Maximilian Kloft, MD, Maastricht University, Maastricht, Netherlands, presented results from a study relating the tumor infiltrating lymphocytes and the tumor-draining lymph nodes in esophageal cancer.

Dr Kloft concluded and coauthors concluded, “with the exception of FOXP3-positive Tregs, there seemed to be no relationship between immune cell types in the primary tumor and immune activation status is of the tumor draining lymph nodes.”

Transcript:

Good morning, my name is Maximilian Kloft. I'm a PhD student at Maastricht University, and also a trainee oncologist in Giesen. At the 2023 World Congress on Gastrointestinal Cancers, I presented my work on the OE02 trial where I looked at the relationship between tumor infiltrating immune cells and the lymph nodes. For that, we analyzed patients in the OE02 trial. In this trial, patients were randomized to either chemotherapy and surgery or surgery alone, and we then earlier already looked into the tumor negative lymph nodes. We found that tumor negative lymph nodes, if they are large, patients have increased overall survival than when they are smaller.

Then, we were interested, "What is inside these lymph nodes?" And we analyzed these lymph nodes to see whether there are certain patterns which are linked to overall survival. And indeed, we found those patterns. We found that patients with more histiocytes and thus more macrophages have decreased overall survival.

And now, we are also interested into the tumor infiltrating lymphocytes. We did immunohistochemistry of micro-areas of CD3, CD68, and FOXP3 cells, and related that to the microarchitecture of the lymph nodes. The lymph nodes microarchitecture was assessed by doing the point counting method and was dichotomized by a high and low microarchitecture. What we saw is that patients with increased FOXP3 in the tumor-infiltrating lymphocytes have decreased germinal centers and decreased lymphocytes in the tumor draining lymph nodes. This was seen only in the chemotherapy and surgery group in the tumor-negative lymph nodes. In the tumor-positive lymph nodes, this was not seen.

In conclusion, this is the first study to relate the tumor-infiltrating lymphocytes and the tumor-draining lymph nodes in esophageal cancer. And we have found that there's a relationship between FOXP3 cells and the germinal centers and lymphocytes in the lymph nodes. But the other parameters were not related. What we learned from this is that we also need to analyze the tumor-draining lymph nodes, and not only the tumor-infiltrating lymphocytes. And there are larger studies needed to find out about the underlying biology and to make conclusions when we look at immunotherapy. Thank you very much.

Source:

Kloft M, Allum W, Cunningham D, et al. The relationship between primary tumour infiltrating immune cells and immune activation status of tumour draining lymph nodes in oesophageal cancer patients – results from the UK MRC OE02 trial. Presented at the 2023 World Congress on Gastrointestinal Cancers; June 28-July 1, 2023; Barcelona, Spain. Abstract SO-9