Oropharyngeal cancer (OPC) exhibits diverse immunological properties; however, their implications for immunotherapy are unknown.
We analysed 37 surgically resected and nine recurrent or metastatic anti-programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1)-treated OPC tumours. OPCs were classified into immune-rich (IR), mesenchymal (MS) and xenobiotic (XB) subtypes based on RNA-sequencing data.
All IR type tumours were human papillomavirus (HPV) positive, most XB types were HPV negative, and MS types showed mixed HPV status. The IR type showed an enriched T cell exhaustion signature with PD-1+ CD8+ T cells and type I macrophages infiltrating the tumour nest on multiplex immunohistochemistry. The MS type showed an exclusion of CD8+ T cells from the tumour nest and high MS and tumour growth factor-β signatures. The XB type showed scant CD8+ T cell infiltration and focal CD73 expression. The IR type was associated with a favourable response signature during anti-PD-1/PD-L1 therapy and showed a high APOBEC mutation signature, whereas the MS and XB types showed resistance signature upregulation. Among anti-PD-1/PD-L1-treated OPC patients, the IR type showed a favourable clinical response (3/4 patients), whereas the XB type showed early progression (3/3 patients).
Our analysis classified OPCs into three subtypes with distinct immune microenvironments that are potentially related to the response to anti-PD-1/PD-L1 therapy.
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We acknowledge Suyeon Jang for administrating the sample collection and transfer procedures. We also acknowledge Macrogen, Inc. for performing RNA-seq and targeted sequencing experiments.
Ethics approval and consent to participate
This study was reviewed and approved by the Institutional Review Board of Severance Hospital. Informed consent was obtained from all participants. This study was performed in accordance with the Declaration of Helsinki.
Consent to publish
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
The authors declare no competing interests.
This research was supported by the Young Medical Scientist Research Grant through the Deawoong Foundation (DY18111P), by the Bio & Medical Technology Development Programme of the National Research Foundation (NRF) funded by the Ministry of Science and ICT (2017M3A9E8029717, 2017M3A9E9072669, 2019M3A9B6065231) and by a grant from the National R&D Programme for Cancer Control, Ministry of Health and Welfare (HA16C0015). This study was also supported by the Research Foundation of Yonsei University (No. 6-2017-0104).
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Kim, M.H., Kim, J., Lee, J.M. et al. Molecular subtypes of oropharyngeal cancer show distinct immune microenvironment related with immune checkpoint blockade response. Br J Cancer 122, 1649–1660 (2020). https://doi.org/10.1038/s41416-020-0796-8