Prospective evaluation of immune activation associated with response to radioembolization assessed with PET/CT in women with breast cancer liver metastasis Journal Article


Authors: Deipolyi, A. R.; Johnson, C. B.; Riedl, C. C.; Kunin, H.; Solomon, S. B.; Oklu, R.; Hsu, M.; Moskowitz, C. S.; Kombak, F. E.; Bhanot, U.; Erinjeri, J. P.
Article Title: Prospective evaluation of immune activation associated with response to radioembolization assessed with PET/CT in women with breast cancer liver metastasis
Abstract: Background The impact of transarterial radioembolization (TARE) of breast cancer liver metastasis (BCLM) on antitumor immunity is unknown, which hinders the optimal selection of candidates for TARE. Purpose To determine whether response to TARE at PET/CT in participants with BCLM is associated with specific immune markers (cytokines and immune cell populations). Materials and Methods This prospective pilot study enrolled 23 women with BCLM who planned to undergo TARE (June 2018 to February 2020). Peripheral blood and liver tumor biopsies were collected at baseline and 1-2 months after TARE. Monocyte, myeloid-derived suppressor cell (MDSC), interleukin (IL), and tumor-infiltrating lymphocyte (TIL) levels were assessed with use of gene expression studies and flow cytometry, and immune checkpoint and cell surface marker levels with immunohistochemistry. Modified PET Response Criteria in Solid Tumors was used to determine complete response (CR) in treated tissue. After log-transformation, immune marker levels before and after TARE were compared using paired t tests. Association with CR was assessed with Wilcoxon rank-sum or unpaired t tests. Results Twenty women were included. After TARE, peripheral IL-6 (geometric mean, 1.0 vs 1.6 pg/mL; P = .02), IL-10 (0.2 vs 0.4 pg/mL; P = .001), and IL-15 (1.9 vs 2.4 pg/mL; P = .01) increased. In biopsy tissue, lymphocyte activation gene 3-positive CD4+ TILs (15% vs 31%; P < .001) increased. Eight of 20 participants (40% [exact 95% CI: 19, 64]) achieved CR. Participants with CR had lower baseline peripheral monocytes (10% vs 29%; P < .001) and MDSCs (1% vs 5%; P < .001) and higher programmed cell death protein (PD) 1-positive CD4+ TILs (59% vs 26%; P = .006) at flow cytometry and higher PD-1+ staining in tumor (2% vs 1%; P = .046). Conclusion Complete response to transarterial radioembolization was associated with lower baseline cytokine, monocyte, and myeloid-derived suppressor cell levels and higher programmed cell death protein 1-positive tumor-infiltrating lymphocyte levels. © RSNA, 2022 Online supplemental material is available for this article.
Keywords: retrospective studies; liver cell carcinoma; carcinoma, hepatocellular; liver neoplasms; biomarkers; biological marker; pathology; breast neoplasms; retrospective study; pilot study; pilot projects; breast tumor; liver tumor; embolization, therapeutic; procedures; humans; human; female; positron emission tomography-computed tomography; positron emission tomography computed tomography; artificial embolization
Journal Title: Radiology
Volume: 306
Issue: 1
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2023-01-01
Start Page: 279
End Page: 287
Language: English
DOI: 10.1148/radiol.220158
PUBMED: 35972356
PROVIDER: scopus
PMCID: PMC9772064
DOI/URL:
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- Export Date: 1 February 2023 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Meier Hsu
    168 Hsu
  2. Chaya S. Moskowitz
    278 Moskowitz
  3. Stephen Solomon
    420 Solomon
  4. Joseph Patrick Erinjeri
    200 Erinjeri
  5. Umeshkumar Kapaldev Bhanot
    91 Bhanot
  6. Henry Samuel Kunin
    23 Kunin
  7. Faruk Erdem Kombak
    16 Kombak