Neoadjuvant chemotherapy enhances tumor-specific T cell immunity in patients with HPV-associated oropharyngeal cancer

Christian Samaniego, Head and Neck Section, Surgical Oncology Program, Center for cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Jay Friedman, Head and Neck Section, Surgical Oncology Program, Center for cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Xinping Yang, Head and Neck Section, Surgical Oncology Program, Center for cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Christopher Badger, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Timothy Shaver, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Shabnam Samankan, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Punam Thakkar, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Joseph Goodman, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Arjun Joshi, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Clint T. Allen, Head and Neck Section, Surgical Oncology Program, Center for cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.

Document Type

Journal Article

Publication Date

7-21-2023

Journal

Head & neck

DOI

10.1002/hed.27463

Keywords

HPV; antigen-specific T cell responses; neoadjuvant chemotherapy; oropharyngeal cancer; pathologic response

Abstract

BACKGROUND: Treatment of patients with newly diagnosed HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) with neoadjuvant chemotherapy (NAC) results in a high rate of 5-year recurrence free survival with few patients requiring adjuvant treatment. We hypothesized that NAC enhances primary tumor HPV-specific T cell responses. METHODS: HPV-specific responses in tumor infiltrating lymphocytes (TILs) before and after NAC were determined using autologous co-culture assays. RESULTS: Greater HPV16-specific TIL responses, sometimes polyclonal, were observed after NAC compared to before in 8 of 10 patients (80%) with PCR-verified HPV16-positive tumors. A significant association was observed between net-negative change in HPV-specific TIL response and disease relapse (p = 0.04, Mann-Whitney test), whereas pathologic complete response at time of surgery did not correlate with recurrence. CONCLUSIONS: NAC induces HPV-specific tumor T cell responses in patients with newly diagnosed HPV-associated OPSCC; whereas lack of an increase following NAC may associate with risk of relapse.

Department

Surgery

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