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Title: Clinical implications of systemic and local immune responses in human angiosarcoma
Authors: Chan, Jason Yongsheng 
Tan, Grace Fangmin
Yeong, Joe
Ong, Chee Wee
Ng, Dave Yong Xiang
Lee, Elizabeth
Koh, Joanna
Ng, Cedric Chuan-Young
Lee, Jing Yi
Liu, Wei
Wong, Ru Xin
Ong, Chin-Ann Johnny
Farid, Mohamad 
Teh, Bin Tean 
Soo, Khee Chee 
Issue Date: 12-Feb-2021
Publisher: Nature Research
Citation: Chan, Jason Yongsheng, Tan, Grace Fangmin, Yeong, Joe, Ong, Chee Wee, Ng, Dave Yong Xiang, Lee, Elizabeth, Koh, Joanna, Ng, Cedric Chuan-Young, Lee, Jing Yi, Liu, Wei, Wong, Ru Xin, Ong, Chin-Ann Johnny, Farid, Mohamad, Teh, Bin Tean, Soo, Khee Chee (2021-02-12). Clinical implications of systemic and local immune responses in human angiosarcoma. npj Precision Oncology 5 (1) : 11. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Angiosarcomas are a rare subtype of soft-tissue sarcomas which exhibit aggressive clinical phenotypes with limited treatment options and poor outcomes. In this study, we investigated the clinical relevance of the peripheral blood neutrophil-to-lymphocyte ratio (NLR) as a marker of systemic immune response, as well as its correlation with intra-tumoral immune profiles in a subgroup of cases (n = 35) using the NanoString PanCancer IO360 panel and multiplex immunohistochemistry. In the overall cohort (n = 150), angiosarcomas of the head and neck (AS-HN) comprised most cases (58.7%) and median overall survival (OS) was 1.1 year. NLR, classified as high in 78 of 112 (70%) evaluable patients, was independently correlated with worse OS (HR 1.84, 95%CI 1.18–2.87, p = 0.0073). Peripheral blood NLR was positively correlated with intra-tumoral NLR (tNLR) (Spearman’s rho 0.450, p = 0.0067). Visualization of tumor-infiltrating immune cells confirmed that tNLR scores correlated directly with both neutrophil (CD15+ cells, rho 0.398, p = 0.0198) and macrophage (CD68+ cells, rho 0.515, p = 0.0018) cell counts. Interestingly, tNLR correlated positively with oncogenic pathway scores including angiogenesis, matrix remodeling and metastasis, and cytokine and chemokine signaling, as well as myeloid compartment scores (all p < 0.001). In patients with documented response assessment to first-line chemotherapy, these pathway scores were all significantly higher in non-responders (47%) compared to responders. In conclusion, systemic and local immune responses may inform chemotherapy response and clinical outcomes in angiosarcomas. © 2021, The Author(s).
Source Title: npj Precision Oncology
ISSN: 2397-768X
DOI: 10.1038/s41698-021-00150-x
Rights: Attribution 4.0 International
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