Mutation in homologous recombination to predict a better prognosis in endometrial cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 6082-6082
Author(s):  
Luyang Zhao ◽  
Dai Yibo ◽  
Yuanjin Hu ◽  
Zhiqi Wang ◽  
Chengcheng Li ◽  
...  
Keyword(s):  
T Cells ◽  
Endometrial Cancer ◽  
Homologous Recombination ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
The Cancer Genome Atlas ◽  
Research Network ◽  
Sequencing Data ◽  
Activated T Cells ◽  
Endometrial Cancers

6082 Background: Endometrial cancers have been categorized into four genomic classes by The Cancer Genome Atlas Research Network (TCGA) with comprehensive genomic analysis. However, TCGA molecular subtypes are hard to utilize in clinic as the expensive cost and a simply version of POLE, TP53 genes cannot fully differentiate the four subtypes. Therefore, more convenient and reliable biomarkers need to be identified for clinical practice. Methods: Whole-exome sequencing and RNA sequencing data for 515 patients with endometrial carcinomas were downloaded from TCGA. Mutations in 48 genes of homologous recombination repair (HR) signaling were defined as HR mutation. Associations between HR mutation and survival and RNA expression were analyzed.Gene set enrichment analysis (GSEA) were used to invesgate the gene signaling. Results: HR mutation was associated with a prolonged disease specific survival (DSS) (HR, 0.39; 95% CI, 0.22-0.71; P = 0.002), progression-free survival (PFS) (HR, 0.46; 95% CI, 0.31-0.68; P < 0.001) and overall survival (OS) (HR, 0.45; 95% CI, 0.28-0.72; P = 0.001) in endometrial cancers. HR mutation was related with clinical characteristics including histological types (P < 0.05). In the multivariable cox proportional hazards regression model including FIGO 2008, histology types, tumor grade and TCGA subtypes, TP53 mutation, POLE mutation, the association between HR mutation and PFS was still significant (HR, 0.48; 95% CI, 0.27-0.86; P < 0.05), which indicating the HR mutation is an independent prognostic factor for PFS. HR mutations were associated with a higher tumor mutation burden. GSEA suggested that HR mutation was involved with the increase of genes related to activated T cells, immune cytolytic activity, and IFN-γ release. In MSS endometrial cancers, HR mutation still showed a longer PFS (HR, 0.57; 95% CI, 0.34-0.98; P = 0.04), suggested HR mutation may help predict the effect of immunotherapy in MSS endometrial carcinoma. Conclusions: HR mutation was related with a favorable prognosis through increasing T cells signature. Identification of HR mutation by genomic profiling provides a potentially novel and convenient approach for endometrial cancer patients to predict the prognosis independent of TCGA four subtype classifications and provides an inspiration for screening patients who may benefit from ICBs in endometrial cancer in the future.

Effect of MUC5B mutation on prognosis by enhancing the infiltration and antitumor immunity of cytotoxic T lymphocytes in the endometrial cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18105-e18105
Author(s):  
Hong Zheng ◽  
Wei Duan ◽  
Qun Zhao ◽  
Chengcheng Li ◽  
Guoqiang Wang ◽  
...  
Keyword(s):  
T Cells ◽  
Endometrial Cancer ◽  
T Lymphocytes ◽  
Cytotoxic T Lymphocytes ◽  
Molecular Subtypes ◽  
The Cancer Genome Atlas ◽  
Research Network ◽  
Sequencing Data ◽  
Activated T Cells ◽  
Endometrial Cancers

e18105 Background: Endometrial cancers have been categorized into four genomic classes by The Cancer Genome Atlas Research Network (TCGA) with comprehensive genomic analysis. However, TCGA molecular subtypes are hard to utilize in clinic as the expensive cost and a simply version of POLE, TP53 genes cannot fully differentiate the four subtypes. Therefore, more convenient and reliable biomarkers need to be identified for clinical practice. Methods: Whole-exome sequencing and RNA sequencing data for 515 patients with endometrial carcinomas were downloaded from TCGA. Associations between MUC5B mutation and survival and RNA expression were analyzed. Results: MUC5B mutation was associated with a prolonged disease specific survival (DSS) (HR, 0.47; 95% CI, 0.28-0.79; P < 0.05), progression-free survival (PFS) (HR, 0.31; 95% CI, 0.17-0.56; P < 0.001) and overall survival (OS) (HR, 0.29; 95% CI, 0.14-0.60; P = 0.001) in endometrial cancers. MUC5B mutation was significantly associated with patients' age at diagnosis (P = 0.027) and histological type (P < 0.001) and grade (P < 0.001). In the multivariable cox proportional hazards regression model including FIGO 2008, histology types, tumor grade, tp53, pole and TCGA molecular subtypes, the association between MUC5B mutation and PFS was still significant (HR, 0.40; 95% CI, 0.20-0.81; P = 0.011), indicating the MUC5B mutation is an independent prognostic factor for PFS. Moreover, MUC5B mutation have a tendency for a favorable OS (HR, 0.52; 95% CI, 0.23-1.22; P = 0.13). Patients harboring MUC5B have a higher tumor mutation burden (TMB). An analysis of immune signature revealed that MUC5B mutation was involved with the increase of genes related to activated T cells, immune cytolytic activity, and IFN-γ release. These results have further been confirmed by GSEA. Moreover, an increased level of cytotoxic T lymphocytes infiltration was observed in the patients with MUC5B mutations. Conclusions: MUC5B mutation was related with a favorable prognosis through increasing T cells signature. Identification of MUC5B mutation by genomic profiling provides a potentially novel and convenient approach for endometrial cancer patients to predict the prognosis.

scholarly journals Supervised Hierarchical Autoencoders for Multi-Omics Integration in Cancer Survival Models

2021 ◽  
Author(s):  
David Wissel ◽  
Daniel Rowson ◽  
Valentina Boeva
Keyword(s):  
Clinical Data ◽  
High Throughput Sequencing ◽  
Cancer Survival ◽  
Linear Models ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
The Cancer Genome Atlas ◽  
Survival Models ◽  
Sequencing Data ◽  
Omics Integration

With the increasing amount of high-throughput sequencing data becoming available, the proper integration of differently sized and heterogeneous molecular and clinical groups of variables has become crucial in cancer survival models. Due to the difficulty of multi-omics integration, the Cox Proportional-Hazards (Cox PH) model using clinical data has remained one of the best-performing methods [Herrmann et al., 2021]. This motivates the need for new models which can successfully perform multi-omics integration in survival models and outperform the Cox PH model. Furthermore, there is a strong need to make multi-omics models more sparse and interpretable to encourage their usage in clinical settings. We developed a neural architecture, termed Supervised Hierarchical Autoencoder (SHAE), based on supervised autoencoders and Sparse-Group-Lasso regularization. Our new method performed competitively with the best performing statistical models used for multi-omics survival analysis. Moreover, it outperformed the Cox PH model using clinical data across all 17 cancers from The Cancer Genome Atlas (TCGA) considered in our work. We further showed that surrogate linear models for SHAE trained on a subset of multi-omics groups achieved competitive performance at consistently high sparsity levels, enabling usage within clinics. Alternatively, surrogate models can act as a feature selection step, permitting improved performance in arbitrary downstream survival models. Code for the reproduction of our results is available on Github.

scholarly journals Eps15 Homology Domain-Containing Protein 3 Hypermethylation as a Prognostic and Predictive Marker for Colorectal Cancer

Biomedicines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 453
Author(s):  
Yu-Han Wang ◽  
Shih-Ching Chang ◽  
Muhamad Ansar ◽  
Chin-Sheng Hung ◽  
Ruo-Kai Lin
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Mrna Expression ◽  
Proportional Hazards ◽  
Uterine Cancer ◽  
Colonic Polyps ◽  
Predictive Marker ◽  
Cox Proportional Hazards ◽  
The Cancer Genome Atlas ◽  
Eps15 Homology Domain

Colorectal cancer (CRC) arises from chromosomal instability, resulting from aberrant hypermethylation in tumor suppressor genes. This study identified hypermethylated genes in CRC and investigated how they affect clinical outcomes. Methylation levels of specific genes were analyzed from The Cancer Genome Atlas dataset and 20 breast cancer, 16 esophageal cancer, 33 lung cancer, 15 uterine cancer, 504 CRC, and 9 colon polyp tissues and 102 CRC plasma samples from a Taiwanese cohort. In the Asian cohort, Eps15 homology domain-containing protein 3 (EHD3) had twofold higher methylation in 44.4% of patients with colonic polyps, 37.3% of plasma from CRC patients, and 72.6% of CRC tissues, which was connected to vascular invasion and high microsatellite instability. Furthermore, EHD3 hypermethylation was detected in other gastrointestinal cancers. In the Asian CRC cohort, low EHD3 mRNA expression was found in 45.1% of patients and was connected to lymph node metastasis. Multivariate Cox proportional-hazards survival analysis revealed that hypermethylation in women and low mRNA expression were associated with overall survival. In the Western CRC cohort, EHD3 hypermethylation was also connected to overall survival and lower chemotherapy and antimetabolite response rates. In conclusion, EHD3 hypermethylation contributes to the development of CRC in both Asian and Western populations.

scholarly journals Expression Profile and Prognostic Values of SMC Family Members in HCC

2021 ◽  
Author(s):  
Wei Yan ◽  
Dan-dan Wang ◽  
He-da Zhang ◽  
Jinny Huang ◽  
Jun-Chen Hou ◽  
...  
Keyword(s):  
Gene Family ◽  
Expression Profile ◽  
Proportional Hazards ◽  
Wide Spectrum ◽  
Clinical Stage ◽  
Family Members ◽  
Enrichment Analysis ◽  
Cox Proportional Hazards ◽  
Gene Set Enrichment Analysis ◽  
The Cancer Genome Atlas

Abstract Background: The structural maintenance of chromosome (SMC) gene family, comprising 6 members, is involved in a wide spectrum of biological functions in many types of human cancers. However, there is little research on the expression profile and prognostic values of SMC genes in hepatocellular carcinoma (HCC). Based on updated public resources and integrative bioinformatics analysis, we tried to determine the value of SMC gene expression in predicting the risk of developing HCC. Methods and materials: The expression data of SMC family members were obtained from The Cancer Genome Atlas (TCGA). The prognostic values of SMC members and clinical features were identified. A gene set enrichment analysis (GSEA) was conducted to explore the mechanism underlying the involvement of SMC members in liver cancer. The associations between tumor immune infiltrating cells (TIICs) and the SMC family members were evaluated using the Tumor Immune Estimation Resource (TIMER) database. Results: Our analysis demonstrated that mRNA downregulation of SMC genes was common alteration in HCC patients. SMC1A, SMC2, SMC3, SMC4, SMC6 were upregulated in HCC. Upregulation of SMC2, SMC3 and SMC4, along with clinical stage, were associated with a poor HCC prognosis based on the results of univariate and multivariate Cox proportional hazards regression analyses. SMC2, SMC3 and SMC4 are also related to tumor purity and immune infiltration levels of HCC. The GSEA results indicated that SMC members participate in multiple biological processes underlying tumorigenesis. Conclusion: This study comprehensively analyzed the expression of SMC gene family members in patients with HCC. This can provide insights for further investigation of the SMC family members as potential targets in HCC and suggest that the use of SMC inhibitor targeting SMC2, SMC3 and SMC4 may be an effective strategy for HCC therapy.

scholarly journals Whole Blood Profiling of T-cell-Derived microRNA Allows the Development of Prognostic models in Inflammatory Bowel Disease

2020 ◽  
Vol 14 (12) ◽  
pp. 1724-1733
Author(s):  
R Kalla ◽  
A T Adams ◽  
N T Ventham ◽  
N A Kennedy ◽  
R White ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
T Cells ◽  
T Cell ◽  
Bowel Disease ◽  
Whole Blood ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Prognostic Models ◽  
Inflammatory Bowel ◽  
Treatment Escalation

Abstract Background MicroRNAs [miRNAs] are cell-specific small non-coding RNAs that can regulate gene expression and have been implicated in inflammatory bowel disease [IBD] pathogenesis. Here we define the cell-specific miRNA profiles and investigate its biomarker potential in IBD. Methods In a two-stage prospective multi-centre case control study, next generation sequencing was performed on a discovery cohort of immunomagnetically separated leukocytes from 32 patients (nine Crohn’s disease [CD], 14 ulcerative colitis [UC], eight healthy controls) and differentially expressed signals were validated in whole blood in 294 patients [97 UC, 98 CD, 98 non-IBD, 1 IBDU] using quantitative PCR. Correlations were analysed with phenotype, including need for early treatment escalation as a marker of progressive disease using Cox proportional hazards. Results In stage 1, each leukocyte subset [CD4+ and CD8+ T-cells and CD14+ monocytes] was analysed in IBD and controls. Three specific miRNAs differentiated IBD from controls in CD4+ T-cells, including miR-1307-3p [p = 0.01], miR-3615 [p = 0.02] and miR-4792 [p = 0.01]. In the extension cohort, in stage 2, miR-1307-3p was able to predict disease progression in IBD (hazard ratio [HR] 1.98, interquartile range [IQR]: 1.20–3.27; logrank p = 1.80 × 10–3), in particular CD [HR 2.81; IQR: 1.11–3.53, p = 6.50 × 10–4]. Using blood-based multimarker miRNA models, the estimated chance of escalation in CD was 83% if two or more criteria were met and 90% for UC if three or more criteria are met. Interpretation We have identified and validated unique CD4+ T-cell miRNAs that are differentially regulated in IBD. These miRNAs may be able to predict treatment escalation and have the potential for clinical translation; further prospective evaluation is now indicated.

scholarly journals Identification of an IRGP Signature to Predict Prognosis and Immunotherapeutic Efficiency in Bladder Cancer

2021 ◽  
Vol 8 ◽  
Author(s):  
Liang-Hao Zhang ◽  
Long-Qing Li ◽  
Yong-Hao Zhan ◽  
Zhao-Wei Zhu ◽  
Xue-Pei Zhang
Keyword(s):  
Bladder Cancer ◽  
Stromal Cells ◽  
Molecular Mechanisms ◽  
Proportional Hazards ◽  
Enrichment Analysis ◽  
Cox Proportional Hazards ◽  
Gene Set Enrichment Analysis ◽  
The Cancer Genome Atlas ◽  
Consensus Clustering ◽  
Validation Set

BackgroundIdentify immune-related gene pairs (IRGPs) signature related to the prognosis and immunotherapeutic efficiency for bladder cancer (BLCA) patients.Materials and MethodsOne RNA-seq dataset (The Cancer Genome Atlas Program) and two microarray datasets (GSE13507 and GSE31684) were included in this study. We defined these cohorts as training set to construct IRGPs and one immunotherapy microarray dataset as validation set. Identifying BLCA subclasses based on IRGPs by consensus clustering. The Lasso penalized Cox proportional hazards regression model was used to construct prognostic signature and potential molecular mechanisms were analyzed.ResultsThis signature can accurately predict the overall survival of BLCA patients and was verified in the immunotherapy validation set. IRGP-signatures can be used as independent prognostic risk factor in various clinical subgroups. Use the CIBERSORT algorithm to assess the abundance of infiltrating immune cells in each sample, and combine the results of the gene set enrichment analysis of a single sample to explore the differences in the immune microenvironment between IRPG signature groups. According to the results of GSVA, GSEA, and CIBERSORT algorithm, we found that IRGP is strikingly positive correlated with tumor microenvironment (TME) stromal cells infiltration, indicating that the poor prognosis and immunotherapy might be caused partly by enrichment of stromal cells. Finally, the results from the TIDE analysis revealed that IRGP could efficiently predict the response of immunotherapy in BLCA.ConclusionThe novel IRGP signature has a significant prognostic value for BLCA patients might facilitate personalized for immunotherapy.

scholarly journals Lymphedema in Endometrial Cancer Survivor: A Nationwide Cohort Study

2021 ◽  
Vol 10 (20) ◽  
pp. 4647
Author(s):  
Su-Jeong Lee ◽  
Jun-Pyo Myong ◽  
Yun-Hee Lee ◽  
Eui-Jin Cho ◽  
Sung-Jong Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Endometrial Cancer ◽  
Cohort Study ◽  
Proportional Hazards ◽  
Gynecological Cancer ◽  
Risk Groups ◽  
Developed Countries ◽  
Cox Proportional Hazards ◽  
Health Care Resources

Background: Endometrial cancer is the most common gynecological cancer in developed countries. Treatment-related lymphedema negatively affects the quality of life and function of patients. This study investigated the cumulative incidence and risk factors of, and utilization of health care resources for, lymphedema in patients with endometrial cancer. Methods: We conducted a nationwide, retrospective cohort study of women with endometrial cancer who underwent cancer-direct treatment using the Korean National Health Insurance Service (NHIS) database. Patients were categorized by age, region, income, and treatment modality. Cox proportional hazards regression models were used to analyze the incidence and risk factors of lymphedema. We also analyzed utilization of health care resources for lymphedema using diagnostic and treatment claim codes. Results: A total of 19,027 patients with endometrial cancer were evaluated between January 2004 and December 2017. Among them, 2493 (13.1%) developed lymphedema. Age (<40 years, adjusted odds ratio [aOR] = 1 vs. 40–59 years, aOR = 1.413; 95% confidence interval (CI) 1.203–1.66 vs. 60+ years, aOR = 1.472; 95% CI 1.239–1.748) and multimodal treatment (surgery only, aOR = 1 vs. surgery + radiation + chemotherapy, aOR = 2.571; 95% CI 2.27–2.912) are considered to be possible risk factors for lymphedema in patients with endometrial cancer (p < 0.001). The utilization of health care resources for the treatment of lymphedema has increased over the years. Conclusions: Lymphedema is a common complication affecting women with endometrial cancer and leads to an increase in national healthcare costs. Post-treatment surveillance of lymphedema, especially in high-risk groups, is needed.

scholarly journals A Prognostic Nomogram Combining Gene Expression Profiles and TNM Stage Predicts Survival in Gastric Cancer

2021 ◽  
Author(s):  
Jian Huang ◽  
Dongcun Wang ◽  
Xiaoliang Wang ◽  
Xiaoxing Ye ◽  
Jiping Da
Keyword(s):  
Gene Expression ◽  
Risk Score ◽  
Proportional Hazards ◽  
Expression Profiles ◽  
Tnm Staging ◽  
Cox Proportional Hazards ◽  
Tnm Stage ◽  
The Cancer Genome Atlas ◽  
Prognostic Indicators ◽  
High Morbidity

Abstract BackgroundGastric carcinoma (GC) is a highly aggressive malignancy and is associated with high morbidity and mortality rates around the world, the current tumor-node-metastasis (TNM) staging system is inadequate to predict overall survival (OS) in GC patients. therefore, potential forecasting methods for prognosis are important to investigate.MethodsDifferentially expressed genes (DEGs) were screened using gene expression data from The Cancer Genome Atlas (TCGA). We then construct a risk score signature model by univariate Cox proportional hazards regression (CPHR) analysis, the Kaplan-Meier method（KM）and multivariate CPHR analysis. Using TNM stage, we developed a signature-based nomogram. Finally, we utilize an independent Gene Expression Omnibus dataset (GSE62254) validate the prognostic value of risk score signature model and nomogram.ResultsWe identified five OS-related mRNAs among 1113 mRNAs that were differentially expressed between GC and normal samples in the TCGA dataset. We then constructed a five-mRNA signature model, which efficiently distinguished high-risk from low-risk patient in both cohort, and even viable in the TNM stage-III, gender(male, female) and age(＜65-year-old, ≥65-year-old) subgroups (P<0.05). Utilizing TNM stage, we developed a signature-based nomogram, which performed better than use the TNM stage or five-mRNA signature alone for prognostic prediction in the TCGA and GSE62254 dataset.ConclusionsThese results suggest that both risk signature and nomogram were effective prognostic indicators for patients with GCs, and could potentially be used for individualized management of such patients.

scholarly journals Integrin Alpha L as an Immune-Related Biomarker Correlated with the Prognosis and Effect of Immunotherapy in Gliomas

2022 ◽  
Author(s):  
Jinyang Ma ◽  
Lei Wang ◽  
Youdong Zhou ◽  
Changtao Fu ◽  
Song Huang ◽  
...  
Keyword(s):  
Tumor Microenvironment ◽  
Proportional Hazards ◽  
Clinical Information ◽  
Cox Proportional Hazards ◽  
The Cancer Genome Atlas ◽  
Functional Enrichment ◽  
Wilcoxon Test ◽  
Normal Brain ◽  
Who Grade ◽  
Genome Atlas

Abstract Backgroud: Discovering effective immune-related biomarkers is vital to ensure efficient immunotherapy for glioma patients. Integrin Alpha L(ITGAL), essential to inflammatory and immune responses, have not been studied in gliomas, systematically. Methods RNA‑seq data and corresponding clinical information of glioma patients were collected from The Cancer Genome Atlas (TCGA) and Chinese Glioma Genome Atlas (CGGA), and mRNA data of normal brain tissues were obtained in Genotype-Tissue Expression (GTEx) project. Wilcoxon test was performed to analyze the correlation of ITGAL expression and glioma subtypes. Univariate and multivariate cox proportional hazards regression, receiver operating characteristic (ROC) curves and Kaplan-Meier plots were used to evaluate the prognostic value of ITGAL in glioma. Functional enrichment analyses and immune infiltration analysis were performed to investigate the potential function in mediating the immune response in the tumor microenvironment. Finally, we evaluated the ability of ITGAL for predicting the efficacy of ICB treatment for patients. Results We found the up-regulation of ITGAL may predict a poor prognosis for glioma patients, the expression level increased with the increasing of WHO grade and 1p19q co-deletion status and IDH mutation status. The total methylation level and copy number variation of ITGAL were moderately correlated with its mRNA expression in LGG samples (P < 0.05). Furthermore, ITGAL was correlated with the immunosuppressive tumor microenvironment for the strong correlation with M2 macrophages and Tregs. Finally, GSEA showed the upregulation of ITGAL was mainly involved in the signal recognition and regulation between immune cells, and Toll-like receptor signaling pathway. Conclusion ITGAL is a novel tumor-related and immune-associated biomarker, which could predict the prognosis and effect of ICB therapy for glioma patients.

Evaluation of glioblastoma tumor microenvironment after treatment with pembrolizumab.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 2559-2559 ◽  
Author(s):  
Nazanin Majd ◽  
Heather Y. Lin ◽  
Ying Yuan ◽  
Kristin Alfaro-Munoz ◽  
Kathy Hunter ◽  
...  
Keyword(s):  
Clinical Trial ◽  
T Cells ◽  
Tumor Microenvironment ◽  
Proportional Hazards ◽  
Progression Free Survival ◽  
Cox Proportional Hazards ◽  
Recurrent Glioblastoma ◽  
T Cell Response ◽  
Rank Test ◽  
Recurrent Gbm

2559 Background: Neoadjuvant pembrolizumab improved outcome of patients with recurrent Glioblastoma (GBM) in two early phase clinical trials. However, several large phase II/III studies in patients with newly diagnosed and recurrent GBM failed to demonstrate a therapeutic benefit of anti-PD-1 therapy. Therefore, identification of biomarkers of response is crucial for appropriate patient selection and further clinical development of anti-PD-1 therapy. We reported the outcome of our window-of-opportunity clinical trial of neoadjuvant pembrolizumab in 15 patients with recurrent GBM, demonstrating rare CD8+ T cells and abundant of CD68+ macrophages in GBM tissue after 3 weeks of anti-PD-1 treatment (NCT02337686). In the current study, we compared tumor infiltrating lymphocyte (TIL) and PD-L1 scores, known biomarkers of response to anti-PD-1 therapy in other cancers, in pre-trial vs. on-trial tumor tissue and associated these markers with survival. Methods: We determined TIL score (morphological assessment of the presence or absence of TILs, 0-3) and PD-L1 H score (defined as [1*1+ %]+[2*2+ %]+[3*3+ %], 0-200) and correlated these with survival. The Wilcoxon signed rank test was used to compare levels of PD-L1 H or TIL scores between pre-trial and on-trial specimens. The Cox proportional hazards models were used to assess associations between correlative markers and progression free survival or overall survival (OS). Results: The on-trial TIL level (median: 3) was significantly higher than the pre-trial TIL level (median: 1) (p = 0.031). However the difference between pre-trial and on-trial PD-L1 levels was not statistically significant (p > 0.9). Patients whose on-trial PD-L1 H score was ≥ 3 trended toward a longer OS than those with a PD-L1 H score < 3 (HR [95% CI] = 0.225 [0.043, 1.183]) (p = 0.0782). Conclusions: Although GBM tissue lacks abundant T cells, treatment with pembrolizumab increases trafficking of T cells to the tumor microenvironment, which is necessary but not sufficient to induce an effector T-cell response. Elevated PD-L1 expression may be a biomarker of response to anti-PD1 therapy in GBM, which needs confirmation in larger studies. Further genomic, transcriptomic, and methylation profiling of the pre-trial and on-trial tissues is ongoing. Clinical trial information: NCT02337686 .

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