title: The head and neck cancer immune landscape and its immunotherapeutic implications.
abstract: Recent clinical trials have demonstrated a clear survival advantage in advanced head and neck squamous cell carcinoma (HNSCC) patients treated with immune checkpoint blockade. These emerging results reveal that HNSCC is one of the most promising frontiers for immunotherapy research. However, further progress in head and neck immuno-oncology will require a detailed understanding of the immune infiltrative landscape found in these tumors. We leveraged transcriptome data from 280 tumors profiled by The Cancer Genome Atlas (TCGA) to comprehensively characterize the immune landscape of HNSCC in order to develop a rationale for immunotherapeutic strategies in HNSCC and guide clinical investigation. We find that both HPV+and HPV-HNSCC tumors are among the most highly immune-infiltrated cancer types. Strikingly, HNSCC had the highest median Treg/CD8+T cell ratio and the highest levels of CD56dimNK cell infiltration, in our pan-cancer analysis of the most immune-infiltrated tumors. CD8+T cell infiltration and CD56dimNK cell infiltration each correlated with superior survival in HNSCC. Tumors harboring genetic smoking signatures had lower immune infiltration and were associated with poorer survival, suggesting these patients may benefit from immune agonist therapy. These findings illuminate the immune landscape of HPV+and HPV-HNSCC. Additionally, this landscape provides a potentially novel rationale for investigation of agents targeting modulators of Tregs (e.g., CTLA-4, GITR, ICOS, IDO, and VEGFA) and NK cells (e.g., KIR, TIGIT, and 4-1BB) as adjuncts to anti-PD-1 in the treatment of advanced HNSCC.
authors: Human Oncology and Pathogenesis Program.|Head and Neck Service, Department of Surgery.|Immunogenomics and Precision Oncology Platform.
authors: Rajarsi
authors: R
authors: Mandal
authors: Ludwig Collaborative/Swim Across America Laboratory, Immunology Program and Department of Medicine.
authors: Yasin
authors: Y
authors: Şenbabaoğlu
authors: Human Oncology and Pathogenesis Program.|Immunogenomics and Precision Oncology Platform.
authors: Alexis
authors: A
authors: Desrichard
authors: Human Oncology and Pathogenesis Program.|Immunogenomics and Precision Oncology Platform.
authors: Jonathan J
authors: JJ
authors: Havel
authors: Human Oncology and Pathogenesis Program.|Immunogenomics and Precision Oncology Platform.
authors: Martin G
authors: MG
authors: Dalin
authors: Immunogenomics and Precision Oncology Platform.|Department of Radiation Oncology.
authors: Nadeem
authors: N
authors: Riaz
authors: Human Oncology and Pathogenesis Program.|Immunogenomics and Precision Oncology Platform.
authors: Ken-Wing
authors: KW
authors: Lee
authors: Head and Neck Service, Department of Surgery.
authors: Ian
authors: I
authors: Ganly
authors: Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors: A Ari
authors: AA
authors: Hakimi
authors: Human Oncology and Pathogenesis Program.|Immunogenomics and Precision Oncology Platform.|Department of Radiation Oncology.
authors: Timothy A
authors: TA
authors: Chan
authors: Human Oncology and Pathogenesis Program.|Head and Neck Service, Department of Surgery.|Immunogenomics and Precision Oncology Platform.
authors: Luc Gt
authors: LG
authors: Morris
mesh_terms: D018414:CD8-Positive T-Lymphocytes / Q000166:cytology; D002294:Carcinoma, Squamous Cell / Q000276:immunology*; D006258:Head and Neck Neoplasms / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007167:Immunotherapy; D007694:Killer Cells, Natural / Q000166:cytology; D027383:Papillomaviridae; D012907:Smoking; D050378:T-Lymphocytes, Regulatory / Q000166:cytology; D059467:Transcriptome; D059016:Tumor Microenvironment