Abstract
We sought to identify candidate biomarkers for early brain metastasis (BM) recurrence in patients who underwent craniotomy followed by adjuvant stereotactic radiosurgery. RNA sequencing was performed on eight resected brain metastasis tissue samples and revealed B-cell related genes to be highly expressed in patients who did not experience a distant brain failure and had prolonged overall survival. To translate the findings from RNA sequencing data, we performed immunohistochemistry to stain for B and T cell markers from formalin-fixed parffin-embedded tissue blocks on 13 patients. CD138 expressing plasma cells were identified and quantitatively assessed for each tumor sample. Patients’ tumor tissues that expressed high levels of CD138 plasma cells (N = 4) had a statistically significant improvement in OS compared to low levels of CD138 (N = 9) (p = 0.01). Although these findings are preliminary, the significance of CD138 expressing plasma cells within BM specimens should be investigated in a larger cohort. Immunologic markers based on resection cavity analysis could be predictive for determining patient outcomes following cavity-directed SRS.
Highlights
We sought to identify candidate biomarkers for early brain metastasis (BM) recurrence in patients who underwent craniotomy followed by adjuvant stereotactic radiosurgery
A standard treatment option for limited brain metastases from solid tumor primaries is stereotactic radiosurgery (SRS), which allows for rapid treatment of brain metastases with preservation of cognition, but it is an expensive modality compared to its alternative, whole brain radiation therapy (WBRT) and often requires a specialized center[7,8,9,10]
Six of the original 8 patients had their formalin-fixed paraffin-embedded (FFPE) tissue evaluated by immunohistochemistry (IHC) and 7 additional patients with available FFPE tissues who had craniotomy and received adjuvant SRS were included in the study
Summary
We sought to identify candidate biomarkers for early brain metastasis (BM) recurrence in patients who underwent craniotomy followed by adjuvant stereotactic radiosurgery. RNA sequencing was performed on eight resected brain metastasis tissue samples and revealed B-cell related genes to be highly expressed in patients who did not experience a distant brain failure and had prolonged overall survival. Patients’ tumor tissues that expressed high levels of CD138 plasma cells (N = 4) had a statistically significant improvement in OS compared to low levels of CD138 (N = 9) (p = 0.01). These findings are preliminary, the significance of CD138 expressing plasma cells within BM specimens should be investigated in a larger cohort. How TILs influence the response of brain metastasis to SRS is not known
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