Abstract
Melanoma associated antigens (MAGE) are potential targets for immunotherapy and have been associated with poor overall survival (OS) in head and neck squamous cell carcinoma (HNSCC). However, little is known about MAGE in lymph node metastases (LNM) and recurrent disease (RD) of HNSCC.To assess whether MAGE expression increases with metastasis or recurrence, a tissue microarray (TMA) of 552 primary tumors (PT), 219 LNM and 75 RD was evaluated by immunohistochemistry for MAGE antigens using three monoclonal antibodies to multiple MAGE family members. Mean expression intensity (MEI) was obtained from triplicates of each tumor specimen.The median MEI compared between PT, LNM and RD was significantly higher in LNM and RD. In paired samples, MEI was comparable in PT to respective LNM, but significantly different from RD. Up to 25% of patients were negative for pan-MAGE or MAGE-A3/A4 in PT, but positive in RD. The prognostic impact of MAGE expression was validated in the TMA cohort and also in TCGA data (mRNA). OS was significantly lower for patients expressing pan-MAGE or MAGE-A3/A4 in both independent cohorts.MAGE expression was confirmed as a prognostic marker in HNSCC and may be important for immunotherapeutic strategies as a shared antigen.
Highlights
Head and neck squamous cell carcinoma (HNSCC) of the oral cavity, pharynx and larynx combined account for 60,000 new cases of malignant tumors and 12,000 tumor related deaths annually in the USA, with comparable numbers in Europe [1,2,3]
To assess whether Melanoma associated antigens (MAGE) expression increases with metastasis or recurrence, a tissue microarray (TMA) of 552 primary tumors (PT), 219 lymph node metastases (LNM) and 75 recurrent disease (RD) was evaluated by immunohistochemistry for MAGE antigens using three monoclonal antibodies to multiple MAGE family members
Cancer-testis antigens (CTA) are a group of immunogenic tumor antigens, which can be detected in different cancers, but not in healthy normal tissue except for human testis [8, 9]
Summary
Head and neck squamous cell carcinoma (HNSCC) of the oral cavity, pharynx and larynx combined account for 60,000 new cases of malignant tumors and 12,000 tumor related deaths annually in the USA, with comparable numbers in Europe [1,2,3]. The prognosis of HNSCC patients remains unsatisfactory with 5-year overall survival rates of approximately 50–65% without significant improvement in the last decades [4]. A subset of HNSCC patients treated with checkpoint blockade therapy experience clinical benefit [5,6,7]. Cancer-testis antigens (CTA) are a group of immunogenic tumor antigens, which can be detected in different cancers, but not in healthy normal tissue except for human testis [8, 9]. Their restricted expression and immunogenicity make them good candidates to assess as shared targets of immunotherapy
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