Abstract 4976: Combining measures of immune infiltration uncovers predictors of survival in high-grade serous ovarian cancer

Background: In colorectal and breast cancer, the density and localization of immune infiltrates provides strong prognostic information. We asked whether similar automated quantitation and combined analysis of immune infiltrates could refine prognostic information in high-grade serous ovarian carcinoma (HGSOC) and tested associations between patterns of immune response and genomic driver alterations. Methods and Findings: Epithelium and stroma were semi-automatically segmented and the infiltration of CD45RO+, CD8+ and CD68+ cells was automatically quantified from images of 332 HGSOC patient tissue microarray cores. Epithelial CD8 (p=0.027, HR=0.83), stromal CD68 (p=3 × 10-4, HR=0.44) and stromal CD45RO (p=7 × 10-4, HR=0.76) were positively associated with survival and remained so when averaged across the tumor and stromal compartments.Using principal component analysis (PCA), we identified optimized multiparameter survival models that combined information from all immune markers (p=0.016, HR=0.88). There was no significant association between PTEN expression, type of TP53 mutation or presence of BRCA1/BRCA2 mutations and immune infiltrate densities or principal components. Conclusions: Combining measures of immune infiltration provided improved survival modeling and evidence for the multiple effects of different immune factors on survival. The presence of stromal CD68+ and CD45RO+ populations was strongly associated with survival, underscoring the benefits that evaluating stromal immune populations may bring for prognostic immunoscores in HGSOC. Citation Format: Anne Montfort, Steph J. Owen, Anna M. Piskorz, Anna Supernat, Luiza Moore, Sarwah Al-Khalidi, Steffen Boehm, Paul Pharoah, Jacqueline McDermott, Frances R. Balkwill, James D. Brenton. Combining measures of immune infiltration uncovers predictors of survival in high-grade serous ovarian cancer [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4976.