Background: Sinonasal undifferentiated carcinoma (SNUC) is a rare, highly aggressive cancer that
arises in the nasal cavity and paranasal sinuses. Despite aggressive multimodal therapy
the prognosis remains poor. To better manage patients with SNUC, identification of
survival predictors and new therapeutic options for SNUC treatments, including immunotherapy
are crucial. The aim of this study was to evaluate the signature of the tumor immune
microenvironment and analyze its correlation with clinical outcomes in SNUC.
Materials and Methods: Tumor samples from 14 previously untreated patients with confirmed diagnosis of SNUC
were included in this study. All the patients were treated at the University of Texas
MD Anderson Cancer Center, and the median follow-up period was 32.2 months (range:
8.1–176.2 months). Opal 7-color multiplex immunofluorescence for pan-cytokeratin,
CD3, CD8, PD-L1, CD68, CD56/NCAM (NK cell marker), and DAPI was performed. Tissue
identification, marker detection and data extraction were done using Visiopharm. Expression
of each marker versus overall survival (OS), response to induction chemotherapy, and
disease recurrence were assessed by Wilcoxon test, and the survival rate differences
were calculated using Log-Rank test.
Results: CD3+CD8+ double positive expression, which is a cytotoxic T-lymphocyte marker, in
stroma was found to be associated with OS rates; patients with higher CD3+CD8+ expression
in stroma had significantly better OS (p = 0.0029).
Conclusions: Our study showed that high expression of CD3+CD8+ in stroma was associated with better
survival rate in patients with SNUC. Investigating this cell population before starting
treatment might be important to manage patients with SNUC.
