Microwave ablation enhances tumor-specific immune response in patients with hepatocellular carcinoma

• DOI: 10.1007/s00262-020-02734-1
• Publication Date: 2020-10-02T12:03:01Z
• Authors: Katharina Leuchte; Elena Staib; Martin Thelen; Philipp Gödel; Axel Lechner; Peter Zentis; Maria Garcia-Marquez; Dirk Waldschmidt; Rabi Raj Datta; Roger Wahba; Christian Wybranski; Thomas Zander; Alexander Quaas; Uta Drebber; Dirk Ludger Stippel; Christiane Bruns; Michael von Bergw...; Kerstin Wennhold; Hans Anton Schlößer
• Keywords: Adult; Aged, 80 and over; Male; Carcinoma, Hepatocellular; Liver Neoplasms; Immunity; Middle Aged; Prognosis; 3. Good health; Survival Rate; 03 medical and health sciences; 0302 clinical medicine; Liver Neoplasms/surgery [MeSH] ; Carcinoma, Hepatocellular/immunology [MeSH] ; Aged, 80 and over [MeSH] ; Aged [MeSH] ; Antigens ; Liver Neoplasms/immunology [MeSH] ; Original Article ; Liver Neoplasms/pathology [MeSH] ; Carcinoma, Hepatocellular/surgery [MeSH] ; Male [MeSH] ; Immunogenic cell death ; Female [MeSH] ; Follow-Up Studies [MeSH] ; Adult [MeSH] ; Humans [MeSH] ; Prospective Studies [MeSH] ; Carcinoma, Hepatocellular/pathology [MeSH] ; Catheter Ablation/methods [MeSH] ; Middle Aged [MeSH] ; Survival Rate [MeSH] ; Microwaves/therapeutic use [MeSH] ; Immunity/immunology [MeSH] ; Immunotherapy ; Prognosis [MeSH] ; Abscopal effect; Catheter Ablation; Humans; Original Article; Female; Prospective Studies; Microwaves; Aged; Follow-Up Studies

AbstractThermal ablative therapies are standard treatments for localized hepatocellular carcinoma (HCC). In addition to local tumor destruction, ablation leads to abscopal effects in distant lesions most likely mediated by an anti-tumor immune response. Although microwave ablation (MWA) is increasingly substituting other ablative techniques, its systemic immunostimulatory effects are poorly studied. We analyzed tumor-specific immune responses in peripheral blood of HCC patients after thermal ablation with regard to T cell responses and disease outcome. While comprehensive flow cytometric analyses in sequential samples of a prospective patient cohort (n = 23) demonstrated only moderate effects of MWA on circulating immune cell subsets, fluorospot analyses of specific T cell responses against seven tumor-associated antigens (TTAs) revealed de-novo or enhanced tumor-specific immune responses in 30% of patients. This anti-tumor immune response was related to tumor control as Interferon-y and Interleukin-5 T cell responses against TAAs were more frequent in patients with a long-time remission (> 1 year) after MWA (7/16) compared to patients suffering from an early relapse (0/13 patients) and presence of tumor-specific T cell response (IFN-y and/or IL-5) was associated to longer progression-free survival (27.5 vs. 10.0 months). Digital image analysis of immunohistochemically stained archival HCC samples (n = 18) of patients receiving combined MWA and resection revealed a superior disease-free survival of patients with high T cell abundance at the time of thermal ablation (37.4 vs. 13.1 months). Our data demonstrates remarkable immune-related effects of MWA in HCC patients and provides additional evidence for a combination of local ablation and immunotherapy in this challenging disease.