Abstract 1687: Systemic immunological changes during first line chemotherapy in patients with high-grade serous ovarian cancer
Authors: Komdeur Fenne L. , Eggink Florine A. , Leffers Ninke , Workel Hagma H. , Brunekreeft Kim L. , Plat Annechien , Bruyn Marco de , Nijman Hans W. 
Published: July 2017

Abstract
Ovarian cancer remains the most lethal gynecological malignancy and new therapeutic strategies are urgently needed. High-grade serous ovarian cancer (HGSC), in particular, is associated with a five-year survival of only 40%. A promising new approach for treating HGSC is immunotherapy, which has resulted in complete and durable responses, albeit in a minority of patients. One potential approach for improving these response rates is by combining chemo- and immunotherapy. Indeed, carboplatin/taxol chemotherapy was shown to augment immune responses in cervical cancer patients by depleting circulating myeloid suppressor cells. As patients with HGSC are treated in first line with similar carboplatin/taxol chemotherapy, we explored the effects of chemotherapy on systemic immunity in HGSC patients. Within this prospective observational study, 75 patients with suspected ovarian cancer were included. Blood was collected at three different time points during first line chemotherapy treatment, namely: prior to chemotherapy, between the third and fourth cycle of chemotherapy and 4-6 weeks after the sixth cycle of chemotherapy. All patients received 6 cycles of carboplatin/taxol chemotherapy and cytoreductive surgery (either as primary debulking, or after 3 cycles of neo-adjuvant chemotherapy). Peripheral blood mononuclear cells were isolated and analyzed for a total of 36 immune markers using 9 flow cytometry panels, in total analyzing 49 immune cell subsets. Results were compared to an age-matched cohort consisting of women surgically treated for a benign disease, and a cohort of healthy young volunteers. 75 patients have been included so far from which 22 were diagnosed with benign disease, 3 were diagnosed with another malignancy, and 50 were diagnosed with OC. Of the 50 OC patients, 18 were diagnosed with HGSC and from 9 HGSC patients, multiple time points were available for analysis of chemotherapy-dependent changes in the immune cell subsets. All patients developed leukopenia as a result of chemotherapeutic treatment. Age-related changes in lymphocyte and myeloid cell subsets were observed in all HGSC patients and patients with benign disease. Chemotherapy-dependent depletion of myeloid cells was observed in a subset of patients. Depletion of myeloid subsets was equally distributed among monocytes, macrophages and dendritic cells. No HGSC- or chemotherapy-dependent changes in T cell subsets or migration and activation markers were observed. Taken together, we observed no major systemic changes in immune cell subsets during carboplatin/taxol chemotherapy treatment, suggesting that combined chemo-immunotherapeutic strategies could be feasible during first line treatment of HGSC.
Citation Format: Fenne L. Komdeur, Florine A. Eggink, Ninke Leffers, Hagma H. Workel, Kim L. Brunekreeft, Annechien Plat, Marco de Bruyn, Hans W. Nijman. Systemic immunological changes during first line chemotherapy in patients with high-grade serous ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 1687. doi:10.1158/1538-7445.AM2017-1687