PD-L1 and HIF-2α Upregulation in Head and Neck Paragangliomas after Embolization

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Alessa Fischer - , University Hospital Zurich (USZ) and University of Zurich (UZH) (Author)
  • Umberto Maccio - , University Hospital Zurich (Author)
  • Katharina Wang - , Hospital of the Ludwig-Maximilians-University (LMU) Munich (Author)
  • Juliane Friemel - , University Hospital Zurich (Author)
  • Martina A Broglie Daeppen - , University Hospital Münster (Author)
  • Diana Vetter - , University Hospital Münster (Author)
  • Kuno Lehmann - , University Hospital Münster (Author)
  • Astrid Reul - , University Hospital Zurich (USZ) and University of Zurich (UZH) (Author)
  • Mercedes Robledo - , Hereditary Endocrine Cancer Group. Spanish National Cancer Research Center (CNIO) (Author)
  • Constanze Hantel - , Department of internal Medicine 3, University Hospital Zurich, University Hospital Carl Gustav Carus Dresden (Author)
  • Nicole Bechmann - , Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus Dresden (Author)
  • Karel Pacak - , Eunice Kennedy Shriver National Institute of Child Health and Human Development (Author)
  • Kathrin Zitzmann - , Hospital of the Ludwig-Maximilians-University (LMU) Munich (Author)
  • Christoph J Auernhammer - , Hospital of the Ludwig-Maximilians-University (LMU) Munich (Author)
  • Ashley B Grossman - , University of Oxford (Author)
  • Felix Beuschlein - , University Hospital Zurich (USZ) and University of Zurich (UZH) (Author)
  • Svenja Nölting - , University Hospital Zurich (USZ) and University of Zurich (UZH) (Author)

Abstract

Hypoxia activates pathways associated with tumor progression, metastatic spread, and alterations in the immune microenvironment leading to an immunosuppressive phenotype. In particular, the upregulation of PD-L1, a target for therapy with checkpoint inhibitors, is well-studied in several tumors. However, the relationship between hypoxia and PD-L1 regulation in pheochromocytomas and paragangliomas (PPGL), and especially in paragangliomas treated with embolization, is still largely unexplored. We investigated the expression of the hypoxia-marker HIF-2α and of PD-L1 in a PPGL-cohort with and without embolization as potential biomarkers that may predict the response to treatment with HIF-2α and checkpoint inhibitors. A total of 29 tumor samples from 25 patients who were operated at a single center were included and analyzed utilizing immunohistochemistry (IHC) for PD-L1 and HIF-2α. Embolization prior to surgery was performed in seven (24%) tumors. PD-L1 expression in tumor cells of head and neck paragangliomas (HNPGLs) receiving prior embolization (median PD-L1 positivity: 15%) was significantly higher as compared to PD-L1 expression in HNPGLs without prior embolization (median PD-L1 positivity: 0%) (p = 0.008). Consistently, significantly more HNPGLs with prior embolization were positive for HIF-2α (median nuclear HIF-2α positivity: 40%) as compared to HNPGLs without prior embolization (median nuclear HIF-2α positivity: 0%) (p = 0.016). Our results support the hypothesis that embolization with subsequent hypoxia leads to the upregulation of both PD-L1 and HIF-2α in HNPGLs, and could thus facilitate targeted treatment with HIF-2α and checkpoint inhibitors in the case of inoperable, locally advanced, or metastatic disease.

Details

Original languageEnglish
Article number5199
JournalCancers
Volume15
Issue number21
Publication statusPublished - 29 Oct 2023
Peer-reviewedYes

External IDs

PubMedCentral PMC10650267
Scopus 85176598384
ORCID /0000-0002-6932-333X/work/148144946

Keywords