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Multicenter Study
. 2023 Jun;54(2):662-671.
doi: 10.1007/s12029-022-00850-y. Epub 2022 Aug 1.

The Prognostic Role of Baseline Eosinophils in HPV-Related Cancers: a Multi-institutional Analysis of Anal SCC and OPC Patients Treated with Radical CT-RT

Margherita Rimini  1 , Pierfrancesco Franco  2 , Federica Bertolini  3 , De Bari Berardino  4   5 , Zampino Maria Giulia  6 , Vegge Stefano  7 , Kalliopi Andrikou  8 , Francesca Arcadipane  9 , Martina Napolitano  3 , Lavajo Vieira Buno  4 , Gerardi Marianna Alessandra  6 , Francesco Olivero  9 , Filippo Ferreri  9 , Umberto Ricardi  9 , Stefano Cascinu  1 , Andrea Casadei-Gardini  1
Affiliations
Multicenter Study

The Prognostic Role of Baseline Eosinophils in HPV-Related Cancers: a Multi-institutional Analysis of Anal SCC and OPC Patients Treated with Radical CT-RT

Margherita Rimini et al. J Gastrointest Cancer. 2023 Jun.

Abstract

Background and aim: Anal squamous cell carcinoma (SCC) and oropharyngeal cancer (OPC) are rare tumors associated with HPV infection. Bioumoral predictors of response to chemoradiation (CT-RT) are lacking in these settings. With the aim to find new biomarkers, we investigated the role of eosinophils in both HPV-positive anal SCC and HPV-related oropharyngeal cancer (OPC).

Methods: We retrieved clinical and laboratory data of patients with HPV-positive anal SCC treated with CT-RT in 5 institutions, and patients with locally advanced OPC SCC treated with CT-RT in 2 institutions. We examined the association between baseline eosinophil count (the best cutoff has been evaluated by ROC curve analysis: 100 × 10^9/L) and disease-free survival (DFS). Unadjusted and adjusted hazard ratios by baseline characteristics were calculated using the Cox proportional hazards model.

Results: Three hundred four patients with HPV-positive anal SCCs and 168 patients with OPCs (122 HPV-positive, 46 HPV-negative diseases) were analyzed. In anal SCC, low eosinophil count (< 100 × 10^9/L) correlates to a better DFS (HR = 0.59; p = 0.0392); likewise, in HPV-positive OPC, low eosinophil count correlates to a better DFS (HR = 0.50; p = 0.0428). In HPV-negative OPC, low eosinophil count confers worse DFS compared to high eosinophil count (HR = 3.53; p = 0.0098). After adjustment for age and sex, eosinophils were confirmed to be independent prognostic factors for DFS (HR = 4.55; p = 0.0139).

Conclusion: Eosinophil count could be used as a prognostic factor in anal HPV-positive SCC. The worse prognosis showed in HPV-positive patients with high eosinophil count is likely to derive from an unfavorable interaction between the HPV-induced immunomodulation and eosinophils, which may hamper the curative effect of RT.

Keywords: Chemoradiotherapy; Eosinophils; HPV; Oropharyngeal cancer; Prognostic factor; Squamous cell anal cancer.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curves for DFS in the anal cancer cohort (A), HPV-positive head and neck cancer cohort (B), HPV-negative head and neck cancer cohort (C)
Fig. 2
Fig. 2
Kaplan–Meier curves for DFS according to the HPV status (HPV-positive vs HPV-negative in OPC cohort of patients)
See this image and copyright information in PMC

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