Dynamics of the Tumor Immune Microenvironment during Neoadjuvant Chemotherapy of High-Grade Serous Ovarian Cancer

Yong Jae Lee, Ha Young Woo, Yoo Na Kim, Junsik Park, Eun Ji Nam, Sang Wun Kim, Sunghoon Kim, Young Tae Kim, Eunhyang Park, Je Gun Joung, Jung Yun Lee

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3 Citations (Scopus)


The dynamic changes in the tumor immune microenvironment (TIME) triggered by neoad-juvant chemotherapy (NAC) have not been clearly defined in advanced-stage ovarian cancer. We analyzed the immunologic changes induced by NAC to correlate them with clinical outcomes. We compared the changes in the immune infiltration of high-grade serous carcinoma biopsies before and after NAC via immunohistochemistry (147 paired samples) and whole transcriptome sequencing (35 paired samples). Immunohistochemistry showed significantly increased PD-L1 levels and TIL levels after NAC. Whole transcriptome sequencing revealed that the stromal score, immune score, and cytolytic activity score significantly increased after NAC. An increased tumor-infiltrating lymphocyte (TIL) level in response to NAC was associated with shorter progression-free survival compared with decreased TIL level after NAC. In tumors with increased TIL levels after NAC, the relative fraction of CD8 T cells and regulatory T cells significantly increased with immunohistochemistry. Post-NAC tumors were enriched in gene sets associated with immune signaling pathways, such as regulatory T cell and JAK/STAT signaling pathways. NAC induced dynamic changes in the TIME that increased TIL levels, but their high abundance did not impart any survival benefit. Our data may provide therapeutic strategies to improve the survival benefit from immunotherapies in ovarian cancer.

Original languageEnglish
Article number2308
Issue number9
Publication statusPublished - 2022 May 1

Bibliographical note

Funding Information:
Acknowledgments: This paper was supported by Bumsuk Academic Research Fund in 2020. This research was supported by the National Research Foundation of Korea (NRF), with a grant funded by the Korean government (MSIT) (NRF-2019R1F1A1061365).

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


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