Racial Differences in the Tumor Immune Landscape and Survival of Women with High-Grade Serous Ovarian Carcinoma

Lauren C. Peres, Christelle Colin-Leitzinger, Sweta Sinha, Jeffrey R. Marks, Jose R. Conejo-Garcia, Anthony J. Alberg, Elisa V. Bandera, Andrew Berchuck, Melissa L. Bondy, Brock C. Christensen, Michele L. Cote, Jennifer Anne Doherty, Patricia G. Moorman, Edward S. Peters, Carlos Moran Segura, Jonathan V. Nguyen, Ann G. Schwartz, Paul D. Terry, Christopher M. Wilson, Brooke L. FridleyJoellen M. Schildkraut

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Tumor-infiltrating lymphocytes (TIL) confer a survival benefit among patients with ovarian cancer; however, little work has been conducted in racially diverse cohorts. Methods: The current study investigated racial differences in the tumor immune landscape and survival of age- and stage-matched non-Hispanic Black and non-Hispanic White women with high-grade serous ovarian carcinoma (HGSOC) enrolled in two population-based studies (n ¼ 121 in each racial group). We measured TILs (CD3þ), cytotoxic T cells (CD3þCD8þ), regulatory T cells (CD3þFoxP3þ), myeloid cells (CD11bþ), and neutrophils (CD11bþCD15þ) via multiplex immunofluorescence. Multivariable Cox proportional hazard regression was used to estimate the association between immune cell abundance and survival overall and by race. Results: Overall, higher levels of TILs, cytotoxic T cells, myeloid cells, and neutrophils were associated with better survival in the intratumoral and peritumoral region, irrespective of tissue compartment (tumor, stroma). Improved survival was noted for T-regulatory cells in the peritumoral region and in the stroma of the intratumoral region, but no association for intratumoral T-regulatory cells. Despite similar abundance of immune cells across racial groups, associations with survival among non-Hispanic White women were consistent with the overall findings, but among non-Hispanic Black women, most associations were attenuated and not statistically significant. Conclusions: Our results add to the existing evidence that a robust immune infiltrate confers a survival advantage among women with HGSOC; however, non-Hispanic Black women may not experience the same survival benefit as non-Hispanic White women with HGSOC. Impact: This study contributes to our understanding of the immunoepidemiology of HGSOC in diverse populations.

Original languageEnglish (US)
Pages (from-to)1006-1016
Number of pages11
JournalCancer Epidemiology Biomarkers and Prevention
Issue number5
StatePublished - May 2022

ASJC Scopus subject areas

  • Epidemiology
  • Oncology


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