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Swati Sonal, MBBS




Research Fellow




Postdoctoral Research Fellow




Swati Sonal MBBS, Vikram Deshpande MBBS MD, David T. Ting MD, Azfar Neyaz MBBS MD, Amaya Pankaj MBBS, Martin S. Taylor MD PhD, Anne M. Dinaux MD PhD, Lieve G.J. Leijssen MD PhD, Aparna R. Parikh MD MS, Chloe Boudreau, Hiroko Kunitake MD MPH, Robert N. Goldstone MD, Christy E. Cauley MD MPH, Liliana G. Bordeianou MD MPH, Rocco Ricciardi MD MPH, David L. Berger MD*

Immunological basis of recurrence in colorectal cancer

I am a medical doctor from India pursuing a research fellowship in General & GI Surgery at the MGH under the leadership of Dr David Berger. I aspire to be a Surgeon-Scientist and my research interests include clinical outcomes and the translational aspects of clinico-pathological characteristics in colorectal cancer. I believe that this symposium would be a great platform to share my work among other scientists with a shared vision of excellence for women. I hope to be inspired and learn leadership skills from the incredible women in various fields and celebrate the career advancement of women physicians and scientists.

Background: This study aims to assess the expression of immune markers in non-metastatic colorectal cancers that recur after curative treatment and compare them to cancers that do not recur.

Methods: Tissue microarrays (TMAs) obtained from colorectal cancer surgical pathology specimens were stained for immune cells (CD8, FOXP3, LAG3, PU1, and PDL1); HLA I, Beta 2 Microglobulin, and HC10 on tumor cells; BRAFV600E mutation; and DNA mismatch repair (MMR) proteins. Stage I-III primary tumors which recurred/metastasized were compared to tumors which did not recur within 5 years of surgery. A logistic regression model was fit to assess the predictive effect of biomarkers on tumor recurrence.

Results: There were 141 tumors which recurred and 494 tumors which did not recur. We found a significantly lower expression of CD8, LAG3, FOXP3, PU1 and PDL1 immune cells in tumors which recurred (p<0.05). Based on multivariate analysis, only low PDL1 immune cells (adjusted OR 1.86, 1.12-3.10) predicted tumor recurrence.

Conclusion: Tumors which recur after curative surgery are associated with a state of low baseline immune response. Low expression of PDL1 on immune cells in the tumor microenvironment seems to be the most crucial prognostic biomarker associated with tumor recurrence.