摘要：SummaryAlthough tobacco use is an independent adverse prognostic feature in HPV(+) oropharyngeal squamous cell carcinoma (OPSCC), the biologic features associated with tobacco use have not been systematically investigated. We characterized genomic and immunologic features associated with tobacco use through whole exome sequencing, mRNA hybridization, and immunohistochemical staining in 47 HPV(+) OPSCC tumors. Low expression of transcripts in a T cell-inflamed gene expression profile (TGEP) was associated with tobacco use at diagnosis and lower overall and disease-free survival. Tobacco use was associated with an increased proportion of T > C substitutions and a lower proportion of expected mutational signatures, but not with increases in mutational burden or recurrent oncogenic mutations. Our findings suggest that rather than increased mutational burden, tobacco’s primary and clinically relevant association in HPV(+) OPSCC is immunosuppression of the tumor immune microenvironment. Quantitative assays of T cell infiltration merit further study as prognostic markers in HPV(+) OPSCC.Graphical abstractDisplay OmittedHighlights•Biologic features of tobacco use in HPV(+) OPSCC not previously described in a systematic fashion•Tobacco use was not associated with increased mutational burden or oncogenic mutations•Tobacco use was associated with low T-cell infiltration of primary TIME•In HPV(+) OPSCC, the major biologic effect of tobacco exposure is an immunosuppressed TIMEOncology; Immunology; Genomics
