Multispectral Immunofluorescence Analysis of the Esthesioneuroblastoma Tumor Immune Microenvironment Reveals T-Cell Stroma Localization and Tumor Parenchyma Exclusion

Background: Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare malignancy of the anterior skull base. The mainstay of treatment is surgery followed by adjuvant radiation; however, treatment options are limited for recurrent or metastatic disease. Multispectral immunofluorescence (mxIF) allows for comprehensive evaluation of tumor immune cell spatial relationships with seven channels simultaneously and thorough characterization of the tumor immune microenvironment (TIME). The objective of this study was to comprehensively define the ENB T cell TIME with mxIF to identify new immunotherapeutic treatment strategies to improve ENB patient outcomes.