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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

3682 - Pathologic assessment following neoadjuvant immunotherapy or chemotherapy demonstrates similar patterns in non-small cell lung cancer (NSCLC)

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Presenters

Annikka Weissferdt

Citation

Annals of Oncology (2018) 29 (suppl_8): viii670-viii682. 10.1093/annonc/mdy304

Authors

A. Weissferdt1, B. Sepesi2, A. Pataer2, N. Kalhor1, C.A. Moran1, W.N. William3, X. Le3, B. Glisson3, F. Skoulidis4, G. Blumenschein5, J. Zhang3, M. Altan6, D. Rice2, R. Mehran2, J.J. Lee7, A. Vaporciyan2, D.L. Gibbons8, S.G. Swisher2, J.V. Heymach3, T. Cascone9

Author affiliations

  • 1 Pathology, The University of Texas MD Anderson Cancer Center, 77030-4095 - Houston/US
  • 2 Thoracic And Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, 77030 - Houston/US
  • 3 Thoracic/head And Neck Medical Oncology, MD Anderson Cancer Center, 77030-4095 - Houston/US
  • 4 Thoracic And Head And Neck Medical Oncology, UT MD Anderson Cancer Center, TX 77030 - Houston/US
  • 5 Thoracic/head And Neck Medical Oncology, MD Anderson Cancer Center, Houston/US
  • 6 Thoracic/ Head And Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 77030-4095 - Houston/US
  • 7 Biostastistics, MD Anderson Cancer Center, 77030-4095 - Houston/US
  • 8 Thoracic Head And Neck, MD ANDERSON CANCER CENTER, 77030 - HOUSTON/US
  • 9 Thoracic Head And Neck Medical Oncology, MD Anderson Cancer Center, TX 77030 - Houston/US
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Resources

Abstract 3682

Background

Neoadjuvant chemotherapy (CT) and immunotherapy (IT) are associated with features of pathologic treatment response (PTR) in NSCLC. Comparison of such features in NSCLC following neoadjuvant CT, IT or upfront surgical resection is lacking. Nivolumab (N) and/or N plus ipilumumab (NI) are being investigated in resectable NSCLC (NCT03158129). We analyzed the histopathologic patterns of CT- and IT-treated NSCLC vs untreated surgically resected tumors.

Methods

Histopathologic assessment of untreated, CT- and IT-treated NSCLC was performed (n = 30, 10/group). Hematoxylin and eosin-stained tumor sections were scored for parameters of PTR: percentage of viable tumor, fibrosis, and necrosis; inflammation, tertiary lymphoid structures (TLS), macrophages, lymphovascular invasion (LVI), cholesterol clefts (CC), giant cells (GC) and neovascularization (NV) were reported as a score (0-3). Values for each variable were expressed as a mean (± SD). Statistical comparison between two groups was calculated with unpaired two-sided t-test. Significance was defined as p-value <0.05.

Results

CT and IT were associated with significantly less viable tumor cells (p = 0.04 and p = 0.02, respectively), IT with more fibrosis (p = 0.04) and CT with more CC (p = 0.03) than untreated tumors. Trends towards higher amounts of inflammation, macrophages and CC were seen in IT-treated compared to untreated tumors. CT had a trend towards more fibrosis and GC compared with untreated NSCLC (Table).Table: 1928P

Summary of PTR parameters

UntreatedCT-treatedIT-treated
Viable tumor67.7%42.4%*37.5%*
Fibrosis26.6%46.6%52.3%*
Necrosis5.6%11.0%10.1%
Inflammation1.461.541.87
TLS0.801.001.00
LVI0.230.160.33
Macrophages0.120.941.17
CC0.130.92*1.04
GC0.400.800.70
NV000
*

p-value <0.05

Conclusions

Neoadjuvant CT and IT are associated with similar histopathological changes compared to untreated tumors but with lower proportions of viable tumor and higher degrees of fibrosis. Neoadjuvant treatment is also associated with a trend towards higher amounts of inflammation, macrophages, CC and GC. Analysis of a larger cohort, including comparison of N- vs NI-treated tumors (estimated n = 80) is ongoing and will be presented in due course.

Clinical trial identification

NCT03158129.

Legal entity responsible for the study

University of Texas MD Anderson Cancer Center.

Funding

The University of Texas MD Anderson Lung Cancer Moon Shot Program, Bristol-Myers Squibb.

Editorial Acknowledgement

Disclosure

B. Glisson: Research funding to institution: Medimmune, Pfizer, ISA Pharmaceuticals, Abbvie. G. Blumenschein: Consulting/advisory role: Bristol-Myers Squibb, Bayer, Clovis, Merck, Celgene, AbbVie, ARIAD; Research funding: Bristol-Myers Squibb, Novartis, Xcovery, AstraZeneca, Adaptimmune, Immatics, Macrogenetics, Bayer, Merck, Celegene, Genentech, GlaxoSmithKline, Kite Pharma; Travel, accomodations, expenses: BMS, AbbVie, Merck. J.V. Heymach: Advisory board: Bristol-Myers Squibb; Research/Grant: Bristol-Myers Squibb. All other authors have declared no conflicts of interest.

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