Abstract 4643
Background
Tumor infiltrating lymphocytes (TILs) and PD-L1 expression have been previously associated with early stage NSCLC prognosis. Most data refer to intra-tumoral (IT) lymphocytes, while evidence on the prognostic role of the tumor immune microenvironment (TME) as a whole is lacking. Moreover, a combined immuno-score (IS) including more than two markers, is currently not available. We investigated the prognostic impact of PD-L1 expression and different immune cell infiltrates (CD3+CD4+, CD3+CD8+ T-lymphocytes and CD68+ macrophages) at peritumoral (PT) and IT level.
Methods
Surgical specimens from chemo-naive stage II-III NSCLC patients radically resected between 2015 and 2017 were analyzed. Immunohistochemistry was carried out to evaluate PD-L1 expression (low <50%, high³50%), and to quantify IT, PT and total CD3+CD4+, CD3+CD8+ T-lymphocytes and CD68+ macrophages. The impact of single marker and of a combination of multiple significant markers on overall survival (OS) was investigated.
Results
Preliminary data of 79 patients are reported; eligible cases were 51(65%) adenocarcinoma and 28(35%) squamous cell carcinoma, 31(39%) stage II and 48(61%) stage III. Median follow-up was 2.5 years. Higher PD-L1 expression identified cases with worse prognosis (2.5 years OS 58% in high compared with 74% in low expressing tumors), even though without statistical significance. Shorter OS was observed in cases with higher PT CD3+CD8 + (p = 0.015), CD3+CD4 + (p = 0.047) and CD68 + (p = 0.047). These three parameters were put together into a combined IS (2/3 low: low, 2/3 high: high) which confirmed a prognostic stratification of evaluated patients (2.5 years OS 96% vs 63% respectively in low and high IS, p = 0.004), also at multivariate analysis. The prognostic impact of combined IS within each pathologic stage was confirmed. IT T-lymphocytes and macrophages infiltrate did not show a negative prognostic impact; 2.5 years OS of 94% vs 67% (p = 0,033) was observed in highe and lower PT-CD8+/IT-CD8+ ratio, respectively.
Conclusions
The amount of PT T-lymphocytes and macrophages might allow early-stage NSCLC patients prognostic stratification for adjuvant strategy plan, especially within a combined immuno-score including multiple TME actors.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Istituto Oncologico Veneto IRCCS.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5444 - Analysis of the tumor microenvironment and tumor genotype through different stages of lung adenocarcinoma
Presenter: Peter Zink
Session: Poster Display session 1
Resources:
Abstract
3124 - Does Progress achieved in the Treatment of Patients with Metastatic Non-Small-Cell Lung Cancer (NSCLC) reach the Elderly Population?
Presenter: Jorune Suipyte
Session: Poster Display session 1
Resources:
Abstract
5142 - Prognostic factors for non-small cell lung cancer patients with driver mutation negative and brain metastases (HOT 1701)
Presenter: Yoshihito Ohhara
Session: Poster Display session 1
Resources:
Abstract
1580 - A novel risk classification system based on nomogram scores to predict survival of patients presenting with brain metastases at the first diagnosis of NSCLC
Presenter: Pengfei Cui
Session: Poster Display session 1
Resources:
Abstract
4442 - Comparison of real-world response rate (rwRR) to RECIST-based response rate in patients with advanced non-small cell lung cancer (aNSCLC)
Presenter: Xinran Ma
Session: Poster Display session 1
Resources:
Abstract
5405 - Estimating the cost and survival impact of new aNSCLC therapies in Canada with the iTEN model
Presenter: Parneet Kaur Cheema
Session: Poster Display session 1
Resources:
Abstract
1893 - SMARCA4 Deficient Non-Small Cell Lung Cancer (NSCLC): A Comprehensive Genomic Profiling (CGP) Study
Presenter: Stephen Graziano
Session: Poster Display session 1
Resources:
Abstract
5582 - Exploring Resistance to Nivolumab [NIV] applying an Immune Genomic Signature (IGS) in advanced pretreated NSCLC [PRINCiPe study]
Presenter: Sara Pilotto
Session: Poster Display session 1
Resources:
Abstract
1408 - DNA damage repair deficiency is associated with early resistance to crizotinib: whole-genome analysis in non-small cell lung cancer patients with ALK-fusion
Presenter: Dongyun He
Session: Poster Display session 1
Resources:
Abstract
5751 - Phase 3 ALTA-3 study of brigatinib (BRG) vs alectinib (ALC) in patients (pts) with advanced anaplastic lymphoma kinase (ALK)−positive non–small cell lung cancer (NSCLC) that progressed on crizotinib (CRZ)
Presenter: Sanjay Popat
Session: Poster Display session 1
Resources:
Abstract