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
5011 - LCSCAF1 maintains cancer stem-like traits by stabilizing c-Myc protein and promotes metastasis and recurrence in lung cancer
Presenter: Tao Guo
Session: Poster Display session 1
Resources:
Abstract
4955 - XAF1 Enhances Temozolomide Induced Autophagic Cell Death through AMPK signaling pathway
Presenter: Mingoo Lee
Session: Poster Display session 1
Resources:
Abstract
5616 - The effect of cortisol on methylation patterns in breast cancer cell lines
Presenter: Haya Intabli
Session: Poster Display session 1
Resources:
Abstract
4649 - Global and sex-specific epigenome-wide association studies for the identification of the main methylated loci related to smoking in a Mediterranean population
Presenter: Judith Begona Ramirez Sabio
Session: Poster Display session 1
Resources:
Abstract
4984 - Whole transcriptomics analyses of mimicking Circulating Tumor Cells (CTCs) by single-cell RNA sequencing (scRNAseq)
Presenter: Jessica Garcia
Session: Poster Display session 1
Resources:
Abstract
5926 - Comparison of enzymatic- and bisulfite conversion to map the plasma cell-free methylome in cancer
Presenter: Nicole Lambert
Session: Poster Display session 1
Resources:
Abstract
5454 - Detection of low mutations in hepatocellular carcinoma by using circulating tumor DNA
Presenter: Esl Kim
Session: Poster Display session 1
Resources:
Abstract
4428 - Variants in the JAK1 and JAK2 genes in the risk and prognosis of patients with cutaneous melanoma
Presenter: Bruna Carvalho
Session: Poster Display session 1
Resources:
Abstract
4409 - P-Rex1 expression in breast cancer patients.
Presenter: Angela Lara Montero
Session: Poster Display session 1
Resources:
Abstract
4185 - Modulation of Risk of Cutaneous Melanoma Patients by Variants in STAT3 Gene and Functional Analysis
Presenter: Gabriela Gomez
Session: Poster Display session 1
Resources:
Abstract