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Poster Display session 3

4692 - Immune cell biomarkers on neo-adjuvant chemo-immunotherapy treatment for resectable stage IIIA NSCLC patients

Date

30 Sep 2019

Session

Poster Display session 3

Topics

Immunotherapy

Tumour Site

Non-Small Cell Lung Cancer

Presenters

Raquel Laza-Briviesca

Citation

Annals of Oncology (2019) 30 (suppl_5): v475-v532. 10.1093/annonc/mdz253

Authors

R. Laza-Briviesca1, A. Cruz-Bermudez1, M. Casarrubios1, E. Nadal2, M.A. Insa Molla3, M. García-Campelo4, G. Huidobro5, M. Domine Gomez6, M. Majem Tarruella7, D. Rodriguez Abreu8, A. Martinez-Marti9, J. De Castro Carpeno10, M. Cobo Dols11, G. López Vivanco12, E. del Barco Morillo13, R. Bernabé14, N. Viñolas15, I.C. Barneto Aranda16, B. Massuti17, M. Provencio1

Author affiliations

  • 1 Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, 28222 - Majadahonda/ES
  • 2 Oncology, Institut Catala d'Oncologia (ICO), 08907 - Barcelona/ES
  • 3 Medical Oncology, Hospital Clinico Universitario de Valencia, 46010 - Valencia/ES
  • 4 Medical Oncology Department, Complejo Hospitalario Universitario A Coruna (CHUAC), 15006 - La Coruña/ES
  • 5 Dept. Medical Oncology, Hospital Universitario Alvaro Cunqueiro, 36312 - Vigo/ES
  • 6 Department Of Medical Oncology, University Hospital "Fundacion Jimenez Diaz", 28040 - Madrid/ES
  • 7 Department Of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona/ES
  • 8 Medical Oncology, Hospital Universitario Insular de Gran Canaria, 35016 - Las Palmas/ES
  • 9 Medical Oncology, Vall d'Hebron Institute of Oncology and University Hospital, 08019 - Barcelona/ES
  • 10 Medical Oncology, Hospital Universitario La Paz, Madrid/ES
  • 11 Medical Oncology, Hospital Regional Universitario de Málaga, 29009 - Málaga/ES
  • 12 Medical Oncology, Hospital Universitario Cruces, 48903 - Barakaldo/ES
  • 13 Department Of Medical Oncology, Hospital Universitario de Salamanca, Salamanca/ES
  • 14 Oncology Department, Hospital Universitario Virgen del Rocío, 41013 - Sevilla/ES
  • 15 Dept. Medical Oncology, Hospital Clinic de Barcelona, 08036 - Barcelona/ES
  • 16 Medical Oncology, University Hospital Reina Sofia, 14004 - Cordoba/ES
  • 17 Department Of Medical Oncology, Hospital General Universitario de Alicante, 03010 - Alicante/ES

Resources

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Abstract 4692

Background

Immunotherapy has become the main therapy in advanced NSCLC patients, but recently, combination with chemotherapy in locally advanced stages is showing promising results. Many studies have described peripheral blood immune cells parameters as response biomarkers. In our study, we described the effect of neo-adjuvant chemo-immunotherapy treatment in Complete Blood Count (CBC) and Peripheral blood mononuclear cells phenotype, as well as, the association of these parameters with pathological response.

Methods

46 resectable stage IIIA NSCLC patients treated with neo-adjuvant chemo-immunotherapy from NADIM clinical trial were analysed. Samples were extracted before initiating the neo-adjuvant treatment with nivolumab plus carboplatin and at the third cycle before patients underwent surgery. We classified patients in 3 subgroups of pathological response: complete (pCR), mayor (<10% viable tumour) and incomplete (>10% viable tumour, pIR).

Results

Absolute numbers of Leucocytes, Eosinophil, Monocytes, Neutrophils, Haemoglobin and Platelets from hemograms were significantly reduced after treatment. However, no changes were observed for Lymphocytes, Basophils, LDH levels or the lung immune prognostic index (LIPI). Additionally, post-treatment neutrophil-to-lymphocyte (NLR), myeloid-to-lymphoid lineage (M:L) and platelets-to-lymphocytes (PLR) ratios were decreased. Remarkably, from all the CBC absolute numbers and ratios, only PLR variation showed differences between pCR and pIR. On the other hand, percentages of T cells, B cells, NK cells and macrophages did not vary after treatment, however activation of CD4 T cells and NK cells were significantly downregulated after treatment, associated to pCR. Also, PD-1 expression on T and NK cells pre-treatment was higher on pCR compared to pIR, reaching statistical significance only on CD4 T cells.

Conclusions

In our study, we described predictive biomarkers of response to treatment. A higher decrease on PLR post-treatment is associated to pIR. Moreover, higher expression of PD-1 pre-treatment in CD4 T cells, as well, as a reduced activation on CD4 T cells and NK cells, after treatment are associated to pCR.

Clinical trial identification

NCT 03081689; EudraCT 2016-003732-20.

Editorial acknowledgement

Legal entity responsible for the study

Spanish Lung Cancer Group.

Funding

BMS.

Disclosure

M. Provencio: Advisory / Consultancy: BMS; Advisory / Consultancy, Travel / Accommodation / Expenses: MSD; Advisory / Consultancy, Travel / Accommodation / Expenses: AstraZeneca; Advisory / Consultancy: Boehringer. All other authors have declared no conflicts of interest.

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