2219 - Prognostic Significance of Tumor Tissue NeuGcGM3 Ganglioside Expression and Predictive Value of Circulating Tumor Cell Count Monitoring in Patients Receiving Racotumomab Immunotherapy

Background

Racotumomab is an anti-idiotype vaccine, a mirror image of N-Glycolylneuraminic acid (NeuGcGM3), which mimics this ganglioside and triggers an immune response in various tumors. In this study we investigated the prognostic significance of tissue NeuGcGM3 expression level and prognostic as well as predictive value of circulating tumor cell count monitoring in patients on Racotumomab treatment.

Methods

Out of 48 patients characterized, 40 were non-small cell lung cancer (NSCLC), 12 stage III and 28 stage IV. 19 Adenocarcinoma and 21 Squamous Ca. 2 were small cell lung cancer (SCLC) and 6 with other carcinomas. Male/Female ratio was 3.36(37/11) and median age was 63 (31-84). All patients received Racotumomab as switch maintenance after chemotherapy. 7 PD-L1 (+) Pts also received check point inhibitors on progression. Expression of NeuGcGM3 was detected with 14F7 monoclonal antibody IHC staining and graded as 0,1+,2+ or 3+ according to intensity. Circulating tumor cell (CTC) count was monitored using Cell Sorter throughout the treatment course, before starting Racotumomab and every 3 months or on clinical progression.

Results

NeuGcGM3 IHC were performed 25 out of 48 patients whose paraffin blocks were available. 9 Patients had strong (3+), 12 had (2+) and 4 patients had (1+) NeuGcGM3 staining intensity. There was no statistically significant difference in the mean overall survival of the patients according to IHC staining level (1+) mean OS:55.3 months, (2+) mean OS:40.9 months, and (3+) OS:39.0 months. In 14 Patients, circulating tumor cell count was monitored from the blood and correlated well with clinical outcomes in 11 out of 14 patients (%78.5). Significant reduction of the CTC counts was compatible with clinical response whereas increased CTC counts were early messengers for clinical progression.

Conclusions

This study revealed that any grade of NeuGcGM3 positivity in the tumor tissue is adequate to select a patient for Racotumomab treatment regardless of the IHC intensity. We also concluded that CTC monitoring in patients receiving immunotherapy is a good predictive and prognostic tool.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Necdet Uskent.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.