Abstract 770P
Background
Immune checkpoint inhibitors (ICI) are standard of care in recurrent/metastatic HNSCC. Here, we evaluated in ICI, in conjunction with a metabolic inhibitor, in HNSCC patients with less severe disease and characterized the immune infiltrate within various tissues.
Methods
We conducted a window of opportunity immunotherapy trial in newly diagnosed HNSCC patients. Patients received either nivolumab alone or in combination with an IDO inhibitor (BMS986205). Patients were evaluated at 4 weeks, and those exhibiting a positive treatment response received an additional 4 weeks of ICI treatment followed by surgery. Tumor tissue and blood were collected prior to treatment (baseline) and at the time of surgery. Tumors and LN microenvironments were assessed using bulk and spatial transcriptomic (GeoMX) RNA analyses. Blood cells subsets and activation status were quantified using flow cytometry and soluble factors were profiled using multiplex Luminex assays. Extracellular vesicles were phenotyped using a combination of flow cytometry and Luminex assays.
Results
Patients were stratified according to HPV status and pathological response criteria. Irrespective of location, a type 1 immune response was more prevalent in patients who responded to treatment and a type 2 or mixed type 1/2 were found in those patients who did not respond or had stable disease.
Conclusions
Newly diagnoses HNSCC patients undergoing neoadjuvant immunotherapy exhibit different states of immune bias based on tissue localization. The current study identified a number of treatment targets to increase those patients who respond to ICI.
Clinical trial identification
NCT03854032.
Editorial acknowledgement
Legal entity responsible for the study
Thomas Jefferson University.
Funding
Bristol Myers Squibb.
Disclosure
All authors have declared no conflicts of interest.