Abstract 48P
Background
The induction of tertiary lymphoid structure (TLS) in solid tumors has been associated with a favorable prognosis. However, the role of TLS in pathological response remains to be further elucidated, especially in patients with resectable non-small cell lung cancer (NSCLC) receiving neoadjuvant chemotherapy.
Methods
NSCLC patients with neoadjuvant chemotherapy, resectable stage I∼III, age ≥18 years, ECOG performance status 0∼1 were recruited in the study. Hematoxylin and eosin (H&E) staining of surgical resection was applied for assessing histopathologic responses. The definition of MPR involved showing no more than 10% residual viable tumor cells, while a pCR referred to no residual tumor cells. Fluorescent multiplex immunohistochemistry (mIHC), which allows the simultaneous detection of multiple markers on a single tissue section was performed by the automated quantitative pathology imaging system. The TLS consists of T cell (CD3+) and B cell (CD20+) rich regions.
Results
Thirty-one patients were enrolled and received neoadjuvant chemotherapy, including pCR (n=4) and MPR (n=12). The TLS was significantly higher in patients with MPR than non-MPR (counts per mm2, p=.0063; μm2 per mm2, p=.0044). The area under the curve (AUC) of TLS to predict MPR was 0.7873 (counts per mm2) and 0.7982 (μm2 per mm2), respective. The optimal cutoff value for TLS were found to be 0.5550 and 32114 at the unit of counts per mm2 and μm2per mm2, respectively. The performance of TLS to predict MPR in NSCLC patients with neoadjuvant chemotherapy. Table: 48P
| TLS cutoff | Se (%); 95% CI | Sp (%); 95% CI | PPV (%); 95% CI | NPV (%); 95% CI |
| 0.5550 counts/mm2 | 66.67; 34.89 to 90.08 | 94.74; 73.97 to 99.87 | 88.89; 53.25 to 98.25 | 81.82 66.75 to 90.98 |
| 32114 μm2/mm2 | 83.33; 51.59 to 97.91 | 84.21; 60.42 to 96.62 | 76.92; 53.37 to 90.66 | 88.89 68.98 to 96.64 |
Conclusions
Higher TLS value indicates better efficacy of neoadjuvant chemotherapy in resectable patients with NSCLC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
National Natural Science Foundation of China (NO. 62076254).
Disclosure
All authors have declared no conflicts of interest.