1309P - Immune exhaustion in tumor-free lymph nodes of non-small cell lung cancer (NSCLC) patients is associated with performance status and survival

Background

Tumor-draining lymph nodes are crucial in initiation and maintenance of antitumoral immune activity. Immune cell exhaustion in these lymph nodes is associated with low therapeutic efficacy and poor prognosis. The effect of different markers of immune exhaustion on patients’ performance status and survival is not yet fully understood.

Methods

Expression profiling of 770 immune-related genes in N1 and N2 tumor-free lymph nodes was performed using the PanCancer IO 360 panel by NanoString Technologies. We analysed the association between immune exhaustion data and performance status and survival using Student’s t-test and Cox regression.

Results

We performed immune transcriptomics on tumor-free lymph nodes of 16 stage II/III NSCLC patients. Patients with worse performance status (ECOG 1/2 vs. 0) showed increased levels of immune dysfunction as measure by increased Tumor Immune Dysfunction and Exclusion (TIDE) scores (p=0.05). In particular, ECOG score was associated with increased levels of immune exhaustion marker IDO1 (p=0.02). IDO1 (HR= 1.003, p=0.02) and LGALS9 (HR= 1.011, p=0.001) expression in N1 and expression of CD276 (HR= 1.005, p=0.01) in N2 lymph nodes were associated with worse survival.

Conclusions

Our data confirm the relevance of immunological exhaustion in lymphatic tissues of NSCLC patients. Increased IDO1 expression is associated with higher ECOG score and worse survival and needs to be further investigated.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Department of Internal Medicine V.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.