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e-Poster Display Session

8P - Immune cell subsets in peripheral blood are associated with primary resistance to immunotherapy as frontline treatment in NSCLC

Date

09 Dec 2020

Session

e-Poster Display Session

Presenters

Hugo Arasanz

Citation

Annals of Oncology (2020) 31 (suppl_7): S1417-S1424. 10.1016/annonc/annonc389

Authors

H. Arasanz1, M. Zuazo2, L. Chocarro2, A.I. Bocanegra Gondan2, M. Martínez-Aguillo1

Author affiliations

  • 1 Complejo Hospitalario de Navarra - Royal Navarre Hospital, Pamplona/ES
  • 2 Navarrabiomed, Pamplona/ES
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Abstract 8P

Background

Kagamu H et al. and our group recently reported the association between high levels of effector and highly differentiated CD4 T cells in peripheral blood and response to ICI in pretreated NSCLC (Zuazo M, 2019; Kagamu H, 2020). We have evaluated the dynamics of immune cell populations in patients receiving pembrolizumab as first line.

Methods

PBMCs from 25 patients with advanced NSCLC receiving pembrolizumab alone or concomitant with chemotherapy were obtained from peripheral blood before treatment. Cell subpopulations have been studied by flow cytometry according to the expression of CD3, CD4, CD8, CD11b, CD14, CD27, CD28, CD56, CD64, CD66b, CD116, CD163 and CD206.

Results

Higher levels of CD116+ CD66b+ neutrophils (21.1% vs 3.8%, p=0.045) and CD11b+ CD56+ CD14- NK cells (22.6% vs 12.7%, p=0.003) were associated with progression, while responders had lower levels of CD4+ CD27- CD28- cells (p = 0.032). Over the mean (OTM) CD4+ CD27- CD28- and NK cell levels were associated with shorter PFS (NR vs 8.3 wk, p = 0.026 and 64.1 vs 2.9 wk, p= 0.005). OTM neutrophils were associated with shorter OS (71.7 vs 9.9 wk, p = 0.012). ROC analysis showed an association between OTM neutrophils and progression as best response (AUC 0.903, p=0.005), with a threshold of 6.2% for a 90% specificity and 75% sensitivity. A score based on OTM neutrophils, NK and CD4+ CD27- CD28- cells discriminates patients according to their mPFS (0 = 64 wk, 1 = 22.9 wk, 2-3 = 2.86 wk; p=0.029).

Conclusions

Pretreatment immune cell subpopulations in peripheral blood quantified by flow cytometry might be useful to predict immunotherapy efficacy. Myeloid and CD27- CD28- CD4 cells cells might play relevant role in primary resistance to ICI.

Legal entity responsible for the study

IdiSNA, Navarra Institute for Health Research.

Funding

Asociación Española Contra el Cáncer (AECC), Instituto de Salud Carlos III.

Disclosure

All authors have declared no conflicts of interest.

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