2023 World Conference on Lung Cancer (Posters)-P2.05. Full Spectrum Flow Cytometry-powered Analysis of PBMC as Biomarkers for Immunotherapy in NSCLC with EGFR-TKI Resistance

P2.05. Full Spectrum Flow Cytometry-powered Analysis of PBMC as Biomarkers for Immunotherapy in NSCLC with EGFR-TKI Resistance - PDF(Abstract)

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This study aimed to identify biomarkers that could predict the efficacy of immunotherapy in non-small cell lung cancer (NSCLC) patients with EGFR-TKI resistance. The authors collected peripheral blood mononuclear cell (PBMC) samples from 60 patients who received immunotherapy plus chemotherapy after failure of EGFR-TKI treatment. Using a 23-color antibody panel and full spectrum flow cytometry (FSFC), the researchers identified and quantitated 19 immune cell subsets and the expression of six immune checkpoint proteins (ICPs) on these cell subsets.<br /><br />The results of the study showed that immunotherapy plus chemotherapy achieved an objective response rate of 21.7% and a median progression-free survival of 6.4 months in EGFR-TKI resistant NSCLC patients. Clinical features associated with worse efficacy included liver metastasis, treatment line 4, and a platelet-to-lymphocyte ratio greater than 200. On the other hand, effective CD4T cells at baseline were associated with better efficacy.<br /><br />Baseline expression of ICPs on specific cell subsets, such as higher expression of HLA-DR on central memory CD8T cells and effective memory CD8T cells, and lower expression of PD-1 on effective memory CD4T cells, were associated with better efficacy. Expression of ICPs after 2 cycles of treatment, such as higher expression of CD25 on CD8T/EM8/Th17/NK cells and higher expression of HLA-DR on NK cells, were also associated with better efficacy. Additionally, dynamic changes in the expression of ICPs, such as a significant decrease in TIGIT expression on Treg cells and an increase in VISTA expression on Th1 cells, were associated with better efficacy.<br /><br />Based on the clinical features and characteristics of peripheral immune cells, the authors successfully constructed a model for predicting the efficacy of immunotherapy plus chemotherapy with high sensitivity and specificity.<br /><br />In conclusion, some NSCLC patients with EGFR-TKI resistance can benefit from immunotherapy plus chemotherapy. Analysis of peripheral immune cells using FSFC can help identify potential beneficiaries, and the expression of ICPs is significantly correlated with immunotherapy efficacy.

Asset Subtitle

Chunxia Su

Meta Tag

Speaker Chunxia Su

Topic Metastatic NSCLC: Immunotherapy - Biomarker

Keywords

biomarkers

immunotherapy

NSCLC

EGFR-TKI resistance

PBMC samples

immune cell subsets

ICPs

HLA-DR

PD-1

predicting efficacy