2024 World Conference on Lung Cancer (WCLC) - Posters-P3.03I.15 The Mechanisms and Impact of EGFR TKIs in Modulating Blood Immune Cells in Patients with Oncogene-Driven NSCLC

P3.03I.15 The Mechanisms and Impact of EGFR TKIs in Modulating Blood Immune Cells in Patients with Oncogene-Driven NSCLC

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This study investigates the effects of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs), particularly osimertinib, on the immune cells in the blood of patients with non-small cell lung cancer (NSCLC) driven by EGFR mutations. Oncogene-driven NSCLC, notably involving common EGFR mutations, presents unique challenges in treatment prognosis. While immune checkpoint inhibitors (ICIs) have transformed the treatment landscape for NSCLC without oncogenic drivers, their efficacy is diminished in cases resistant to TKIs.<br /><br />Researchers focused on examining the mechanisms by which EGFR TKIs, such as osimertinib, influence immune cells, potentially mimicking the response seen with ICIs. The study utilized peripheral blood mononuclear cells (PBMCs) from patients with metastatic NSCLC before and after osimertinib treatment, analyzed via RNA sequencing and detailed bioinformatics.<br /><br />Key findings highlight that osimertinib significantly impacts the number and function of CD4 and CD8 T cells. The study suggests that both absolute lymphocyte counts and neutrophil levels serve as independent biomarkers for monitoring responses to treatments involving TKIs and ICIs in patients with EGFR-mutant NSCLC. Among the cohort, 29 patients who received ICIs following osimertinib demonstrated a median progression-free survival (PFS) of 8.1 months with osimertinib, dropping to 5.3 months with ICIs.<br /><br />Conclusively, osimertinib exhibits significant immune regulatory effects, which may influence subsequent ICI treatments. This study is a pioneering comprehensive evaluation of osimertinib’s effects on blood immune cells in EGFR-mutant NSCLC, suggesting potential pathways that could interfere with ICI efficacy. The authors propose further research to validate these findings and explore novel immunotherapy strategies for patients with oncogene-driven NSCLC.

Asset Subtitle

Tianhong Li

Meta Tag

Speaker Tianhong Li

Topic Tumor Biology – Translational Biology

Keywords

EGFR TKIs

osimertinib

immune cells

NSCLC

EGFR mutations

immune checkpoint inhibitors

CD4 T cells

CD8 T cells

biomarkers

progression-free survival