WCLC 2025 - Posters & ePosters-P2.06.58 Predictive Value of Tumor Microenvironment Biomarkers in Neoadjuvant Immunotherapy Combined With Chemotherapy for Locally Advanced NSCLC

P2.06.58 Predictive Value of Tumor Microenvironment Biomarkers in Neoadjuvant Immunotherapy Combined With Chemotherapy for Locally Advanced NSCLC

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This retrospective study by Xu Wang from the First Hospital of Jilin University investigated tumor microenvironment (TME) biomarkers as predictors of response to neoadjuvant immunotherapy combined with chemotherapy in 77 patients with stage IIIA-IIIB locally advanced non-small cell lung cancer (LA-NSCLC). Neoadjuvant immunochemotherapy is a critical treatment approach in LA-NSCLC, with the pathologic response serving as an important prognostic indicator. The study aimed to clarify the prognostic significance of TME immune cell biomarkers using a multidimensional approach.<br /><br />Methods included immunohistochemical quantification of immune cell markers in tumor specimens, calculation of H-scores correlating biomarker levels with pathological response and prognosis, development of a predictive model for Major Pathological Response (MPR), and validation using single-cell RNA sequencing data from the GEO database.<br /><br />Key findings showed that pretreatment H-scores for CD8+ T cells and CD20+ B cells significantly predicted MPR, confirmed independently by single-cell sequencing analyses. After neoadjuvant therapy, the TME exhibited immunological remodeling characterized by increases in activating immune populations (CD4+ T, CD8+ T, CD20+ B, CD56+ NK cells, and CD86+ M1 macrophages) alongside decreases in immunosuppressive cells (FOXP3+ regulatory T cells and CD163+ M2 macrophages). A combined predictive model incorporating CD8 and CD20 immune scores achieved superior prognostic accuracy (AUC 0.761) over single biomarker assessments.<br /><br />The study concludes that pretreatment levels of CD8+ T and CD20+ B cells in the tumor microenvironment are valuable predictors of therapeutic response in LA-NSCLC patients receiving neoadjuvant immunochemotherapy. Treatment induces dynamic immune remodeling, and integrating multiple immune signatures into a predictive model enhances prognostic precision, potentially guiding personalized therapeutic strategies.

Asset Subtitle

Xu Wang

Meta Tag

Speaker Xu Wang

Topic Pathology and Biomarkers

Keywords

tumor microenvironment

TME biomarkers

neoadjuvant immunotherapy

chemotherapy

locally advanced non-small cell lung cancer

LA-NSCLC

CD8+ T cells

CD20+ B cells

major pathological response

immune remodeling