WCLC 2025 - Posters & ePosters-P2.10.07 Combined Immunoscore for Predictive Stratification of Unresectable Non-Small Cell Lung Cancer

Pdf Summary

This study evaluates a combined immunoscore integrating multiple tumor microenvironment biomarkers to predict chemotherapy response in patients with unresectable non-small cell lung cancer (NSCLC). Key biomarkers analyzed include tumor PD-L1 expression, CD8 and CD4 T lymphocyte infiltration, tumor-associated macrophages (TAMs), tumor-associated neutrophils (TANs), and the derived neutrophil-to-lymphocyte ratio (dNLR). The cohort consisted of 56 patients, predominantly male, mostly smokers, with a median age of 67 and advanced-stage adenocarcinomas.<br /><br />Findings show that patients with low CD8 T-cell infiltration, low TAN density, and a dNLR below 0.12 experienced significantly better progression-free survival (PFS) and overall survival (OS) under chemotherapy. Specifically, low CD8 infiltration correlated with PFS of 6.63 vs. 3.01 months and OS of 14.07 vs. 5.06 months compared to high CD8 infiltration. Similarly, low TAN density and low dNLR were also linked to improved survival outcomes.<br /><br />A combined immunoscore was developed by scoring eight biomarkers based on established criteria, categorizing patients into low (≤9) or high (>9) immunoscore groups. This composite score provided enhanced stratification, with low combined immunoscore patients showing significantly longer PFS (6.60 vs. 3.13 months) and OS (12.26 vs. 7.05 months).<br /><br />The study suggests that applying this integrated immunoscore could guide personalized therapeutic decisions, optimizing patient selection for chemotherapy. It also highlights the importance of tumor immune contexture in influencing treatment outcomes. Future work should validate this immunoscore in larger cohorts and explore its utility alongside immunotherapy or novel targeted agents. Additionally, investigating the biological mechanisms of immune cell infiltration and its impact on chemotherapy response may uncover novel therapeutic targets. Overall, the combined immunoscore represents a promising tool to refine prognosis and tailor treatments in unresectable NSCLC.

Asset Subtitle

Oussama Aazzane

Meta Tag

Speaker Oussama Aazzane

Topic Metastatic Non-small Cell Lung Cancer – Cytotoxic Therapy

Keywords

immunoscore

tumor microenvironment

non-small cell lung cancer

chemotherapy response

PD-L1 expression

CD8 T-cell infiltration

tumor-associated neutrophils

derived neutrophil-to-lymphocyte ratio

progression-free survival

overall survival