Evaluation of tumor microenvironment and biomarkers of immune checkpoint inhibitor (ICI) response in metastatic renal cell carcinoma (mRCC).

Authors

Jason Zhu

Jason Zhu

Duke University, Durham, NC

Jason Zhu, Sarabjot Pabla, Matthew Labriola, Rajan T. Gupta, Shannon McCall, Daniel J. George, Devin Dressman, Sean T. Glenn, Mary Nesline, Saby George, Carl Morrison, Tian Zhang

Organizations

Duke University, Durham, NC, OmniSeq, Inc., Buffalo, NY, Duke Medical Center, Durham, NC, Duke University Medical Center, Durham, NC, Duke Cancer Institute, Durham, NC, Thermo Fisher Scientific, Waltham, MA, Roswell Park Comprehensive Cancer Center, Buffalo, NY

Research Funding

Pharmaceutical/Biotech Company

Background: ICIs are now standard of care for mRCC; however, there are few biomarkers to predict ICI response. Recent data from atezolizumab/bevacizumab trials in mRCC suggest tumors with high Teffhigh/PD-L1+ are more likely to respond to ICI. Here, we use this Teff gene panel as well as other markers of inflammation in the tumor microenvironment to correlate with ICI responses. Methods: This multicenter study evaluated 69 pts with mRCC treated with ICIs. FFPE tumor samples were evaluated by RNA sequencing to measure transcript levels of genes related Teff status. Teff status was defined as the mRNA expression of 17 genes (CD8, CD27, IFNG, GZMA, GZMB, PRF1, EOMES, CXCL9, CXCL10, CXCL11, CD274, CTLA4, FOXP3, TIGIT, IDO1, PSMB9, TAP1), with Teffhigh/low separated at the median. PD-L1 positivity was defined as ≥1% TPS based on Dako 22C3 IHC assay, and TMB high as > 10 mutations per megabase. Inflamed tumors were defined as CD8 expression in the top 75th percentile compared to a large reference population of multiple tumor types. Best responses to ICI was determined by an expert radiologist using RECIST 1.1 criteria. Inflamed tumor status, Teff gene expression, PD-L1 positive, and TMB were associated with disease control (DC, defined as CR, PR, or stable disease). DC comparisons were tested using a chi-squared test with Yates’s continuity correction. Results: DC was 63% (5/8) amongst PD-L1 positive pts and 52% (31/60) in PD-L1 negative patients (p = 0.84). Only 2 pts were TMB high. The majority of mRCC tumors (97%, 67/69) were TMB low. 6-month DC in TMB high tumors was 50% (1/2) and 49.3% (33/67) in TMB low tumors (p = 1.0). 36 pts were classified as Teffhigh and 33 patients were classified as Tefflow. 6-month DC was 61% (22/36) in the Teffhigh cohort and 36% (12/33) in the Tefflow cohort (p = 0.069). 6-month DC was 64% of inflamed tumors (16/25) vs 41% of non-inflamed tumors (18/44) (p = 0.111). Conclusions: TMB high and PD-L1 expression do not reliably predict for DC in pts with mRCC. Utilizing a gene signature score may better predict ICI response.

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Abstract Details

Meeting

2019 ASCO-SITC Clinical Immuno-Oncology Symposium

Session Type

Poster Session

Session Title

Poster Session B

Track

Breast and Gynecologic Cancers,Developmental Therapeutics,Genitourinary Cancer,Head and Neck Cancer,Lung Cancer,Melanoma/Skin Cancers,Gastrointestinal Cancer,Combination Studies,Implications for Patients and Society,Miscellaneous Cancers,Hematologic Malignancies

Sub Track

Biomarkers and Inflammatory Signatures

Citation

J Clin Oncol 37, 2019 (suppl 8; abstr 63)

DOI

10.1200/JCO.2019.37.8_suppl.63

Abstract #

63

Poster Bd #

D6

Abstract Disclosures

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