Multiomics profiling and association with molecular and immune features in association with benefits from immunotherapy for patients with previously treated stage IV or recurrent squamous cell lung cancer from the phase III SWOG LungMAP S1400I trial.

Authors

null

Edwin R. Parra

Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX

Edwin R. Parra , Dzifa Yawa Duose , Jiexin Zhang , Mary Weber Redman , Rossana Lazcano Segura , Mario L. Marques-Piubelli , Caddie Laberiano Fernandez , BaiLi Zhang , James Lindsay , Radim Moravec , Kasthuri Kannan , Rajyalakshmi Luthra , Gheath Alatrash , Roy S. Herbst , Ignacio Ivan Wistuba , Scott N. Gettinger , Lyudmila Bazhenova , J. Jack Lee , Jianjun Zhang , Cara L. Haymaker

Organizations

Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, The University of Texas MD Anderson Cancer Center, Houston, TX, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, MD Anderson Cancer Center, Houston, TX, University of Texas MD Anderson Cancer Center, Houston, TX, The University of Texas/MD Anderson Cancer Center, Houson, TX, Dana-Farber Cancer Institute, Boston, MA, National Cancer Institute, Bethesda, MD, Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX, Yale University, New Haven, CT, Yale School of Medicine and Smilow Cancer Center, Yale New Haven Hospital, New Haven, CT, University of California, San Diego, San Diego, CA, Department of Thoracic and Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Department of Genomic Medicine, University of Texas MD Anderson Cancer Center, Houston, TX

Research Funding

Other Foundation
U.S. National Institutes of Health

Background: Immune checkpoint blockade (ICB) has become a standard pillar of treatment for lung cancer. However, only ̃20% of unselected patients can achieve durable clinical benefits. We performed immunogenomic profiling of tissue specimens from a randomized Phase III trial S1400I on metastatic lung squamous cell carcinoma (SCC) to evaluate if there were factors associated with better prognoses with ICB from single-agent versus combined targeting PD-1/CTLA-4 and evaluate if any differentiated between the treatments. Methods: We utilized FFPE tumor tissue submitted for Lung-MAP screening provided by the SWOG bank. SCC samples from 82 eligible patients treated with combined nivolumab+ipilimumab (N+I) or single agent nivolumab (N) were subjected to multiplex immunofluorescence (mIF, n = 82) and NanoString (ncounter PanCancer Immune Profiling Panel, n = 32). Cell density phenotypes (cells/mm2) were defined using image analysis of staining for cytokeratin, CD3, CD8, granzyme B, CD45RO, FOXP3, PD1, PD-L1, and CD68. Immunogenomic features were associated with response, PFS, and OS derived from data provided by the LungMap team to the CIDC portal. For statistical analyses, non-parametric tests were utilized to assess associations of cell phenotypes versus continuous or categorical variables, and log-rank test analysis was performed to identify cell phenotypes or genes correlated with survival. Results: In both arms higher densities of total CD3+CD45RO+ T cells (P= 0.041), CD3+PD-1+ T cells (P= 0.024) and CD3+CD8+PD-1 T cells in stroma (P= 0.042) and CD3+CD8+GZMB+ T cells in the tumor compartment (P= 0.011) were positively associated with PFS. In the N+I arm but not in the N arm, higher densities of CD3+CD8+GZMB+ T cells in the tumor compartment were associated with better PFS (P= 0.015) and higher densities of stroma CD3+CD8-FOXP3+ T cells with worse OS. Spatial analysis showed that the presence of CD8+GZMB+ T cells close to malignant cells (median, ≤19.27 µm) was associated with better PFS (P= 0.037) in N+I arm and cluster analysis showed low clustering of cells in TMB-high vs. TMB-low tumors (P < 0.01). Gene expression profiling demonstrated that myeloid infiltration, immune recruitment, and inflammation genes were associated with a positive clinical outcome (P< 0.05). In both arms, BLNK,CD163, FCGR2A were associated with better OS (P< 0.01), IRF1 and BLNK were associated with increased PFS (P< 0.01). In the N+I arm but not in the N arm, we observed significantly higher CD45 immune cell scores, including CD8 T cells and neutrophils, in responders versus non-responders. Conclusions: Our findings suggest a potential advantage in PFS and OS with an increased presence of cytotoxic immune cells and genes associated with the recruitment and proliferation of these cell types before therapy.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Biologic Correlates

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 9046)

DOI

10.1200/JCO.2022.40.16_suppl.9046

Abstract #

9046

Poster Bd #

34

Abstract Disclosures