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Multiplexed imaging of tumor immune microenvironmental markers in locally advanced or metastatic non-small-cell lung cancer characterizes the features of response to PD-1 blockade plus chemotherapy

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机构: [1]Tongji Univ, Shanghai Pulm Hosp, Dept Thorac Med Oncol, Sch Med, Shanghai 200433, Peoples R China [2]Harbin Med Univ, Dept Resp Med, Canc Hosp, Harbin 150000, Heilongjiang, Peoples R China [3]Kunming Med Univ, Dept Thorac Surg Oncol, Yunnan Canc Hosp, Kunming 650118, Yunnan, Peoples R China [4]Kunming Med Univ, Affiliated Hosp 3, Kunming 650118, Yunnan, Peoples R China [5]Yunnan Canc Ctr, Kunming 650118, Yunnan, Peoples R China [6]Zhejiang Univ, Dept Resp Med, Affiliated Hosp 1, Hangzhou 310009, Zhejiang, Peoples R China [7]Guangzhou Univ Chinese Med, Dept Oncol Ctr, Affiliated Hosp 1, Guangzhou 510405, Guangdong, Peoples R China [8]Nanjing Med Univ, Dept Thorac Med Oncol, Jiangsu Canc Hosp, Nanjing 210009, Jiangsu, Peoples R China [9]Nanjing Med Univ, Jiangsu Inst Canc Res, Nanjing 210009, Jiangsu, Peoples R China [10]Nanjing Med Univ, Affiliated Canc Hosp, Nanjing 210009, Jiangsu, Peoples R China [11]Shandong Canc Hosp & Inst, Dept Resp, Jinan 250117, Shandong, Peoples R China [12]Jiangsu Prov Hosp, Dept Oncol, Nanjing 210000, Jiangsu, Peoples R China [13]Linyi Canc Hosp, Dept Med Oncol, Linyi 276000, Shandong, Peoples R China [14]Chinese Peoples Liberat Army Gen Hosp, Dept Oncol, Beijing 100853, Peoples R China [15]Henan Canc Hosp, Dept Resp Med, Zhengzhou 450000, Henan, Peoples R China [16]Jilin Canc Hosp, Dept Thorac Oncol, Changchun 130012, Jilin, Peoples R China [17]Hunan Canc Hosp, Dept Med Oncol Chest, Changsha 410006, Hunan, Peoples R China [18]Fujian Med Univ, Dept Oncol, Union Hosp, Fuzhou 350001, Fujian, Peoples R China [19]Sichuan Univ, West China Hosp, Dept Thorac Med Oncol, Chengdu 610000, Sichuan, Peoples R China [20]Suzhou Univ, Dept Respirat, Affiliated Hosp 1, Suzhou 215002, Jiangsu, Peoples R China [21]Jilin Univ, Dept Med Oncol, Bethune Hosp 1, Changchun 130021, Jilin, Peoples R China [22]Univ Sci Technol China, Affiliated Hosp 1, Pulm & Crit Care Med, Hefei 230036, Anhui, Peoples R China [23]China Med Univ, Dept Med Oncol, Hosp 1, Shenyang 110000, Liaoning, Peoples R China [24]Zhejiang Canc Hosp, Thorac Med Oncol, Hangzhou 310022, Zhejiang, Peoples R China [25]Univ Sci Technol China, Dept Tumor Chemotherapy, Affiliated Hosp 1, Hefei 230036, Anhui, Peoples R China [26]Peking Univ, Dept Thorac Med Oncol, Canc Hosp & Inst, Beijing 100142, Peoples R China [27]Zhengzhou Univ, Dept Med Oncol, Affiliated Hosp 1, Zhengzhou 450000, Henan, Peoples R China [28]Fudan Univ, Dept Med Oncol, Shanghai Canc Ctr, Shanghai 200032, Peoples R China [29]Fuzhou Pulm Hosp Fujian, Dept Oncol, Fuzhou 350008, Fujian, Peoples R China [30]Tianjin Med Univ Canc Inst & Hosp, Dept Biotherapy, Tianjin 300060, Peoples R China [31]Nanchang Univ, Pneumol Dept, Affiliated Hosp 1, Nanchang 330006, Jiangxi, Peoples R China [32]Zhejiang Canc Hosp, Dept Thorac Med Oncol, Hangzhou 310022, Zhejiang, Peoples R China [33]Fujian Canc Hosp, Dept Thorac Oncol, Fuzhou 350000, Fujian, Peoples R China [34]Peking Univ, Dept Thorac Oncol 2, Key Lab Carcinogenesis & Translat Res, Canc Hosp & Inst,Minist Educ Beijing, Beijing 100142, Peoples R China [35]Anhui Med Univ, Dept Med Oncol, Affiliated Hosp 1, Hefei 230031, Anhui, Peoples R China [36]Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Canc Ctr, Wuhan 430022, Hubei, Peoples R China [37]Jiangsu Hengrui Med Co Ltd, Clin Res & Dev, Shanghai 201210, Peoples R China [38]Genecast Biotechnol Co Ltd, Wuxi 214100, Jiangsu, Peoples R China
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关键词: Non-small-cell lung cancer PD-1 CD8 CD68 tumor immune microenvironment

摘要:
Background Although programmed cell death 1 (PD-1) blockade plus chemotherapy can significantly prolong the progression-free survival (PFS) and overall survival (OS) in first-line settings in patients with driver-negative advanced non-small-cell lung cancer (NSCLC), the predictive biomarkers remain undetermined. Here, we investigated the predictive value of tumor immune microenvironmental marker expression to characterize the response features to PD-1 blockade plus chemotherapy. Methods Tumor tissue samples at baseline were prospectively collected from 144 locally advanced or metastatic NSCLC patients without driver gene alterations who received camrelizumab plus chemotherapy or chemotherapy alone. Tumor immune microenvironmental markers, including PD-1 ligand (PD-L1), CD8, CD68, CD4 and forkhead box P3, were assessed using multiplex immunofluorescence (mIF) assays. Kaplan-Meier curves were used to determine treatment outcome differences according to their expression status. Mutational profiles were compared between tumors with distinct expression levels of these markers and their combinations. Results Responders had significantly higher CD8/PD-L1 (P = 0.015) or CD68/PD-L1 co-expression levels (P = 0.021) than non-responders in the camrelizumab plus chemotherapy group, while no difference was observed in the chemotherapy group. Patients with high CD8/PD-L1 or CD68/PD-L1 co-expression level was associated with significantly longer PFS (P = 0.002, P = 0.024; respectively) and OS (P = 0.006, P = 0.026; respectively) than those with low co-expression in camrelizumab plus chemotherapy group. When comparing survival in the camrelizumab plus chemotherapy with chemotherapy by CD8/PD-L1 co-expression stratification, significantly better PFS (P = 0.003) and OS (P = 0.032) were observed in high co-expression subgroups. The predictive value of CD8/PD-L1 and CD68/PD-L1 co-expression remained statistically significant for PFS and OS when adjusting clinicopathological features. Although the prevalence of TP53 or KRAS mutations was similar between patients with and without CD8/PD-L1 or CD68/PD-L1 co-expression, the positive groups had a significantly higher proportion of TP53/KRAS co-mutations than the negative groups (both 13.0% vs. 0.0%, P = 0.023). Notably, enriched PI3K (P = 0.012) and cell cycle pathway (P = 0.021) were found in the CD8/PD-L1 co-expression group. Conclusion Tumor immune microenvironmental marker expression, especially CD8/PD-L1 or CD68/PD-L1 co-expression, was associated with the efficacy of PD-1 blockade plus chemotherapy as first-line treatment in patients with advanced NSCLC.

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大类 | 1 区 医学
小类 | 1 区 肿瘤学
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大类 | 1 区 医学
小类 | 2 区 肿瘤学
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Q1 ONCOLOGY
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Q1 ONCOLOGY

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第一作者机构: [1]Tongji Univ, Shanghai Pulm Hosp, Dept Thorac Med Oncol, Sch Med, Shanghai 200433, Peoples R China
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通讯机构: [1]Tongji Univ, Shanghai Pulm Hosp, Dept Thorac Med Oncol, Sch Med, Shanghai 200433, Peoples R China [*1]Tongji Univ, Dept Med Oncol, Shanghai Pulm Hosp, Sch Med, 507 Zhengmin Rd, Shanghai 200433, Peoples R China
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