Advancing Understanding of Non-Small Cell Lung Cancer with Multiplexed Antibody-Based Spatial Imaging Technologies

SIMPLE SUMMARY: Non-small cell lung cancer is common and potentially lethal. Existing treatments that enable a person’s own immune system to attack their cancer significantly improve survival, but only for a minority of people. This difference between people likely depends on the types of cells, secreted molecules and other conditions present in and around the tumour. New technologies have recently allowed many cell types and molecules to be identified on the same tumour slide, whereas previously only a few cell markers could be used; this allows common and rare cell types to be reliably identified, and the relationships between different cells and cell types to be studied in far greater detail than before. These technologies may help to identify new cancer treatments to improve outcomes for patients. Here, we review studies which have used these new technologies in non-small cell lung cancer, and aim to summarise their findings. ABSTRACT: Non-small cell lung cancer (NSCLC) remains a cause of significant morbidity and mortality, despite significant advances made in its treatment using immune checkpoint inhibitors (ICIs) over the last decade; while a minority experience prolonged responses with ICIs, benefit is limited for most patients. The development of multiplexed antibody-based (MAB) spatial tissue imaging technologies has revolutionised analysis of the tumour microenvironment (TME), enabling identification of a wide range of cell types and subtypes, and analysis of the spatial relationships and interactions between them. Such study has the potential to translate into a greater understanding of treatment susceptibility and resistance, factors influencing prognosis and recurrence risk, and identification of novel therapeutic approaches and rational treatment combinations to improve patient outcomes in the clinic. Herein we review studies that have leveraged MAB technologies to deliver novel insights into the TME of NSCLC.