Tumor mutational load, CD8(+) T cells, expression of PD-L1 and HLA class I to guide immunotherapy decisions in NSCLC patients

OBJECTIVES: A minority of NSCLC patients benefit from anti-PD1 immune checkpoint inhibitors. A rational combination of biomarkers is needed. The objective was to determine the predictive value of tumor mutational load (TML), CD8(+) T cell infiltration, HLA class-I and PD-L1 expression in the tumor....

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Detalles Bibliográficos
Autores principales: Hurkmans, Daan P., Kuipers, Merian E., Smit, Jasper, van Marion, Ronald, Mathijssen, Ron H. J., Postmus, Piet E., Hiemstra, Pieter S., Aerts, Joachim G. J. V., von der Thüsen, Jan H., van der Burg, Sjoerd H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Original Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183487/
https://www.ncbi.nlm.nih.gov/pubmed/32047958
http://dx.doi.org/10.1007/s00262-020-02506-x
Descripción
Sumario:OBJECTIVES: A minority of NSCLC patients benefit from anti-PD1 immune checkpoint inhibitors. A rational combination of biomarkers is needed. The objective was to determine the predictive value of tumor mutational load (TML), CD8(+) T cell infiltration, HLA class-I and PD-L1 expression in the tumor. MATERIALS AND METHODS: Metastatic NSCLC patients were prospectively included in an immune-monitoring trial (NTR7015) between April 2016-August 2017, retrospectively analyzed in FFPE tissue for TML (NGS: 409 cancer-related-genes) and by IHC staining to score PD-L1, CD8(+) T cell infiltration, HLA class-I. PFS (RECISTv1.1) and OS were analyzed by Kaplan–Meier methodology. RESULTS: 30 patients with adenocarcinoma (67%) or squamous cell carcinoma (33%) were included. High TML was associated with better PFS (p = 0.004) and OS (p = 0.025). Interaction analyses revealed that patients with both high TML and high total CD8(+) T cell infiltrate (p = 0.023) or no loss of HLA class-I (p = 0.026), patients with high total CD8(+) T cell infiltrate and no loss of HLA class-I (p = 0.041) or patients with both high PD-L1 and high TML (p = 0.003) or no loss of HLA class-I (p = 0.032) were significantly associated with better PFS. Unsupervised cluster analysis based on these markers revealed three sub-clusters, of which cluster-1A was overrepresented by patients with progressive disease (15 out of 16), with significant effect on PFS (p = 0.007). CONCLUSION: This proof-of-concept study suggests that a combination of PD-L1 expression, TML, CD8(+) T cell infiltration and HLA class-I functions as a better predictive biomarker for response to anti-PD-1 immunotherapy. Consequently, refinement of this set of biomarkers and validation in a larger set of patients is warranted. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00262-020-02506-x) contains supplementary material, which is available to authorized users.

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