1. Tumor Characteristics Associated with Benefit from Pembrolizumab in Advanced Non–Small Cell Lung Cancer
- Author
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Hu-Lieskovan, Siwen, Lisberg, Aaron, Zaretsky, Jesse M, Grogan, Tristan R, Rizvi, Hira, Wells, Daniel K, Carroll, James, Cummings, Amy, Madrigal, John, Jones, Benjamin, Gukasyan, Jacklin, Shintaku, I Peter, Slamon, Dennis, Dubinett, Steven, Goldman, Jonathan W, Elashoff, David, Hellmann, Matthew D, Ribas, Antoni, and Garon, Edward B
- Subjects
Lung ,Cancer ,Clinical Research ,Lung Cancer ,2.1 Biological and endogenous factors ,Aetiology ,Adult ,Aged ,Aged ,80 and over ,Antibodies ,Monoclonal ,Humanized ,Antineoplastic Agents ,Immunological ,Carcinoma ,Non-Small-Cell Lung ,Female ,Humans ,Immunohistochemistry ,Lung Neoplasms ,Male ,Middle Aged ,Molecular Targeted Therapy ,Neoplasm Grading ,Neoplasm Metastasis ,Neoplasm Staging ,Treatment Outcome ,Exome Sequencing ,Oncology and Carcinogenesis ,Oncology & Carcinogenesis - Abstract
PurposeSeveral biomarkers have been individually associated with response to PD-1 blockade, including PD-L1 and tumor mutational burden (TMB) in non-small cell lung cancer (NSCLC), and CD8 cells in melanoma. We sought to examine the relationship between these distinct variables with response to PD-1 blockade and long-term benefit.Experimental designWe assessed the association between baseline tumor characteristics (TMB, PD-L1, CD4, and CD8) and clinical features and outcome in 38 patients with advanced NSCLC treated with pembrolizumab (median follow-up of 4.5 years, range 3.8-5.5 years).ResultsPD-L1 expression and CD8 infiltration correlated with each other and each significantly associated with objective response rate (ORR) and progression-free survival (PFS). TMB was independent of PD-L1 and CD8 expression, and trended towards association with ORR and PFS. There was no association between CD4 infiltration and outcomes. Only PD-L1 expression was correlated with overall survival (OS). Among 5 patients with long-term survival >3 years with no additional systemic therapy, PD-L1 expression was the only discriminating feature. The increased predictive value for PFS and OS of composite biomarker inclusive of PD-L1, CD8, CD4, and TMB was limited.ConclusionsIn patients with NSCLC treated with PD-1 blockade with long-term follow up, TMB, PD-L1, and CD8 were each associated with benefit from PD-1 blockade. Pretreatment PD-L1 expression was correlated with T lymphocyte infiltration and OS, whereas models incorporating TMB and infiltrating CD4 and CD8 lymphocytes did not substantially add to the predictive value of PD-L1 alone for OS.
- Published
- 2019