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Torsten Bauer
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P1.04 - Immuno-oncology (ID 164)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.04-27 - Processing Escapes: Novel Resistance Mechanisms Under Immune Checkpoint Inhibition in NSCLC (Now Available) (ID 1153)
09:45 - 18:00 | Author(s): Torsten Bauer
- Abstract
Background
Immune checkpoint inhibition, especially the blocking of PD-1 and PD-L1, has become one of the most thriving therapeutic approaches in modern oncology. Unfortunately, 60-80% of all patients will develop long-term resistances under immunotherapy. We believe immune evasion caused by altered tumour epitope processing may be one possibility to explain therapy resistance. In a previous work, we were able to establish these so-called processing escapes as an intrinsic immune escape mechanism in patients suffering from neuroendocrine lung cancers. In the present study, we aim to demonstrate the effects of processing escapes on immunotherapy outcome in NSCLC-patients.
Method
Whole exome sequencing data of 400 NSCLC-patients (AdC and SCC) were extracted from the TCGA database serving as a training cohort. The validation cohort was composed of primary tumour probes from 48 NSCLC-patients, who received Nivolumab treatment. Mutational characteristics of these patients were determined by targeted amplicon-based sequencing including hotspots and whole exomes of 22 genes. The effect of mutations on proteasomal processing was evaluated by deep learning methods previously trained on 1260 known MHC-I ligands. Cox-regression modelling was used to determine the influence on overall survival.
Result
In the training cohort, processing escapes were connected to decreased overall survival (p= 0.025) as well as lowered expression of immune factors including Granzyme K (p= 0.15), CD20 (p=0.05) and CD40L (p= 0.025). In the validation cohort, the group of patients showing high abundances of processing escapes in combination with high levels of PD-L1 (n=9/48) had a significantly decreased overall survival (figure 1). The predictive significance of processing escapes proved to be independent of mutational load or PD-L1 status in multivariate analysis.
Conclusion
Based on our retrospective data, the impact of processing escapes and PD-L1 status as a composite predictive score for checkpoint inhibitor response in NSCLC should be further investigated in prospective studies.
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P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.16-11 - ADVANCE-1: Development and Feasibility Testing of a Benchmarking Approach for Quality Improvement in Lung Cancer Care (Now Available) (ID 280)
10:15 - 18:15 | Author(s): Torsten Bauer
- Abstract
Background
Benchmarking is successfully utilized in industry to improve working process and productivity. In its original sense benchmarking is a systematic process for comparing performances, functions or processes of organisations against the best in the world.
However, the majority of research within lung cancer is focused on prevention, diagnosis and treatment rather than examining infrastructure or processes of managing lung cancer patients.
ADVANCE-1 is a European Respiratory Society (ERS) funded pilot study with the aim of creating a benchmarking tool that can easily document and reflect the structure and process within a lung cancer centre and its associated registry and how these processes impact on the pathway of a patient through the individual centres.
Method
The ADVANCE-1 study group was constituted by the two ERS fellowship-holders and senior lung cancer specialists from the two participating lung cancer services in the Beatson West of Scotland Cancer Centre, Glasgow, Scotland, and the Lungenklinik Heckeshorn in the Helios Klinikum Emil von Behring, Berlin, Germany. We created the study design with direct cooperation of the German Benchmarking Centre as well as the University of Glasgow. Final results were externally reviewed by the German Society for Quality Management in Health Care.
Result
Two benchmarking tools were created; the first for documentation of the service provided at each centre, the underlying cancer registry and a test of the robustness and comprehensiveness of information and data collecting resources available at each centre. Secondly; a patient pathway tool to reflect the journey of a patient through each of the relevant centres. Patient satisfaction surveys and staff satisfaction surveys were also created.
Prospective testing of these benchmarking tools in Glasgow and Berlin will allow a comparison between the two centres in order to ascertain best practice and learning from each centre in a so called ‘collaborative’ benchmarking approach.
Conclusion
This unique study has created a benchmarking tool that can easily document the service of a lung cancer centre and the pathway of a patient through that service. With comparison and learning from each other using this tool we aim to improve the patient care and journey through a lung cancer service.
