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Hayat Oum El Kheir Ramdani
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P33 - Pathology - Immunotherapy Biomarker (ID 101)
- Event: WCLC 2020
- Type: Posters
- Track: Pathology, Molecular Pathology and Diagnostic Biomarkers
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P33.20 - Evaluation of Combined Biomarker of Response to Immunotherapy in Patients with Advanced Non-Small Cell Lung Cancer (ID 1801)
00:00 - 00:00 | Presenting Author(s): Hayat Oum El Kheir Ramdani
- Abstract
Introduction
Immunotherapy revolutionized NSCLC treatment. At present, the only established predictive biomarker for I/O-therapy stratification is PD-L1 expression. However, the expression of PD-L1 is limited by heterogeneous expression and even low expressors harbor patients that respond to I/O therapy. The aim of the study is to evaluate the value of combinations of positive (Tumor Mutational Burden, PD-L1) and negative (a.o. CD73 and VISTA expression, inactivating STK11 and KEAP1 mutations) predictive markers in patients (pts) with advanced NSCLC on I/O-therapy.
Methods
A retrospective study was performed on a cohort of 56 pts with advanced NSCLC treated with I/O between 2015 and 2019. Patients were selected by the availability of tumor tissue and based on tumor response evaluated by RECIST v1.1 criteria: only patients with durable tumor response (CR,PR > 6 months) and patients with no tumor response (PD as best response) were analyzed for biomarkers: hybrid capture NGS assay for TMB (New Oncology) including STK11 mutations and IHC tests for PD-L1, CD73 and VISTA. Adjusted Cox regression and ROC analysis will be performed to evaluate the predictive value of the different biomarkers.
Results
43/54 pts received nivolumab, 13 pembrolizumab in different therapy lines (from 1st to 5th). 24 pts were defined as having a durable tumor response (median PFS 44 months, median OS 53 months; p<0.0001) 30 pts as primary progressors (median PFS 2 months, median OS 12 months; p<0.0001). In 32 pts enough material was available for TMB testing. In 13 durable responders median TMB-value was 12.51 mutations/Mb versus 11.42 mutations/Mb in 17 primary non-responders. STK11 mutations were observed in 3/17 primary non-responders (10%) vs. 0/13 in durable responders (0%). Final analyses of the biomarkers will be presented at the meeting as well as correlative data of the parameters analyzed.
Conclusion
The combination of different biomarkers may better predict responses to I/O than PD-L1 alone and improve the selection of patients that benefit from I/O treatment.
