Abstract A58: Increased systemic activated CD4+ T cells and non-classical monocytes are associated with improved immunotherapy response and progression-free survival in non-small cell lung cancer patients


 The development of immune checkpoint inhibitors initiated a new era of anti-cancer therapies with very promising results. Although effective for many patients, others are primarily refractory to this treatment. Identifying systemic immune cell subpopulations associated with treatment success or failure can reveal mechanisms behind therapeutic failure and offer potential predictive markers of clinical use. Here, for the first time, we performed a prospective non-interventional study and evaluated the pretreatment systemic immunological status of 33 patients with stage IV non-small cell lung cancer treated with anti-PD-1 combined with chemotherapy by flow cytometry. Treatment outcome was evaluated 9 weeks after treatment to define patients as Responders and Non-responders. Patients were reevaluated 6 months after therapy. Responders presented a higher frequency of activated CD4+ CD69+ T lymphocytes and non-classical monocytes before treatment began, which acted as predictive biomarkers for response measured at nine weeks. Conversely, CTLA-4+CD4+ T lymphocytes were more frequent in Non-responders and may contribute to an immunosuppressive milieu impairing the control of the tumor. Patients with durable responses (³ 6 months) also had higher frequency of activated CD4+ T lymphocytes before treatment started, compared with non-responders. In contrast, non-classical monocytes did not predict a durable response. However, patients with a higher frequency of both immune populations had longer median progression free survival. Our results suggest that higher frequency of peripheral activated CD4+CD69+, CD4+CTLA-4+ T cells may be useful biomarkers of therapeutic success or failure in NSCLC and point to mechanisms underlying therapeutic outcome. Studies are underway to further characterize the functional potential and activation status these systemic immune subpopulations.
 Citation Format: Amanda B Figueiredo, Stephanie M Iasbeke Ferreira, Guilherme FB Evangelista, Iasmim P Santos, Larissa M Kuil, Clara M Cavalcanti, Kátia LP Morais, Nayane AL Galdino, Ananda D Lopes, Helano C Freitas, Jefferson L Gross, Clóvis A Lopes Pinto, Rubens Chojniak, Vladmir C Cordeiro de Lima, Kenneth J Gollob. Increased systemic activated CD4+ T cells and non-classical monocytes are associated with improved immunotherapy response and progression-free survival in non-small cell lung cancer patients [abstract]. In: Proceedings of the AACR Special Conference: Tumor Immunology and Immunotherapy; 2022 Oct 21-24; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2022;10(12 Suppl):Abstract nr A58.