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Mazzaschi G, Minari R, Zecca A, Cavazzoni A, Ferri V, Mori C, Squadrilli A, Bordi P, Buti S, Bersanelli M, Leonetti A, Cosenza A, Ferri L, Rapacchi E, Missale G, Petronini PG, Quaini F, Tiseo M. Soluble PD-L1 and Circulating CD8+PD-1+ and NK Cells Enclose a Prognostic and Predictive Immune Effector Score in Immunotherapy Treated NSCLC patients. Lung Cancer 2020; 148:1-11. [PMID: 32768804 DOI: 10.1016/j.lungcan.2020.07.028] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/15/2020] [Accepted: 07/24/2020] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Upfront criteria to foresee immune checkpoint inhibitors (ICIs) efficacy are far from being identified. Thus, we integrated blood descriptors of pro-inflammatory/immunosuppressive or effective anti-tumor response to non-invasively define predictive immune profiles in ICI-treated advanced non-small cell lung cancer (NSCLC). METHODS Peripheral blood (PB) was prospectively collected at baseline from 109 consecutive NSCLC patients undergoing ICIs as first or more line treatment. Soluble PD-L1 (sPD-L1) (immunoassay), CD8+PD-1+ and NK (FACS) cells were assessed and interlaced to generate an Immune effector Score (IeffS). Lung Immune Prognostic Index (LIPI) was computed by LDH levels and derived Neutrophil-to-Lymphocyte Ratio (dNLR). All these parameters were correlated with survival outcome and treatment response. RESULTS High sPD-L1 and low CD8+PD-1+ and NK number had negative impact on PFS (P < 0.001), OS (P < 0.01) and ICI-response (P < 0.05). Thus, sPD-L1high, CD8+PD-1+low and NKlow were considered as risk factors encompassing IeffS, whose prognostic power outperformed that of individual features and slightly exceeded that of LIPI. Accordingly, the absence of these risk factors portrayed a favorable IeffS characterizing patients with significantly (P < 0.001) prolonged PFS (median NR vs 2.3 months) and OS (median NR vs 4.1) and greater benefit from ICIs (P < 0.01). We then combined each risk parameter composing IeffS and LIPI (LDHhigh, dNLRhigh), thus defining three distinct prognostic classes. A remarkable impact of IeffS-LIPI integration was documented on survival outcome (PFS, HR = 4.61; 95%CI = 2.32-9.18; P < 0.001; OS, HR=4.03; 95%CI=1.91-8.67; P < 0.001) and ICI-response (AUC=0.90, 95%CI=0.81-0.97, P < 0.001). CONCLUSION Composite risk models based on blood parameters featuring the tumor-host interaction might provide accurate prognostic scores able to predict ICI benefit in NSCLC patients.
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Affiliation(s)
- G Mazzaschi
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Department of Medicine & Surgery, University of Parma, Italy
| | - R Minari
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
| | - A Zecca
- Infectious Diseases and Hepatology Unit, Laboratory of Viral Immunopathology, University Hospital of Parma, Italy
| | - A Cavazzoni
- Department of Medicine & Surgery, University of Parma, Italy
| | - V Ferri
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - C Mori
- Infectious Diseases and Hepatology Unit, Laboratory of Viral Immunopathology, University Hospital of Parma, Italy
| | - A Squadrilli
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - P Bordi
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - S Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - M Bersanelli
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - A Leonetti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - A Cosenza
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - L Ferri
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - E Rapacchi
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - G Missale
- Department of Medicine & Surgery, University of Parma, Italy; Infectious Diseases and Hepatology Unit, Laboratory of Viral Immunopathology, University Hospital of Parma, Italy
| | - P G Petronini
- Department of Medicine & Surgery, University of Parma, Italy
| | - F Quaini
- Department of Medicine & Surgery, University of Parma, Italy
| | - M Tiseo
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Department of Medicine & Surgery, University of Parma, Italy
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Mazzaschi G, Minari R, Ferri V, Gnetti L, Bersanelli M, Cavazzoni A, Bordi P, Squadrilli A, Buti S, Cosenza A, Ferri L, Rapacchi E, Petronini P, Missale G, Quaini F, Tiseo M. Genetic, tissue and circulating PD-L1 profiling to predict the response to immuno-checkpoint inhibitors in advanced NSCLC. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz447.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cinausero M, Laprovitera N, De Maglio G, Gerratana L, Riefolo M, Macerelli M, Fiorentino M, Porcellini E, Buoro V, Gelsomino F, Squadrilli A, Fasola G, Tiseo M, Ferracin M, Ardizzoni A. KRAS and ERBB-family genetic alterations affect response to PD-1 inhibitors in metastatic non-squamous NSCLC. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz063.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tiseo M, Facchinetti F, Buti S, Gelsomino F, Veneziani M, Squadrilli A, Bordi P, Bersanelli M, Cosenza A, Ferri L, Rapacchi E, Mazzaschi G, Leonardi F, Quaini F, Ardizzoni A, Missale G. Circulating immune-profile as predictor of outcome in advanced NSCLC patients treated with Nivolumab. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx426.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tiseo M, Facchinetti F, Gelsomino F, Buti S, Veneziani M, Squadrilli A, Bordi P, Bersanelli M, Cosenza A, Ferri L, Rapacchi E, Mazzaschi G, Leonardi F, Quaini F, Ardizzoni A, Missale G. Circulating immune-profile as predictor of outcome in advanced NSCLC patients treated with nivolumab. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx390.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tiseo M, Veneziani M, Gelsomino F, Facchinetti F, Bordi P, Rapacchi E, Squadrilli A, Buti S, Missale G, Ardizzoni A. Circulating immune-profile as predictor of outcome in NSCLC patients treated with nivolumab. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx089.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Negri F, Bozzetti C, Azzoni C, Bottarelli L, Squadrilli A, Pedrazzi G, Lagrasta C, Tamagnini I, Bisagni A, Porzio R, Tomasello G, Leonardi F, Pinto C, Ardizzoni A, Sala R, Quaini F. P-027 Cancer stem cells marker CD44 and Notch activation predict unfavorable prognosis in metastatic colon cancer patients treated with anti VEGF-therapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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