Abstract 4460: Spatial profiling of immune biomarkers in resected treatment-naïve early stage lung adenocarcinoma

Background: Recently, neoadjuvant immunotherapy plus chemotherapy has been approved for treatment of resectable non-small cell lung carcinoma (NSCLC). Defining the immune landscape of these tumors and its spatial distribution will help to understand lung cancer biology. Here, we analyzed the distribution of immune-related biomarkers in tumor-defined regions and its associations with clinicopathological variables in resected lung adenocarcinomas using high-plex profiling approaches.

Methodology: Thirty-three FFPE tumor tissues from surgically resected treatment-naïve lung adenocarcinoma stage I/II were used to construct a tissue microarray from the MD Anderson ICON cohort. We used three 1-mm core per patient [2 from central tumor (CT), and 1 from invasive margin (IM)] and performed the GeoMx Digital Spatial Profiling protein protocol to assess 49 immune biomarkers. Pancytokeratin (panCK; epithelial), CD45 (immune) and SYTO 13 (nuclear) were utilized as morphology biomarkers. Regions of interests were placed in cores containing tumor, and segmented in ‘”Tumor (Tu)” (PanCK+) and the “tumor microenvironment (TME)” (PanCK-). Digital counts were normalized using background correction. Statistical analysis was performed using linear mixed model. A p value equal or less than 0.05 was considered significant.

Results: We first compared the relative counts of immune biomarkers in the TME in CT and IM. IM had higher CD3, CD8, CD45RO, as well as CD163 and STING (P ranges 0.006 to 0.035), while CT had higher PD1 (P 0.025). Then we analyzed differential biomarker expression by sex and smoking status. Females had higher counts of Immune related biomarkers: CD45, CD3, CD20, immune checkpoints: PD-L1, VISTA, CTLA4, LAG3, and ICOS, and myeloid: CD68, CD11c, CD163, and B2M (P ranges 0.0005 to 0.046). Smokers had higher counts of CD66b (P 0.007) and B2M (P 0.039) while never smokers had higher counts of HLA-DR, CD34, FoxP3, OX40L, Tim-3, and B7-H3 (P ranges 0.001 to 0.049). Finally, we analyzed Tu segments. IM had higher CD66b, VISTA, CD163, OX40L, HLA-DR, GZMB, STING, and CD8 (P ranges 0.007 to 0.045) than CT. Female patients had higher CD45, CD68, CD11c and CD163 (P ranges 0.008 to 0.045), and males had higher SMA (P 0.005). Smokers had higher CD66b (P 0.007), B2-microglobulin (P 0.043), and never smokers had higher HLA-DR, STING, CD34, CD44, FoxP3 and CD25 (P ranges 0.006 to 0.043).

Conclusions: In this study, biomarker analysis of treatment-naïve adenocarcinoma in CT areas and IM indicates a higher immune response in the IM and presence of inhibitory signaling inside the tumor. Our data also showed that tumors from females have higher immune response than tumors from males, which is concordant with previous studies. Distinct profiling by smoking status was also observed. Further analysis of gene expression analysis of this set is ongoing.

Citation Format: Sharia D. Hernandez, Wei Lu, Alejandra G. Serrano, Claudio J. Arrechedera, Beatriz Sanchez-Espiridion, Nejla Ozirmak, Max Molina, Larisa Kostousov, Sean Barnes, Khaja Khan, Ximing Tang, Junya Fujimoto, Edwin R. Parra, Gabriela Raso, Stephanie T. Schmidt, Carmen Behrens, John Heymach, Jianjun Zhang, Ken Chen, Boris Sepesi, Tina Cascone, Don Gibbons, Ignacio I. Wistuba, Cara Haymaker, Luisa M. Solis. Spatial profiling of immune biomarkers in resected treatment-naïve early stage lung adenocarcinoma. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4460.

Differential Spatial Gene and Protein Expression Associated with Recurrence Following Chemoradiation for Localized Anal Squamous Cell Cancer

The identification of transcriptomic and protein biomarkers prognosticating recurrence risk after chemoradiation of localized squamous cell carcinoma of the anus (SCCA) has been limited by a lack of available fresh tissue at initial presentation. We analyzed archival FFPE SCCA specimens from pretreatment biopsies prior to chemoradiation for protein and RNA biomarkers from patients with localized SCCA who recurred (N = 23) and who did not recur (N = 25). Tumor cells and the tumor microenvironment (TME) were analyzed separately to identify biomarkers with significantly different expression between the recurrent and non-recurrent groups. Recurrent patients had higher mean protein expression of FoxP3, MAPK-activation markers (BRAF, p38-MAPK) and PI3K/Akt activation (phospho-Akt) within the tumor regions. The TME was characterized by the higher protein expression of immune checkpoint biomarkers such as PD-1, OX40L and LAG3. For patients with recurrent SCCA, the higher mean protein expression of fibronectin was observed in the tumor and TME compartments. No significant differences in RNA expression were observed. The higher baseline expression of immune checkpoint biomarkers, together with markers of MAPK and PI3K/Akt signaling, are associated with recurrence following chemoradiation for patients with localized SCCA. These data provide a rationale towards the application of immune-based therapeutic strategies to improve curative-intent outcomes beyond conventional therapies for patients with SCCA.