Circulating T-cell Immunosenescence in Patients with Advanced Non-small Cell Lung Cancer Treated with Single-agent PD-1/PD-L1 Inhibitors or Platinum-based Chemotherapy

  • R. Ferrara
  • , M. Naigeon
  • , E. Auclin
  • , B. Duchemann
  • , L. Cassard
  • , J.M. Jouniaux
  • , L. Boselli
  • , J. Grivel
  • , A. Desnoyer
  • , L. Mezquita
  • , M. Texier
  • , C. Caramella
  • , L. Hendriks
  • , D. Planchard
  • , J. Remon
  • , S. Sangaletti
  • , C. Proto
  • , M.C. Garassino
  • , J.C. Soria
  • , A. Marabelle
  • A.L. Voisin, S. Farhane, B. Besse*, N. Chaput*
*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Purpose: CD28, CD57, and KLRG1 have been previously identified as markers of T-cell immunosenescence. The impact of immunosenescence on anti-PD(L)-1 (ICI) or platinum-based chemotherapy (PCT) in patients with advanced non–small cell lung cancer (aNSCLC) is unknown. Experimental Design: The percentage of CD28, CD57 þ, KLRG1 þ among CD8 þ T cells [senescent immune phenotype (SIP)] was assessed by flow cytometry on blood from patients with aNSCLC before single-agent ICI (discovery cohort). A SIP cutoff was identified by log-rank maximization method and patients with aNSCLC treated with ICI (validation cohort) or PCT were classified accordingly. Proliferation and functional properties of SIP þ CD8 þ T cells were assessed in vitro. Results: In the ICI discovery cohort (N ¼ 37), SIP cut-off was 39.5%, 27% of patients were SIP þ. In the ICI validation cohort (N ¼ 46), SIP þ status was found in 28% of patients and significantly correlated with worse objective response rate (ORR; 0% vs. 30%, P ¼ 0.04), median progression-free survival (PFS) [1.8 (95% confidence interval (CI), 1.3-NR) vs. 6.4 (95% CI, 2–19) months, P ¼ 0.009] and median overall survival, OS [2.8 (95% CI, 2.0-NR) vs. 20.8 (95% CI, 6.0-NR) months, P ¼ 0.02]. SIP þ status was significantly associated with circulating specific immunephenotypes, in vitro lower CD8 þ T cells proliferation, lower IL2 and higher TNFa and IFNg production. In the ICI-pooled population (N ¼ 83), SIP þ status did not correlate with any clinical characteristics and it was associated with significantly worse ORR, PFS, and OS. In PCT cohort (N ¼ 61), 11% of patients were SIP þ. SIP status did not correlate with outcomes upon PCT. Conclusions: Circulating T-cell immunosenescence is observed in up to 28% of patients with aNSCLC and correlates with lack of benefit from ICI but not from PCT.

Original languageEnglish
Pages (from-to)492-503
Number of pages12
JournalClinical Cancer Research
Volume27
Issue number2
DOIs
Publication statusPublished - 15 Jan 2021

Keywords

  • biomarkers
  • blockade
  • docetaxel
  • elderly-patients
  • nivolumab
  • nsclc
  • outcomes
  • pd-1
  • replicative senescence
  • therapy
  • NSCLC
  • DOCETAXEL
  • REPLICATIVE SENESCENCE
  • BIOMARKERS
  • THERAPY
  • OUTCOMES
  • NIVOLUMAB
  • BLOCKADE
  • ELDERLY-PATIENTS
  • PD-1

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