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Genomic and immune profiling

Presented by
Dr Ke-Zhong Chen, Peking University People’s Hospital, Beijing, China
ELCC 2019
Recently, neoadjuvant targeted therapy and immunotherapy have shown a promising clinical effect for localised stage NSCLC. However, the relation between genomic and immune profiling has been poorly delineated.

Dr Ke-Zhong Chen (Peking University People’s Hospital, Beijing, China) reported the first prospective study integrating genomic variation and profiling of the T cell receptor repertoire in localised surgical lung adenocarcinoma [4]. In 100 enrolled patients, EGFR (65.4%), TP53 (36.5%), and KRAS (11.5%) were most frequently mutated. Change in T cell receptor repertoire and tumour mutational burden were found to be dependent on invasiveness of tumour type and to have a broad range in EGFR mutation.

Invited discussant Dr Anne-Marie Dingemans (University Hospital Maastricht, the Netherlands) applauded the investigators on their data. “In 1 year, tissue and plasma samples of more than 100 patients was collected. They performed an enormous amount of analyses.” The characteristics of these Asian patients (e.g. 60% with EGFR mutation and mostly stage 1A NSCLC) are completely different from European patients. However, it was disappointing that the abundance of collected ctDNA was very low. “So, you still need tissue to evaluate early stage lung cancer”, Dr Dingemans concluded. She continued on the relationship of the tissue immune repertoire with the EGFR mutation, because patients with EGFR-positive NSCLC are less responsive to immunotherapy. Dr Chen showed some data about this item and found that EGFR mutation is not related to the invasiveness of the tumour and the presence of ground-glass opacities. However, the investigators found that the tumour mutational burden was very low. Also the clonality was low in patients with EGFR-positive lung cancer. The question is whether these factors are related to outcome.

  1. Chen K, et al. ELCC 2019, abstract 69O.

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