Baseline CD8+ T-cells predict NSCLC immunotherapy safety

In patients with advanced non-small-cell lung cancer (NSCLC) who undergo treatment with immune checkpoint inhibitors (ICIs), baseline levels of peripheral blood CD8+ T cells may be predictive of immune-related adverse events (irAEs) and clinical outcomes [1].

Immunotherapy has revolutionised the treatment landscape for several types of cancer, but immunotherapeutic protocols are frequently accompanied by irAEs. Thus, there is an urgent need to discover biomarkers that can be used to predict disease course and response to treatment. Researchers have speculated that the activation of T-cell activity elicited by ICIs may result in a loss of immune tolerance in various organs, leading to irAEs.

Prof. Kan Wu (Zhejiang University School of Medicine, China) and colleagues sought to determine the association between baseline subsets of lymphocytes and irAEs and clinical outcomes (i.e. progression-free survival [PFS] and overall survival [OS]) in 109 patients with advanced NSCLC who had been treated with ICIs at any point. Retrospective analysis showed that 55 (50.5%) patients had experienced at least 1 type of irAE, and 38 (34.9%) had experienced multiple irAEs. Severe irAEs had occurred in 16 (14.7%) patients.

Univariate and multivariate regression models evaluated predictive factors of irAEs, and the Kaplan-Meier method was used to evaluate PFS and OS. Cox-regression analyses then assessed the prognostic effects of CD8+ T cells on PFS and OS. These analyses revealed that the incidence of irAEs was higher and PFS and OS were longer in the group with high counts of CD8+ lymphocytes than in the group with low counts of CD8+ lymphocytes.

The investigators concluded that in patients with advanced NSCLC who receive ICI therapy, baseline peripheral blood CD8+ T-cells may be useful to predict irAEs as well as clinical outcomes such as PFS and OS. These findings require further research for validation.

1. Wu K. Peripheral CD8+ T Cells predicts immune-related adverse events and survival in advanced non-small cell lung cancer treated with immunotherapy. MA 09.03, WCLC 2021, 8–14 September.

 

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Posted on 21 September 202115 February 2024