1
|
Ahn BC, Park C, Lee SJ, Hong S, Hwang JE, Kwon K, Kim JY, Kim KH, Kim HY, Lee GK, Lee Y, Han JY. Nivolumab after Induction Chemotherapy in Previously Treated Non-Small-Cell Lung Cancer Patients with Low PD-L1 Expression. Cancers (Basel) 2023; 15:4460. [PMID: 37760429 PMCID: PMC10526182 DOI: 10.3390/cancers15184460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
This study aimed to investigate whether cyclophosphamide (C) and adriamycin (A) induction therapy (IT) prior to nivolumab could enhance the efficacy of nivolumab in previously treated patients with non-squamous (NSQ) non-small-cell lung cancer (NSCLC) with less than 10% programmed death-ligand 1 (PD-L1) expression. Twenty-two enrolled patients received four cycles of CA-IT every 3 weeks. Nivolumab was given 360 mg every 3 weeks from the second cycle and 480 mg every 4 weeks after four cycles of CA-IT. The median progression-free survival (PFS) and overall survival (OS) were 2.4 months and 11.6 months, respectively. Fluorescence-activated cell sorting revealed the lowest ratio of myeloid-derived suppressor cells (MDSCs) to CD8+T-cells in the responders. Proteomic analysis identified a consistent upregulation of extracellular matrix-receptor interactions and phagosome pathways in the responders. Among the differentially expressed proteins, the transferrin receptor protein (TFRC) was higher in the responders before treatment (fold change > 1.2). TFRC validation with an independent cohort showed the prognostic significance of either OS or PFS in patients with low PD-L1 expression. In summary, CA-IT did not improve nivolumab efficacy in NSQ-NSCLCs with low PD-L1 expression; however, it induced decreasing MDSC, resulting in a durable response. Higher baseline TFRC levels predicted a favorable response to nivolumab in NSCLC with low PD-L1 expression.
Collapse
Affiliation(s)
- Beung-Chul Ahn
- Center for Lung Cancer, Division of Hematology and Oncology, Department of Internal Medicine, Research Institute and Hospital, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Republic of Korea; (B.-C.A.); (K.K.)
| | - Charny Park
- Research Institute, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Republic of Korea; (C.P.); (S.-J.L.); (J.-E.H.); (J.Y.K.)
| | - Sang-Jin Lee
- Research Institute, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Republic of Korea; (C.P.); (S.-J.L.); (J.-E.H.); (J.Y.K.)
| | - Sehwa Hong
- Research Institute, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Republic of Korea; (C.P.); (S.-J.L.); (J.-E.H.); (J.Y.K.)
| | - Ji-Eun Hwang
- Research Institute, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Republic of Korea; (C.P.); (S.-J.L.); (J.-E.H.); (J.Y.K.)
| | - Kyoungsuk Kwon
- Center for Lung Cancer, Division of Hematology and Oncology, Department of Internal Medicine, Research Institute and Hospital, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Republic of Korea; (B.-C.A.); (K.K.)
| | - Jin Young Kim
- Research Institute, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Republic of Korea; (C.P.); (S.-J.L.); (J.-E.H.); (J.Y.K.)
| | - Kyung-Hee Kim
- Proteomics Core Facility, Research Core Center, Research Institute and Hospital, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Republic of Korea
| | - Hyae Young Kim
- Department of Radiology, Research Institute and Hospital, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Republic of Korea;
| | - Geon Kook Lee
- Department of Pathology, Research Institute and Hospital, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Republic of Korea;
| | - Youngjoo Lee
- Center for Lung Cancer, Division of Hematology and Oncology, Department of Internal Medicine, Research Institute and Hospital, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Republic of Korea; (B.-C.A.); (K.K.)
| | - Ji-Youn Han
- Center for Lung Cancer, Division of Hematology and Oncology, Department of Internal Medicine, Research Institute and Hospital, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Republic of Korea; (B.-C.A.); (K.K.)
| |
Collapse
|