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  • American Society of Clinical Oncology (ASCO)  (9)
  • 2020-2024  (9)
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  • American Society of Clinical Oncology (ASCO)  (9)
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  • 2020-2024  (9)
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Subjects(RVK)
  • 1
    Online Resource
    Online Resource
    RNA sequencing analysis and T-cell receptor repertoire in triple-negative breast cancer (TNBC).
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  Journal of Clinical Oncology Vol. 38, No. 15_suppl ( 2020-05-20), p. 1075-1075
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 15_suppl ( 2020-05-20), p. 1075-1075
    Abstract: 1075 Background: Triple negative breast cancer (TNBC) is defined by the lack of two hormone receptors (HR) and human epidermal growth factor receptor 2 (HER2), and well known to have poor prognosis. In this study, we conducted a RNA sequencing including T-cell receptor (TCR) repertoire analysis to develop prognostic biomarker in patients with TNBC. In addition, genes and signaling pathways that correlated with selected biomarker were also investigated. Methods: Total of 78 tumor tissues from TNBC patients were participated for RNA-seq (Illumina Hiseq) analysis. Groups of significant genes were selected by differentially expressed genes (DEGs) analysis, whose expression levels differed more than 1.5 times between patients and normal, or early stage and advanced stage TNBC. Transcript expression levels for prognostic biomarker were analyzed based on R v3.4.3. Using CBS ProbePINGS, a genomic big data analytics platform, we evaluated druggable pathways and protein-protein interaction (PPI). The Interaction Frequency Ratio Score (IFRS) was calculated by investigating highly interactive pathways, and the drugs were matched to patients. TCR repertoire analysis was performed by MiXCR. Results: Ten candidate gene signatures were selected based on RNA sequencing data of each sample. Cross-validation through machine learning showed that the accuracy of the first-ranked signature was 92.3%, the second was 92.0%, and the third was 90.3%. The accuracy of 4 th to 6 th was 88.7%, and the accuracy of 7 th to 10 th was over 88.0%. Cross-validated gene signature, age, and TNM staging showed significant discriminant power under univariate Cox regression analysis (p 〈 0.05). In the CBS ProbePINGS, human papillomavirus infection, MAPK pathway, and tumorigenesis pathway were correlated with cell signaling. CDK2, FN1, and JUN genes were highly interactive each other. In addition, the drug matching result according to IFRS value suggested imatinib and regorafenib could be possible candidates. TCR repertoire analysis presented that number of clonecount was lower in recurrent or metastatic TNBC than early stage cancer. Conclusions: This study revealed a specific gene signatures that can accurately determine recurrence and metastasis in patients with TNBC based on RNA sequencing analysis. TCR repertoire analysis and CBS ProbePINGS could be valuable method in treatment selection
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2020.38.15_suppl.1075
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
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  • 2
    Online Resource
    Online Resource
    The effect of aroma lymphatic tressage for lower extremity edema associated with the taxane chemotherapy in patients with breast cancer: A phase 2 clinical trial.
    American Society of Clinical Oncology (ASCO) ; 2022
    In:  Journal of Clinical Oncology Vol. 40, No. 16_suppl ( 2022-06-01), p. e24099-e24099
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 16_suppl ( 2022-06-01), p. e24099-e24099
    Abstract: e24099 Background: Taxane-associated lower extremity edema is a distinctive adverse effect of taxane, which severely compromise patients’ quality-of-life. Aroma lymphatic tressage (ALT) has been established as a complementary technique that uses a combination of aromatherapy and hand massage to relieve distress and modulate lymphatic drainage in cancer patients. This study aimed to evaluate the symptom-relieving efficacy of a short course ALT on taxane-induced lower extremity edema. Methods: Patients treated with taxane-based chemotherapy for early or advanced stage breast cancer were screened for the study. Patients were enrolled when they presented more than CTCAE G3 of lower-extremity edema. A total of 8 sessions of ALT were applied twice a week for 4 weeks after completing taxane. The primary endpoint was to determine the leg circumference change before and after receiving ALT. Patients’ subjective degree of edema, and quality-of-life were also assessed. Results: A total of 37 patients completed all sessions of planned treatment. All of the participants were female, with the median age of 55.4-years-old. 30.8% of them were premenopausal. The median height of the patients was 157.6cm, median weight was 60.9kg, and median BMI was 1.6kg/m 2 . Most of the patients received docetaxel (87.2%). The baseline thigh, calf, and ankle circumferences were 56.5cm, 37.4cm, and 22.6cm, each. After 8 sessions of ALT, the median circumferences decreased to 54.7cm, 36.2cm, and 21.9cm. 23 (62.2%) participants experienced a 3% or more reduction in circumference change with a month of ALT. Patients’ subjective degree of edema decreased 56.9% for 4 weeks compared to baseline, while mean body weight decreased from 62.6kg to 61.2kg. All the differences before and after the ALT were statistically significant (p-value 〈 0.0001) Most of the indicators assessing patients’ quality-of-life improved during the ALT periods, especially physical subscale (from 14.8 to 19.1, p-value 〈 0.0001). EORTC-QLQ-C30 score also improved from 70.8 to 57.1 (p-value 〈 0.0001). Conclusions: To our knowledge, this is the first clinical trial to evaluate clinical efficacy of ALT on taxane-associated lower extremity edema. Patients who received ALT after taxane-based chemotherapy presented significant decline of leg circumference and improvement of QoL.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2022.40.16_suppl.e24099
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 3
    Online Resource
    Online Resource
    Randomized phase II study of axitinib versus observation in patients with recurred or metastatic adenoid cystic carcinoma.
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  Journal of Clinical Oncology Vol. 38, No. 15_suppl ( 2020-05-20), p. 6503-6503
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 15_suppl ( 2020-05-20), p. 6503-6503
    Abstract: 6503 Background: Adenoid cystic carcinoma (ACC) does not respond to cytotoxic chemotherapy. Several anti-angiogenic agents were evaluated in single arm phase II trials. However, the role of chemotherapy is still controversial, because of natural stable disease course without chemotherapy and lack of randomized trial. We firstly conducted a randomized trial to evaluate the efficacy of axitinib compared to observation. Methods: In this multicenter, prospective phase II trial, we enrolled recurred, metastatic ACC patients who progressed within 9 months. Patients were randomly assigned either axitinib (5mg twice daily) or observation arm with 1:1 ratio. Crossover to the axitinib arm was permitted for patients in the observation arm who had disease progression. The primary endpoint was 6-month progression-free survival (PFS) rate. The secondary endpoints included objective response rate (ORR), overall survival (OS), PFS, duration of response and adverse events. Results: A total of 60 patients randomly allocated to axitinib (N=30) and observation arm (N=30) and response evaluation was conducted in 57 patients. With a median follow-up of 25.4 months, the 6-month PFS rate was 73.2% (95% confidence interval [CI] , 54.8 to 88.1%) in the axitinib arm and 23.2% (95% CI, 9.3 to 41.1%) in the observation arm (hazard ratio, 0.19; 95% CI, 0.08 to 0.45; P 〈 0.001). Median PFS was 10.8 months in axitinib arm and 2.8 months in observation arm ( P 〈 0.001). The ORR was 3.3% (95% CI, 0.1 to 17.2%) in the axitinib arm, and 0% (95% CI, 0 to 12.8%) in the observation arm. The disease control rate was 100% (95% CI, 88.4 to 100%) in the axitinib arm and 51.9% (95% CI, 32.0 to 71.3%) in the observation arm. After crossover, ORR of axitinib in the observation arm was 11.1% (95% CI, 2.4 to 29.2%). Median OS was not reached in axitinib arm, 28.5 months in observation arm ( P = 0.688). The most frequently reported adverse events of axitinib were grade 1 or 2 oral mucositis and fatigue. Detailed data of adverse events and mutational profile data will be presented. Conclusions: In this first randomized trial in patients with recurred or metastatic ACC, axitinib significantly increased 6-month PFS rate compared to observation. Clinical trial information: NCT02859012 .
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2020.38.15_suppl.6503
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
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  • 4
    Online Resource
    Online Resource
    Deep learning-based ensemble model using hematoxylin and eosin (H&E) whole slide images (WSIs) for the prediction of MET mutations in non-small cell lung cancer (NSCLC).
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. e13578-e13578
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. e13578-e13578
    Abstract: e13578 Background: The MET proto-oncogene is involved in tumorigenesis and progression and has emerged as an attractive targetable genomic alteration in NSCLC. However, it has not been actively tested in NSCLC due to the lack of a cost-effective screening tool. We developed a deep-learning based model to predict genomic profiles from H & E WSI and applied it to MET pathologic mutations in NSCLC. The prediction model is based on an ensemble model trained not solely on H & E images but also on multi-layered semantic contents that were produced by a pre-trained AI analyzer, Lunit SCOPE IO. Methods: The model was trained on the MET aberration (exon 14 skipping, n=191; pathogenic mutation, n=109) and paired wild-type dataset (n=500). To extract deep features from raw H & E images, a self-supervised vision transformer was used, and an AI-based pathology profiling analyzer extracted semantic contents such as the spatial information of tumor cells, lymphocytes, cancer epithelium, and cancer stroma. A set of classifiers was trained based on the two features, and the ensemble of these features was used to improve robustness. Following cross-validation, the model was applied to an independent clinical dataset with MET sequencing results from The Cancer Genome Atlas (TCGA) LUAD and LUSC datasets (n=914), Samsung Medical Center (SMC, n=361), and Chonnam National University Hospital (CNUH, n=54). Results: The best cross-validation performances of the models predicting MET aberration measured by mean area under the receiver operating characteristic curve (AUROC) were 0.772 when trained by only H & E images (HE-only), 0.788 by AI semantic content with MLP classifier (AISC-MLP), and 0.803 by AISC with random forest (AI-RF), respectively. An ensemble of the three models showed an increased AUROC of 0.837 in the training dataset by cross-validation. These models were applied to the external validation dataset (n=1,329), including 20 (1.5%) MET exon 14 skipping and known pathologic mutations. The mean AUROC to predict MET aberration by the ensemble model was 0.817 with 95% sensitivity, 64.7% specificity. The AUROC of TCGA, SMC, and CNUH cohorts were 0.815, 0.802, and 0.812, respectively. Conclusions: An AI-based ensemble model combining H & E images with semantic contents extracted from pre-developed AI models significantly improved the accuracy and robustness of MET pathogenic mutation prediction using an H & E sample in NSCLC. These findings allow for cost-effective screening for MET alterations.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.e13578
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 5
    Online Resource
    Online Resource
    The metabolic activity assessed by 18 F-FDG PET and its correlation with tumor immune status and prognosis in advanced biliary tract cancer patients treated with 1L GemCis plus durvalumab +/-tremelimumab.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. 4092-4092
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. 4092-4092
    Abstract: 4092 Background: Gemcitabine/Cisplatin (GemCis) in combination with durvalumab have been established as a global new standard of care in first-line (1L) advanced biliary tract cancer (BTC) in the TOPAZ-1 trial (Oh et al. NEJM Evid, 2022). In our phase 2 study (NCT03046862, Oh et al. Lancet Gastroenterol Hepatol, 2022) exploring GemCis/durvalumab +/- tremelimumab, dynamics of PD-L1 expression after one cycle of treatment has been suggested as a predictor for clinical outcomes. Tumor metabolic activity assessed with 18 F-FDG PET is usually associated with prognosis in solid tumors. However, the role of metabolic activity in patients treated with the combination of chemotherapy and immunotherapy has not yet been much studied, in terms of correlation with tumor immune landscape and prognosis. Methods: This study recruited 1L, advanced BTC patients in 3 different cohorts. 18 F-FDG PET was conducted at baseline (pre-treatment) and at the time of first tumor response evaluation (post-treatment). Metabolic indices of the main tumor lesion were measured, including maximum standardized uptake values (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Metabolic response evaluation was assessed according to EORTC criteria. Tumor biopsies were done at baseline and after 1 cycle of treatment. Results: Among total 124 enrolled patients, 118 patients were included in this PET analysis. The early metabolic response rate was 54.3% (mCR 10.2%, mPR 44.1%, mSD 36.4%, mPD 9.3%). Pre-treatment metabolic parameters (SUVmax, MTV, TLG) were associated with disease status, previous operation history, and CRP level. High pre-treatment SUVmax was associated with poor progression-free survival (PFS) and overall survival (OS). Low post-treatment metabolism and large reduction in metabolism between pre- and post-treatment were associated with responder (vs non-responder), long PFS and long OS. In terms of PD-L1 expression and tumor metabolism, Tumor cell (TC) PD-L1 at pre-treatment was not associated with metabolic parameters; however, high immune cell (IC) PD-L1 expression showed significant association with lower MTV and TLG. In terms of dynamics of PD-L1 and tumor metabolism, post-treatment SUVmax was higher in patients with TC PD-L1 decrease. In patients with decrease of PD-L1 on both TC and IC (worst prognostic group), smaller reduction in metabolism between pre- and post-treatment was observed than the other patients. Conclusions: In BTC patients treated with 1L GemCis plus durvalumab +/- tremelimumab, tumor metabolic activity and its dynamics conferred prognostic impact. Furthermore, tumor metabolic activity has a potential to be associated with tumor immune landscape. Clinical trial information: NCT03046862 .
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.4092
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 6
    Online Resource
    Online Resource
    Co-mutation of ATM and ASXL1 and relationship to durable response of a novel PARP1/2 inhibitor, venadaparib, in patients with pancreatic cancer.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. e15019-e15019
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. e15019-e15019
    Abstract: e15019 Background: Homologous recombination repair (HRR) alterations such as BRCA mutation (BRCAm) and ATM mutation (ATMm) are established predictive biomarkers for poly (adenosine diphosphate [ADP]–ribose) polymerase (PARP) inhibitor in pancreatic cancer (PC). Mutations in the ASXL1 gene (ASXL1m) have been associated with hematologic malignancies. In solid cancers, however, associations between HRR and non-HRR mutation such as ASXL1m as well as treatment response in patients with those are not well known. The aim of this analysis was to explore genetic alterations co-existing with HRR mutation to better predict efficacy from a monotherapy of venadaparib, a PARP inhibitor under development, in patients with metastatic PC. Methods: Patients with HRR mutation and no standard treatment or prior treatment failure were enrolled in a phase Ib basket trial (NCT04174716) to receive venadaparib monotherapy. Tumor response to treatment was evaluated according to RECIST 1.1. Exploratory blood samples were collected to analyze genetic alterations using ctDNA next-generation sequencing (NGS) (GuardantOMNI Gene Panel version 1.0, Redwood City, CA) on Day 1 pre-dose. Prevalence of co-occurring mutations was estimated and mutual exclusivity between HRR and non-HRR mutations were statistically tested by Fisher’s exact test using the cBioPortal for Cancer Genomics ( http://cbioportal.org ) in The Cancer Genome Atlas (TCGA) Pan-cancer and AACR Project Genie v13.0 registries. Efficacy between patients with co-mutations and single mutation only were presented. Results: In public dataset, the prevalence of ATMm and ASXL1m was 3.0% and 0.9% in TCGA pan-cancer study (n = 10,967), 3.0% and 1.7% in Genie v13.0 (n = 131,996), respectively. In both datasets, co-mutation of ATM and ASXL1 was tested significant (Log2 Odds Ratio 2.663 and 1.176 respectively; q-value 0.001 and 0.006 respectively). In the basket trial, 8 patients were enrolled, with 50% male, and a median age 66 (range 47-72). 6 patients had 2 prior palliative chemotherapy. 6 patients had ATMm and 2 had BRCA2m confirmed by enrolling institution at baseline. All patients had responded to prior platinum containing regimen. ctDNA NGS samples were available in 6 patients. Patients with ATMmASXL1m (n = 3) had a 33% overall response rate (1 partial response, 2 stable disease, range of progression-free survival (PFS), 23-113 weeks), while those with ATMmASXL1wt (n = 1) had a 0% (1 progressive disease (PD), PFS 9 weeks) and others (ATMwtASXL1wt, n = 2, 1 PD; ctDNA not available, n = 2, 2 PD) had a 0% response rate (range PFS 3-16 weeks). Two patients with BRCA2m only had PD on weeks 3 and 8. Conclusions: In this exploratory analysis, patients with co-occurring ATMm and ASXL1m showed higher tumor response. This signals potential value from ATM and ASXL1 co-mutation predicting efficacy of Venadaparib in PC and warrants further validation. Clinical trial information: NCT04174716 .
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.e15019
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 7
    Online Resource
    Online Resource
    A phase II biomarker-oriented study to evaluate paclitaxel, olaparib, and durvalumab combination in patients with advanced gastric cancer.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 4_suppl ( 2023-02-01), p. 404-404
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 4_suppl ( 2023-02-01), p. 404-404
    Abstract: 404 Background: DNA damage response (DDR) gene alterations are observed in 27% of gastric cancer (GC), therefore, targeting DDR might be an interesting strategy in GC. Olaparib plus paclitaxel showed numerically improved overall survival (OS) compared to paclitaxel in 2L GC patients (pts), even though it did not meet the endpoint. (Lancet Oncol 2017). Besides DNA damage repair, olaparib induces immune modulation. The role of immune checkpoint inhibitor (ICI) is established in 1L and 3L+ GC. The combination of cytotoxic chemotherapy, DDR acting agent and ICI might have synergistic effects in GC, which has not been tested in clinical studies. Here, we report biomarker-oriented phase II study of paclitaxel/olaparib/durvalumab combination in 2L GC. (NCT03579784). Methods: Advanced GC pts who have failed to 1L chemotherapy were enrolled. During 1st cycle, paclitaxel (80 mg/m 2, D1, 8, 15 Q 4wk) and olaparib (150mg bid, D1-28) was administered. From 2 nd cycle, durvalumab (1500 mg, D1 Q 4wk) was added on them. Tumor biopsy (pretreatment, after 1st cycle, at disease progression) and blood collection (every cycle) was mandatory. Primary endpoint was the disease control rate (DCR). Secondary endpoints included ORR, DoR, PFS, OS and safety. For biomarker study, multiplex IHC, NGS, ctDNA, and cytokines and angiogenic factors analysis were performed. Efficacy analysis set (ES) and safety analysis set (SS) were defined as pts who underwent at least one tumor assessment and all pts who received cycle1 day1 or more, respectively. Results: Fifty pts were enrolled (6 screening fail or withdrawal of consent, 44 in SS, 38 in ES) HER2+ GC were 13.2%. Among 38 in ES, DCR and ORR were 84.1% (95% CI, 72.5-95.7) and 39.5% (95% CI, 24.0-55.0) (1 CR, 14 PR and 17 SD). PFS, DoR and OS were 6.7 (95% CI, 4.5-10.3), 6.5 (95% CI, 5.1-10.7) and 11.4 (95% CI, 9.2-13.2) months. Homologous recombination repair (HRR) genetic alterations (9.6 vs. 5.9 in PFS, p=0.037), high CD8/CD3 ratio (8.8 vs. 3.7 in PFS, p=0.008), high PD-L1 (CPS≥10) (9.6 vs 5.1 in PFS, p=0.031), low ATM IHC (13.3 vs. 9.8 in OS, p=0.066), and low serum IL-6 (12.9 vs. 8.3 in OS, p=0.001) were associated with prolonged PFS or OS. In SS, most adverse events (AEs) were mild, and Gr 3/4 leukopenia and anemia were observed in 52.2% and 31.8%. There were no treatment related AEs resulted in study discontinuation. Conclusions: Paclitaxel/olaparib/durvalumab is a promising combination in 2L GC, and is worth to be further explored, especially in biomarker-enriched patients with HRR, specific T-cells subsets, high PD-L1, low ATM and IL-6. Clinical trial information: NCT03579784 .
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.4_suppl.404
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 8
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    Online Resource
    Artificial Intelligence–Powered Spatial Analysis of Tumor-Infiltrating Lymphocytes as Complementary Biomarker for Immune Checkpoint Inhibition in Non–Small-Cell Lung Cancer
    American Society of Clinical Oncology (ASCO) ; 2022
    In:  Journal of Clinical Oncology Vol. 40, No. 17 ( 2022-06-10), p. 1916-1928
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 17 ( 2022-06-10), p. 1916-1928
    Abstract: Biomarkers on the basis of tumor-infiltrating lymphocytes (TIL) are potentially valuable in predicting the effectiveness of immune checkpoint inhibitors (ICI). However, clinical application remains challenging because of methodologic limitations and laborious process involved in spatial analysis of TIL distribution in whole-slide images (WSI). METHODS We have developed an artificial intelligence (AI)–powered WSI analyzer of TIL in the tumor microenvironment that can define three immune phenotypes (IPs): inflamed, immune-excluded, and immune-desert. These IPs were correlated with tumor response to ICI and survival in two independent cohorts of patients with advanced non–small-cell lung cancer (NSCLC). RESULTS Inflamed IP correlated with enrichment in local immune cytolytic activity, higher response rate, and prolonged progression-free survival compared with patients with immune-excluded or immune-desert phenotypes. At the WSI level, there was significant positive correlation between tumor proportion score (TPS) as determined by the AI model and control TPS analyzed by pathologists ( P 〈 .001). Overall, 44.0% of tumors were inflamed, 37.1% were immune-excluded, and 18.9% were immune-desert. Incidence of inflamed IP in patients with programmed death ligand-1 TPS at 〈 1%, 1%-49%, and ≥ 50% was 31.7%, 42.5%, and 56.8%, respectively. Median progression-free survival and overall survival were, respectively, 4.1 months and 24.8 months with inflamed IP, 2.2 months and 14.0 months with immune-excluded IP, and 2.4 months and 10.6 months with immune-desert IP. CONCLUSION The AI-powered spatial analysis of TIL correlated with tumor response and progression-free survival of ICI in advanced NSCLC. This is potentially a supplementary biomarker to TPS as determined by a pathologist.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.21.02010
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 9
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    Online Resource
    Immune phenotype-driven treatment outcome of IO-only versus chemo-IO in PD-L1-high, first-line, advanced non-small cell lung cancer (NSCLC).
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. e21179-e21179
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. e21179-e21179
    Abstract: e21179 Background: PD-L1 tumor proportion score (TPS) is the only biomarker for clinical decision-making regarding immunotherapy (IO) in advanced NSCLC. Currently, there is uncertainty when selecting treatment options between IO monotherapy (IO-only) and in combination with chemotherapy (Chemo-IO) when solely based on PD-L1, in patients with PD-L1 TPS ≥ 50%. Here, we explored a novel biomarker, immune phenotype as assessed by artificial intelligence (AI)-powered spatial tumor infiltrating lymphocytes (TIL) analysis to provide additional information in determining first-line treatment for advanced NSCLC, using a real-world dataset. Methods: A total of 349 whole-slide images (WSIs) of H & E-stained slides for advanced/metastatic NSCLC patients without actionable EGFR mutation and ALK translocation treated with IO-only or Chemo-IO as their first-line were retrospectively collected from Samsung Medical Center. An AI-powered spatial TIL analyzer, Lunit SCOPE IO classified inflamed immune phenotype (IIP, the proportion of inflamed area ≥ 33.3% in tumor microenvironment) versus non-inflamed IP (non-IIP). PD-L1 TPS was assessed based on PD-L1 pharmDx 22C3 staining. Progression-free survival (PFS) was measured by the investigators per RECIST v1.1. Results: In the analysis set, all IO-only group (n = 84) had TPS ≥ 50%, but Chemo-IO group (n = 265) consisted of 21.1%, 29.8%, and 49.1% of TPS ≥ 50%, 1-49%, and 〈 1%, respectively. Proportions of squamous cell carcinoma were not significantly different between IO-only and Chemo-IO (32.1% vs 27.5%, p = 0.5008). Proportions of IIP were significantly correlated with the TPS group, as they were 33.6%, 19.0%, and 13.1% in TPS ≥ 50%, 1-49%, and 〈 1%, respectively (p = 0.0002). In the merged dataset (n = 349), PFS was significantly increased in IIP (22.6%) compared to non-IIP (median PFS [mPFS] 14.6 vs 6.0 m, 6-m PFS rate 72.1% vs 49.9%, hazard ratio [HR, 95% confidence interval] 0.57 [0.39-0.82], p = 0.0014). In TPS ≥ 50% group, IIP was significantly correlated with favorable PFS in IO-only group (IIP vs non-IIP; mPFS 14.6 vs 4.6 m, 6-m rate 65.5 vs 45.2%, HR 0.55 [0.31-0.98] , p = 0.0375), however, it was not statistically different in Chemo-IO (n = 56, mPFS not reached [NR] vs 8.3 m, 6-m rate 88.5 vs 65.3%, HR 0.45 [0.15-1.33] , p = 0.1185). Interestingly, in the subgroup of TPS ≥ 50% with IIP (n = 47), PFS was not significantly different based on treatment regimen (Chemo-IO vs IO-only, mPFS NR vs 14.6 m, 6-m rate 88.5 vs 65.5%, HR 0.52 [0.17-1.59], p = 0.2263), but Chemo-IO was significantly superior to IO-only in TPS ≥ 50% with non-IIP group (n = 93, mPFS 8.3 vs 4.6 m, 6-m rate 65.3 vs 45.2%, HR 0.53 [0.30-0.94] , p = 0.0255). Conclusions: Immune Phenotype based on AI-powered spatial TIL analysis may provide complementary information for clinical decision-making between IO-only and Chemo-IO in advanced NSCLC patients with TPS ≥ 50%.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.e21179
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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