Using a host immune classifier (HIC) test for patients with non–small cell lung cancer (NSCLC) may provide better predictors of treatment response and improve outcomes, according to research presented by Akerley et al at the International Association for the Study of Lung Cancer (IASLC) 2020 World Conference on Lung Cancer (WCLC) Singapore, which was moved to a virtual format and held January 28–31, 2021, in light of the COVID-19 pandemic (Abstract MA08.03).
Immune checkpoint inhibitors have revolutionized cancer care in patients with advanced-stage NSCLC, but better predictors of treatment response are still needed to guide treatment decisions for patients diagnosed with NSCLC, according to presenting author Wallace Akerley, MD, of Huntsman Cancer Institute. HIC is a serum proteomic measure of inflammation. A classification of “hot” implies that the tumor is inflamed.
Study Details and Findings
Researchers from 33 sites enrolled 3,500 patients with NSCLC in a prospective, observational study that assessed the ability of clinical factors and a clinically validated, blood-based HIC to predict immune checkpoint inhibitor therapy outcomes. Overall survival of subjects with newly diagnosed advanced NSCLC did not differ significantly between those treated with immunotherapy alone and those treated with immunotherapy plus chemotherapy (median overall survival = 9.4 vs 12.5 months; hazard ratio = 0.80, 95% confidence interval [CI] = 0.54–1.19, P = .28).
Results demonstrated that patients receiving immune checkpoint inhibitors indicated that HIC, better performance status, and younger age—but not high PD-L1 expression (either 50% or 90% cutoff)—were significantly associated with longer overall survival. When adjusted for covariates in a multivariate analysis, HIC and age remained significant predictors of overall survival (P = .0006 and P = .005), whereas performance status did not (P = .40).
“The HIC test provides clinically meaningful information in addition to currently used clinical factors to potentially help guide immunotherapy treatment decisions for patients with newly diagnosed NSCLC,” said Dr. Akerley.
Disclosure: For full disclosures of the study authors, visit wclc2020.iaslc.org/disclosures.
