The following is a summary of the “27-gene Immuno-Oncology (IO) Score is Associated With Efficacy of Checkpoint Immunotherapy in Advanced NSCLC: A Retrospective BC Cancer Study,” published in the March 2023 issue of Lung Cancer by Saltman, et al.
In advanced non-small cell lung cancer, immunotherapy in the form of immune checkpoint inhibitors (ICI) is the gold standard NSCLC. Despite this, not all patients benefit, even among those with a PD-L1 tumor proportional score (TPS) 50%, highlighting the unmet need for additional biomarkers such as those assessing the tumor immune microenvironment (TIME). DetermaIO is a gene expression analysis that classifies TIME along 27 different genes and has been linked to ICI response.
Patients with a performance status (PS) of 2 or higher and who had received at least 2 cycles of ICI monotherapy in first (1L) or second (2L) line treatment at BC Cancer or West Clinic Cancer Center provided the FFPE samples (2L). The correlation between IO scores and PFS and OS was investigated. Overall survival (HR=0.68, 95%CI 0.47-0.99, P =.042) and progression-free survival (HR=0.62, 95%CI 0.43-0.88, P =.0069) were both significantly correlated with IO score in the entire cohort (N=147).
The IO score was significantly associated with PFS (HR=0.55, 95% CI 0.32-0.94, P =.028) in patients who were treated with 1L (PD-L150%, N=78). It was confirmed in PFS subgroup analysis in the independent West Cancer Center study (N=13 HR=0.14, 95%CI 0.027-0.76, P =.023) that IO score was associated with benefit in 1L PS2 patients for OS (HR = 0.26, 95%CI 0.091-0.74, P =.012) and PFS (HR = 0.27, 95%CI 0.098-0.72, P =.0095). These results corroborate the prior observation that DetermaIO is associated with ICI clinical benefit in NSCLC and extend previous research by showing that PD-L150% patients treated in the first line can be further stratified by IO score to identify efficacy. Initial hypothesis testing indicated that the IO score can identify benefit in patients with low PS.