The following article features coverage from the European Society for Medical Oncology (ESMO) 2019 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

Results of a study evaluating the T-cell composition of presurgical and postsurgical blood specimens collected from patients with resectable early-stage non-small cell lung cancer (NSCLC) showed a significant decrease in the percentage of effector T cells following surgery. The findings from this study were presented at the European Society for Medical Oncology (ESMO) Congress 2019 in Barcelona, Spain. 

Immune checkpoint inhibitors (ICIs) are designed to interfere with the function of tumor-primed effector T cells.  Hence, the potential impact of surgery on the immunologic status of the patient is an important factor to consider in the decision making related to the use of ICIs in the neoadjuvant vs the adjuvant setting for early-stage cancer. 

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In this study, which involved 20 patients with stage I, II, or III NSCLC treated at a single center, significant drops in the percentages of effector memory CD8-positive cells (P =.0045) and CD4-positive cells (P <.0001) cells, along with a significant increase in central memory CD8-positive cells (P <.0037), were observed in postsurgical compared with presurgical blood specimens. These findings led the authors to speculate that effector memory T cells were converted to central memory T cells following surgery. 

The study authors further noted the likelihood that this conversion was “due to [the] disappearance of cancer antigens, because the decrease was not observed in the patients [with] incomplete resection.”

Other findings included an increase in PD-1 expression on both CD8-positive and CD4-positive T cells in postsurgical compared with presurgical blood specimens. In addition, an increase in the percentage of myeloid derived suppressor cells (MDSC) (P <.0001) — which have been associated with resistance to ICIs in some studies of patients with cancer — was reported. Also observed following surgery: a decrease in the percentage of natural killer (NK) cells (P =.0001). These cells may have both direct and indirect tumoricidal activity.  

In their concluding remarks, the abstract authors stated that “the immunological status before surgery seems more appropriate for immune checkpoint inhibitor therapy.”

Read more of Cancer Therapy Advisor‘s coverage of the ESMO annual meeting by visiting the conference page.

Reference

  1. Yanagihara A, Kagamu H, Sakaguchi H, et al. Immunological impact of surgery in NSCLC patients. Presented at: European Society for Medical Oncology (ESMO) Congress 2019; September 27-October 1, 2019: Barcelona, Spain. Abstract 1446P.