The following article features coverage from the European Society for Medical Oncology 2020 virtual meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

Several biomarkers, including density of PD-L1 expression in tumors and the presence of cytotoxic T cells within tumors or in circulation, were associated with outcomes after immune checkpoint inhibition (ICI) among patients with non-small cell lung cancer (NSCLC), according to initial results of a study presented at the ESMO Virtual Congress 2020.

“The PIONeeR project was set up…in order to understand and predict on the basis of the biomarker trial while also trying to uncover the resistances to PD-1 and PD-L1 inhibitors in non-small cell lung cancer patients,” Fabrice Barlesi, MD, PhD, of the Gustave Roussy Cancer Campus and Aix-Marseille University in France, and presenter of the study, said.

The PIONeeR study ( Identifier: NCT03493581) included archived tumor tissue of patients treated with nivolumab, pembrolizumab, or atezolizumab monotherapy or combination therapy. Patients were then rebiopsied and blood specimens were collected at 6 weeks after treatment initiation. Circulating and tumor-infiltrating immune cells (TILs) and PD-L1–mediated inhibition were assessed using FACS and multiplex immunohistochemistry with digital pathology.

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This first analysis included 100 patients, of whom 64% were male and 86% received ICI in the second-line setting. The histology was adenocarcinoma for 57% of tumors and 38% of tumors were PD-L1–positive. The second biopsy was available in 46% of cases.

During a median follow-up time of 6.55 months, the overall response rate was 13%. The median progression-free survival (PFS) and overall survival (OS) were 3.0 and 11.0 months, respectively.

Higher baseline PD-L1 tumor cell percentage and tumor infiltration by cytotoxic lymphocytes were associated with higher response. Among patients with PD-L1 tumor expression, lower density of PD-L1-positive cells was associated with nonresponse.

PFS was associated with the percent of PD-L1 expression in tumor cells, the number of circulating activated T cells, serum interleukin (IL)–6 levels, and the number of cytotoxic T cells within the tumor.

OS was associated with circulating activated T cells and serum IL-6 levels, but was also associated with the number of circulating T cells and serum tumor necrosis factor-alpha levels.

Dr Barlesi said that “the study is for sure still ongoing, and additional patients and analyses will provide with additional data with the idea to be able to set up immunogram, something that would be easy to use by the clinicians in order to design a predictive precision immunotherapy.”

Disclosures: Multiple authors declared affiliation with industry. Please refer to the original abstract for a full list of disclosures.

Read more of Cancer Therapy Advisor‘s coverage of the ESMO Virtual Congress 2020 by visiting the conference page.


Barlesi F, Greillier L, Monville F, et al. Precision immuno-oncology for advanced non-small cell lung cancer (NSCLC) patients (pts) treated with PD1/L1 immune checkpoint inhibitors (ICIs): A first analysis of the PIONeeR study. Presented at: European Society for Medical Oncology (ESMO) Virtual Congress 2020; September 19-21, 2020. Abstract LBA53.