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Ablative radiation alone in stage I lung cancer produces an adaptive systemic immune response: insights from a prospective study
- Source :
- Journal for ImmunoTherapy of Cancer, Vol 11, Iss 10 (2023)
- Publication Year :
- 2023
- Publisher :
- BMJ Publishing Group, 2023.
-
Abstract
- Stereotactic ablative body radiation (SABR) delivers high rates of local control in early-stage non-small cell lung cancer (NSCLC); however, systemic immune effects are poorly understood. Here, we evaluate the early pathologic and immunologic effects of SABR. Blood/core-needle tumor biopsies were collected from six patients with stage I NSCLC before and 5–7 days after SABR (48 Gy/4 or 50 Gy/5 fractions). Serial blood was collected up to 1-year post-SABR. We used immunohistochemistry to evaluate pathological changes, immune-cell populations (CD8, FoxP3), and PD-L1/PD-1 expression within the tumor. We evaluated T-cell receptor (TCR) profile changes in the tumor using TCR sequencing. We used the MANAFEST (Mutation-Associated Neoantigen Functional Expansion of Specific T-cells) assay to detect peripheral neoantigen-specific T-cell responses and dynamics. At a median follow-up of 40 months, 83% of patients (n=5) were alive without tumor progression. Early post-SABR biopsies showed viable tumor and similar distribution of immune-cell populations as compared with baseline samples. Core-needle samples proved insufficient to detect population-level TCR-repertoire changes. Functionally, neoantigen-specific T-cells were detected in the blood prior to SABR. A subset of these patients had a transient increase in the frequency of neoantigen-specific T-cells between 1 week and 3–6 months after SABR. SABR alone could induce a delayed, transient neoantigen-specific T-cell immunologic response in patients with stage I NSCLC.
- Subjects :
- Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Subjects
Details
- Language :
- English
- ISSN :
- 20511426
- Volume :
- 11
- Issue :
- 10
- Database :
- Directory of Open Access Journals
- Journal :
- Journal for ImmunoTherapy of Cancer
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.73057316b1824f259f171d6d18eefaee
- Document Type :
- article
- Full Text :
- https://doi.org/10.1136/jitc-2023-007188