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SITC 2021: Immunomodulatory Effects of Neoadjuvant Nivolumab and Chemotherapy in NSCLC

By: Vanessa A. Carter, BS
Posted: Wednesday, November 24, 2021

Stephanie Schmidt, PhD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues evaluated the impact of platinum-based chemotherapy, nivolumab, and their combination as neoadjuvant therapy for patients with resected non–small cell lung cancer (NSCLC). Presented during the 2021 Society for Immunotherapy of Cancer (SITC) Annual Meeting as a late-breaking abstract (Abstract 962), these results suggest that nivolumab may lessen the immunosuppressive effects of chemotherapy when used in combination.

The investigators focused on patients from the NEOSTAR trial with stage I to IIIA resectable NSCLC who received nivolumab and those with stage IB to IIIA who received nivolumab and chemotherapy. Participants with stage IB to IIIA resectable NSCLC who were administered chemotherapy before surgery were recruited from the ICON study.

Regardless of major pathologic response, chemotherapy increased PD-1–positive T cells and decreased Ki67-positive populations, correlating with immunosuppression among all participants. Additionally, immunosuppression appeared to be heightened by an increase in Ki67-positive regulatory T cells across patients without a major pathologic response.

In contrast, nivolumab was associated with immune activation regardless of major pathologic response, with an observed increase in inducible co-stimulator-positive T cells. Notably, when comparing nivolumab and its combination with chemotherapy, it appears that the addition of chemotherapy may drive exhaustion by increasing T-cell immunoglobulin and mucin-domain containing-3–positive populations; this effect tended to be more prominent in patients who did not respond to treatment, according to the study findings.

Disclosure: No disclosure information was provided.



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