Use of Blood-Based Proteomic Test to Predict Outcomes With Immunotherapy for NSCLC

By: Jenna Carter, PhD
Posted: Wednesday, January 26, 2022

An article published in the Journal for ImmunoTherapy of Cancer reported findings on the performance of a blood-based proteomic test in predicting treatment outcomes in patients with non–small cell lung cancer (NSCLC). Wallace Akerley, MD, of the Huntsman Cancer Institute Cancer Hospital, Salt Lake City, and colleagues conducted a progressively designed, observational study across 35 U.S. cities. Based on proteomic testing, patients were classified as having a hot host-immune classifier (a good systemic inflammatory state) or a cold host-immune classifier (poor systemic inflammatory state). Their findings revealed that patients with a hot immune profile had a longer overall survival rate than those classified as having a cold immune profile, across treatment regimens.

“Predictive and prognostic tests that aid therapeutic decision-making are critical for optimizing patient outcomes while minimizing toxicity and costs,” stated Dr. Akerley and colleagues.

Using the observational INSIGHT study (n = 3,570), the investigators focused on patients with advanced-stage NSCLC. Of them, 877 received first-line therapies while in the study, and 284 received regimens including immune checkpoint inhibitors. A prespecified interim analysis was performed after 1 year of follow-up, and the primary endpoint was overall survival.

Patients classified with a hot immune profile had an increased likelihood of better outcomes across multiple lines of treatment compared with their counterparts with a cold immune profile. The median overall survival of those with a hot immune profile treated with platinum-based chemotherapy was 14.8 months compared with 7.0 months for those with a cold immune profile (hazard ratio [HR] = 0.56, 95% confidence interval [CI] = 0.42%–0.75%, P < .0001). For patients treated with immune checkpoint inhibition monotherapy, overall survival was 16.8 months in those with a hot immune profile versus 2.8 months in those with a cold immune profile (HR = 0.36, 95% CI = 0.22%–0.58%, P < .0001). These findings suggest that immune checkpoint inhibitors should not be the only course of treatment in patients who present with a cold immune profile.

Disclosure: For full disclosures of the study authors, visit jitc.bmj.com.

Journal for ImmunoTherapy of Cancer