PO.CL05.07 · 临床研究

Immune-related RNA-seq biomarker-based clustering reveals heterogeneous immunotherapy responses and guides subtype-specific strategies in metastatic NSCLC

海报缩略图:Immune-related RNA-seq biomarker-based clustering reveals heterogeneous immunotherapy responses and guides subtype-specific strategies in metastatic NSCLC
编号 7748 展板 8 🕑 4/22 09:00–12:00 📍 Section 42 主讲 Sanghwa Kim, MD
分会场 Immune Response to Therapies
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作者与单位 Authors & Affiliations

Jiyon Lyu1, Sebastià Franch-Expósito2, Sanghwa Kim1, Liam Il-Young Chung1, Ronald Min1, Sung Hwan Lee3, Shinkyo Yoon1, Michelle M. Stein2, JACOB MERCER2, Paul Fields2, Bella Kim4, Young Kwang Chae1

1Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL,2Tempus AI, Chicago, IL,3Department of Surgery, CHA Bundang Medical Center, Seongnam, Korea, Republic of,4Northwestern University, Chicago, IL

摘要 Abstract

Metastatic non-small cell lung cancer (mNSCLC) represents a highly heterogeneous disease with variable clinical outcomes under first-line immunotherapy plus chemotherapy. To better understand immune landscape features associated with heterogeneous response to immunotherapy, we performed biomarker-driven RNA-seq molecular clustering using known immune-related markers TIGIT, FOXP3, CD274 ( PD-L1 ), and tumor-associated macrophage (TAM) score. We analyzed a real-world cohort of 2,235 mNSCLC patients with pre-treatment tumor biopsies in the de-identified Tempus database treated with first-line PD-(L)1 plus chemotherapy. Unsupervised clustering of RNA-seq data defined four distinct immune subtypes. Real-world overall survival (rwOS) and progression-free survival (rwPFS) were assessed via Kaplan-Meier analysis with a log-rank test. Pathway enrichment using hallmark gene sets, tumor mutational burden (TMB), and immune cell composition using QuantiSeq were analyzed. Expression levels of RNA-seq biomarkers and TAM score were significantly different across identified clusters (ANOVA; p <0.001). These clusters also showed significantly differential prevalence of TMB-high and PD-L1-positive (IHC) (Chi-squared; p < 0.001, respectively), as well as characteristic pathway enrichment and immune profiles. Non-squamous/Never smoker were more frequent in Cluster 2, whereas Squamous/Current smoker were predominant in Cluster 1 (Chi-squared; Histology/Smoking, p <0.05, respectively). Survival differed significantly, being poorest in Cluster 1 and best in Cluster 3 (rwOS/rwPFS, p <0.001) (Table 1). This biomarker-driven RNA-seq analysis identified four immune clusters of mNSCLC with differential survival outcomes. This study provides a foundation for understanding tumor heterogeneity and supports the use of immune biomarkers to enable patient stratification for therapeutic combinations. Table 1. Cluster 1 (Immune-desert) N=713 Cluster 2 (TAM-enriched) N=402 Cluster 3 (Immune-hot) N=813 Cluster 4 (Myeloid-inflamed, PD-L1-high) N=302 p -value Median Survival Time (Months) rwOS/rwPFS 11.5/5.95 mo 14.8/7.33 mo 18.1/8.15 mo 16.7/6.84 mo Log-rank test; p <0.001 RNA-Seq Biomarkers (TIGIT, FOXP3, CD274 (PD-L1)) and TAM Score Uniformly low expression of all markers High TAM but low TIGIT/FOXP3/PD-L1 High TIGIT/FOXP3/PD-L1 with elevated TAM High PD-L1 with low TIGIT/FOXP3 ANOVA test; p <0.001 Pathway Enrichment TME: tumor microenvironment ↑ Oncogenic signalings and proliferation ↓ Immune -related pathways ↑ TME remodeling pathways ↑ Immune/inflammatory signaling (e.g., IFNgamma) and TME remodeling pathways ↑ Proliferation and DNA-repair pathways Welch ANOVA + Games-Howell or Kruskal-Wallis and Dunn (BH) test; adjusted p <0.05 Immune Cell Composition ↓ Lymphoid and myeloid cell infiltration ↑ M1/M2 macrophage Broad infiltration (↑ CD8, CD4, Treg, B, NK) ↑ Myeloid cell infiltration Kruskal-Wallis and Dunn (BH) test; adjusted p <0.05 TMB-High (TMB ≥10 mut/Mb) 283 (34%) 92 (20%) 254 (26%) 124 (35%) Chi-squared test; p <0.001 PD-L1-Positive (IHC; TPS ≥ 1%) 203 (36%) 174 (54%) 421 (68%) 213 (94%) Chi-squared test; p <0.001 Tumor Histology Chi-squared test; p <0.001 Squamous 232 (33%) 73 (18%) 221 (27%) 84 (28%) Non-Squamous 444 (62%) 315 (78%) 555 (68%) 201 (67%) NOS 37 (5.2%) 14 (3.5%) 37 (4.6%) 17 (5.6%) Smoking Status Chi-squared test; p <0.05 Current Smoker 118 (62%) 44 (46%) 113 (55%) 48 (59%) Never Smoker 16 (8.4%) 23 (24%) 32 (15%) 12 (15%) Ex-Smoker 56 (29%) 29 (30%) 62 (30%) 21 (26%) Unknown 523 306 606 221
利益披露 Disclosure
J. Lyu, None. S. Franch-Expósito, Tempus Employment, Stock. S. Kim, None.. L. I. Chung, None.. R. Min, None.. S. Lee, None.. S. Yoon, None. M. M. Stein, Tempus Employment, Stock. J. Mercer, Tempus Employment. P. Fields, Tempus Employment, Stock. Adaptive Biotechnologies Stock. B. Kim, None. Y. K. Chae, AbbVie ). Bristol Myers ). Squibb ). Biodesix ). Freenome ). Predicine ). Picture Health ). Roche/Genentech Other, Consulting fees, payments, and/or honoraria. AstraZeneca Other, Consulting fees, payments, and/or honoraria. Foundation Medicine Other, Consulting fees, payments, and/or honoraria. Neogenomics Other, Consulting fees, payments, and/or honoraria. Guardant Health Other, Consulting fees, payments, and/or honoraria. Boehringer Ingelheim Other, Consulting fees, payments, and/or honoraria. Biodesix Other, Consulting fees, payments, and/or honoraria. ImmuneOncia Other, Consulting fees, payments, and/or honoraria. Lilly Oncology Other, Consulting fees, payments, and/or honoraria. Merck Other, Consulting fees, payments, and/or honoraria. Takeda Other, Consulting fees, payments, and/or honoraria. Lunit Other, Consulting fees, payments, and/or honoraria. Jazz Pharmaceutical, Tempus, Bristol Myers Squibb, Regeneron, NeoImmunTech, Esai, and Novocure. Other, Consulting fees, payments, and/or honoraria.

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