Abstract 7088: MALDI-IHC high-plex protein biomarker imaging for fast, non-iterative identification of lung carcinoma subtypes

Abstract

Abstract Lung cancer is the second most common cancer worldwide, with over 2.2 million new cases in 2020 and is the leading cause of cancer-related deaths worldwide. Most lung cancer (80-85%) is non-small cell (NSCLC), comprising mostly adenocarcinoma and squamous cell carcinoma, while roughly 10-15% of lung cancer is small cell lung cancer (SCLC), also termed neuroendocrine lung cancer. Subtype identification is critical for determining treatment, and with limited samples, it is critical to get the most data possible from each tissue section. NSCLC subtypes can be treated with chemotherapy or targeted drugs, whereas SCLC tends to respond best to a combination of chemotherapy and radiation. While there have been many improvements in the detection and treatment of lung carcinoma, the immuno-histochemical (IHC) confirmation of subtype remains a prolonged and often iterative process. To overcome this limitation, we have developed a new IHC approach which uses antibodies labeled with novel photocleavable mass-tags combined with matrix assisted laser desorption ionization (MALDI) mass spectrometry imaging. The approach, termed MALDI-IHC, provides fast (1 hr/cm2 imaging time) and highly multiplexed IHC (100+-plex) without the need for iterative cycling procedures. Here, we present a 20+-plex panel for the determination of subtype in lung cancer. An antibody panel comprised of established clinical biomarkers was developed to differentiate between the lung carcinoma subtypes and provide potentially prognostic information. This included markers for adenocarcinoma (TTF-1, Napsin A), squamous cell carcinoma (p40, CK5), and small cell lung cancer (CD56, Chromogranin A and Synaptophysin), as well as general carcinoma markers for t cells, b cells, macrophages, and fibroblasts These markers were first validated individually by immunofluorescence and then compared to MALDI-IHC on annotated tissues. Here we present an overview of the antibody validation for the 20+-plex lung carcinoma panel. Biomarker presence and peak signal intensity for the various subtypes was then determined using pathologist classified tissues for normal lung, adenocarcinoma, squamous cell carcinoma and small cell lung cancer. We report application of the MALDI-IHC approach to the simultaneous determination of lung carcinoma subtypes on a 99-core human lung tissue microarray (TMA) comprised of normal, normal adjacent, cancer adjacent, and cancerous tissues. Moreover, because MALDI-IHC is a non-destructive process, it can be followed by conventional H&E staining on the same tissue section for accurate co-registration of traditional pathology annotations with the highly multiplexed MALDI-IHC results. In the future, even larger, 100+-plex antibody panels can be used for precision medicine on a wide range of cancers, in order to determine the molecular subtypes and guide treatment paths. Citation Format: Catherine A. Kita, Kristina Schwamborn, Gargey Yagnik, Kenneth J. Rothschild, Mark J. Lim. MALDI-IHC high-plex protein biomarker imaging for fast, non-iterative identification of lung carcinoma subtypes [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7088.