Immunotherapy For Advanced Cancer Research Articles

Efficacy of immunotherapy in advanced gastric cancer: preliminary results of a multicenter observational study

Background. Due to the low efficacy of PD-L1 antibodies in second and subsequent lines of metastatic gastric cancer (mGC), the optimal treatment strategy of such patients and appropriate choice of predictive biomarkers remain challenging. The aim of our study is to assess the efficacy of immune checkpoint inhibitors monotherapy in patients with mGC in routine clinical practice, especially in heavily-pretreated patients.Materials and methods. We retrospectively analyzed data of patients treated in five oncology centers in Moscow between 2018 and 2023, who received nivolumab or pembrolizumab for advanced gastric cancer. Primary end-point of our study was 6-months PFS. Secondary end-points were overall survival (OS), objective response rate (ORR), and disease control rate (DCR). Toxicity was assessed using CTC AE v5.0 scale.Results. 122 patients with mGC who received immune checkpoint inhibitors were included between 1 January 2018 and 28 February 2023. 6-months PFS rate was 31,6%. The median OS was 7 months (95% CI: 2-20), the median PFS was 3 months (95% CI: 1,5-9,5). A statistically significant difference in OS was detected in patients with MSI compared to MSS (25 months vs 6 months; 95% CI: 0,21 – 0,86; HR: 0,43). A trend towards higher PFS was observed as well (10 months in MSI vs 3 months in MSS; 95% CI:0,26 – 1,01; HR: 0,51). No statistical significance in PFS and OS according to PD-L1 CPS was found among patients with MSS. ORR and DCR were 36,6% and 10,6%, respectively. No cases of pseudoprogression or fatal immune-related AEs were observed.Conclusion. Our real-world data is consistent with published literature and the results from clinical trials. Further studies are needed to determine prognostic factors and to establish prognostic model of patients receiving ICIs for optimal treatment strategy of mGC.

Cancer Nanovaccines: Nanomaterials and Clinical Perspectives.

Cancer nanovaccines represent a promising frontier in cancer immunotherapy, utilizing nanotechnology to augment traditional vaccine efficacy. This review comprehensively examines the current state-of-the-art in cancer nanovaccine development, elucidating innovative strategies and technologies employed in their design. It explores both preclinical and clinical advancements, emphasizing key studies demonstrating their potential to elicit robust anti-tumor immune responses. The study encompasses various facets, including integrating biomaterial-based nanocarriers for antigen delivery, adjuvant selection, and the impact of nanoscale properties on vaccine performance. Detailed insights into the complex interplay between the tumor microenvironment and nanovaccine responses are provided, highlighting challenges and opportunities in optimizing therapeutic outcomes. Additionally, the study presents a thorough analysis of ongoing clinical trials, presenting a snapshot of the current clinical landscape. By curating the latest scientific findings and clinical developments, this study aims to serve as a comprehensive resource for researchers and clinicians engaged in advancing cancer immunotherapy. Integrating nanotechnology into vaccine design holds immense promise for revolutionizing cancer treatment paradigms, and this review provides a timely update on the evolving landscape of cancer nanovaccines.

Anti-angiogenic agents combined with immunotherapy for advanced non-small cell lung cancer: a systematic review and meta-analysis.

Anti-angiogenic agents could enhance tumor immunity response, and anti-angiogenesis plus immunotherapy has become a novel treatment option for advanced non-small cell lung cancer (NSCLC). The efficacy of this combination therapy remains controversial and obscure. We conducted a meta-analysis to evaluate the clinical efficacy and safety of this therapeutic strategy in patients with advanced NSCLC and provide more guidance for treating NSCLC clinically. A systematic literature search was performed in PubMed, Embase, Web of Science, CNKI, and Wanfang databases to identify relevant studies published up to December 2021. The primary endpoint was the objective response rate (ORR). Second endpoints were progression-free survival (PFS), overall survival (OS), and grade ≥3 AEs adverse events (AEs). The sensitivity analysis was conducted to confirm the stability of the results. STATA 15.0 was utilized for all pooled analyses. Eleven studies were eventually included in the meta-analysis, involving 533 patients with advanced NSCLC. The pooled ORR rate was 27% (95% CI 18% to 35%; I2 =84.2%; p<0.001), while the pooled median PFS and OS was 5.84 months (95% CI 4.66 to 7.03 months; I2=78.4%; p<0.001) and 14.20 months (95% CI 11.08 to 17.32 months; I2=82.2%; p=0.001), respectively. Most common grade ≥3 AEs included hypertension, hand-foot syndrome, diarrhea, adrenal insufficiency, hyponatremia, proteinuria, rash, thrombocytopenia, and fatigue. Anti-angiogenesis combined with immunotherapy demonstrated satisfactory antitumor activity and an acceptable toxicity profile in patients with advanced NSCLC. The pooled results of our meta-analysis provided further evidence supporting the favorable efficacy and safety of this therapeutic strategy.

Hypoxia-accelerating pyroptosis nanoinducers for promoting image-guided cancer immunotherapy

Precise image-guided cancer immunotherapy holds immense potential in revolutionizing cancer treatment. The strategies facilitating activatable imaging and controlled therapeutics are highly desired yet to be developed. Herein, we report a new pyroptosis nanoinducer that integrates aggregation-induced emission luminogen (AIEgen) and DNA methyltransferase inhibitor with hypoxia-responsive covalent organic frameworks (COFs) for advanced image-guided cancer immunotherapy. We first synthesize and compare three donor-acceptor type AIEgens featuring varying numbers of electron-withdrawing units, and find that the incorporation of two acceptors yields the longest response wavelength and most effective photodynamic therapy (PDT) property, surpassing the performance of analogs with one or three acceptor groups. A COF-based nanoplatform containing AIEgen and pyroptosis drug is successfully constructed via the one-pot method. The intra-COF energy transfer significantly quenches AIEgen, in which both fluorescence and PDT properties greatly enhance upon hypoxia-triggered COF degradation. Moreover, the photodynamic process exacerbates hypoxia, accelerating pyroptosis drug release. The nanoagent enables sensitive delineation of tumor site through in situ activatable fluorescence signature. Thanks to the exceptional ROS production capabilities and hypoxia-accelerating drug release, the nanoagent not only inhibits primary tumor growth but also impedes the progression of distant tumors in 4T1 tumor-bearing mice through potent pyroptosis-mediated immune response. This research introduces a novel strategy for achieving activatable phototheranostics and self-accelerating drug release for synergetic cancer immunotherapy.

Prognostic value of pretreatment neutrophil-to-lymphocyte ratio in advanced gastrointestinal cancer immunotherapy: evidence from published studies and a Chinese single center cohort

BackgroundIdentification of prognostic biomarkers for outcomes in gastrointestinal (GI) cancer with immunotherapy is important. This study investigated the relationship between the prognostic biomarker, pretreatment neutrophil-to-lymphocyte ratio (preNLR), and immunotherapeutic outcomes in patients with advanced GI cancer.MethodsWe searched the PubMed, Embase, and Cochrane Library databases for studies reporting predictive values for preNLR in patients with advanced GI cancer treated with immune checkpoint inhibitor (ICI). The primary outcomes considered were progression-free survival (PFS) and overall survival (OS). Hazard ratios (HRs) with 95% confidence intervals (CIs) for PFS and OS were pooled using a random effects model. We then validated the results observed in an in-house cohort of patients treated with ICIs for advanced GI cancers. Other prognostic factors for PFS and OS were explored using Cox proportional hazard analyses.ResultsOverall, 27 observational studies involving 3,610 patients with advanced GI cancer were included. Patients with higher preNLR were associated with poorer PFS (HR 1.70, 95% CI 1.50–1.92) and OS (HR 2.35, 95% CI 1.82–3.03) with ICI treatment. Subgroup analyses based on NLR cut-off value, research center, sample size, and ICI drugs used were consistent with the primary results. A retrospective analysis of the in-house patient cohort validated these results (PFS: HR 3.173, 95% CI 2.314–4.351; OS: HR 3.004, 95% CI 1.837–4.912). Multivariable Cox regression analysis of 174 patients showed that higher preNLR and negative programmed death ligand-1 (PD-L1) expression were independently, significantly, and unfavorably associated with PFS and OS.ConclusionPreNLR might be an effective prognostic biomarker for patients with advanced GI cancer treated with ICIs.

Magnetite nanoparticles: an emerging adjunctive tool for the improvement of cancer immunotherapy.

Cancer immunotherapy has emerged as a groundbreaking field, offering promising and transformative tools for oncological research and treatment. However, it faces several limitations, including variations in cancer types, dependence on the tumor microenvironments (TMEs), immune cell exhaustion, and adverse reactions. Magnetic nanoparticles, particularly magnetite nanoparticles (MNPs), with established pharmacodynamics and pharmacokinetics for clinical use, hold great promise in this context and are now being explored for therapeutic aims. Numerous preclinical studies have illustrated their efficacy in enhancing immunotherapy through various strategies, such as modulating leukocyte functions, creating favorable TMEs for cytotoxic T lymphocytes, combining with monoclonal antibodies, and stimulating the immune response via magnetic hyperthermia (MHT) treatment (Front Immunol. 2021;12:701485. doi: 10.3389/fimmu.2021.701485). However, the current clinical trials of MNPs are mostly for diagnostic aims and as a tool for generating hyperthermia for tumor ablation. With concerns about the adverse effects of MNPs in the in vivo systems, clinical translation and clinical study of MNP-boosted immunotherapy remains limited. The lack of extensive clinical investigations poses a current barrier to patient application. Urgent efforts are needed to ascertain both the efficacy of MNP-enhanced immunotherapy and its safety profile in combination therapy. This article reviews the roles, potential, and challenges of using MNPs in advancing cancer immunotherapy. The application of MNPs in boosting immunotherapy, and its perspective role in research and development is also discussed.

Prognostic analysis of related factors of adverse reactions to immunotherapy in advanced gastric cancer and establishment of a nomogram model.

Immunotherapy for advanced gastric cancer has attracted widespread attention in recent years. However, the adverse reactions of immunotherapy and its relationship with patient prognosis still need further study. In order to determine the association between adverse reaction factors and prognosis, the aim of this study was to conduct a systematic prognostic analysis. By comprehensively evaluating the clinical data of patients with advanced gastric cancer treated by immunotherapy, a nomogram model will be established to predict the survival status of patients more accurately. To explore the characteristics and predictors of immune-related adverse reactions (irAEs) in advanced gastric cancer patients receiving immunotherapy with programmed death protein-1 (PD-1) inhibitors and to analyze the correlation between irAEs and patient prognosis. A total of 140 patients with advanced gastric cancer who were treated with PD-1 inhibitors in our hospital from June 2021 to October 2023 were selected. Patients were divided into the irAEs group and the non-irAEs group according to whether or not irAEs occurred. Clinical features, manifestations, and prognosis of irAEs in the two groups were collected and analyzed. A multivariate logistic regression model was used to analyze the related factors affecting the occurrence of irAEs, and the prediction model of irAEs was established. The receiver operating characteristic (ROC) curve was used to evaluate the ability of different indicators to predict irAEs. A Kaplan-Meier survival curve was used to analyze the correlation between irAEs and prognosis. The Cox proportional risk model was used to analyze the related factors affecting the prognosis of patients. A total of 132 patients were followed up, of whom 63 (47.7%) developed irAEs. We looked at the two groups' clinical features and found that the two groups were statistically different in age ≥ 65 years, Ki-67 index, white blood cell count, neutrophil count, and regulatory T cell (Treg) count (all P < 0.05). Multivariate logistic regression analysis showed that Treg count was a protective factor affecting irAEs occurrence (P = 0.030). The ROC curve indicated that Treg + Ki-67 + age (≥ 65 years) combined could predict irAEs well (area under the curve = 0.753, 95% confidence interval: 0.623-0.848, P = 0.001). Results of the Kaplan-Meier survival curve showed that progression-free survival (PFS) was longer in the irAEs group than in the non-irAEs group (P = 0.001). Cox proportional hazard regression analysis suggested that the occurrence of irAEs was an independent factor for PFS (P = 0.006). The number of Treg cells is a separate factor that affects irAEs in advanced gastric cancer patients receiving PD-1 inhibitor immunotherapy. irAEs can affect the patients' PFS and result in longer PFS. Treg + Ki-67 + age (≥ 65 years old) combined can better predict the occurrence of adverse reactions.

Abstract LB445: USP24 suppresses T cell anti-tumor activity by enhancing the stability of the PD-1 protein

Abstract Persistent programmed cell death-1 (PD-1)/PD-L1 inhibitory signaling disrupts T cell cytotoxic function, leading to T cell exhaustion—a phenomenon strongly associated with advanced cancer progression and immunotherapy failure. Deciphering the mechanisms behind dysregulated PD-1 expression and reactivating tumor-infiltrating lymphocytes (TILs) in the tumor microenvironment (TME) is crucial. Our previous research established that tumor-associated macrophage-derived IL-6 promotes STAT3-dependent PD-1 transcriptional activity and immunotherapy resistance. The current study further explores whether IL-6 abundance in the TME contributes to PD-1 protein stability. Results indicate that IL-6 extended PD-1 protein half-life in T cells, suggesting its role in modulating PD-1 protein stability. Furthermore, analysis of the GEO database showed a positive correlation between the expression of ubiquitin-specific-processing protease (USP) family enzymes and PD-1 in non-responding patients receiving anti-PD-1 therapy. Knockdown experiments revealed that USP24 strongly downregulated PD-1 protein expression and stability. USP24 depletion reversed IL-6-induced PD-1 expression and stability, with USP24 colocalizing with PD-1 at the plasma membrane upon IL-6 stimulation. Immunoprecipitation-Western blot assays confirmed that USP24 directly interacted with PD-1 and countered E3 ligase c-Cbl-mediated ubiquitination. Depleting USP24 suppressed PD-1-mediated immunosuppression both in vitro and in vivo. In lung-specific EGFRL858R/USP24C1698A functional knockout mice, tumor progression was slower, and exhausted tumor-infiltrating PD-1+ TIM-3+ CD8+ T cells reduced compared to EGFRL858R mice. Inhibiting PD-1 stability with an IL-6 neutralizing antibody or the novel inhibitor USP24-i-101 decreased tumor volume and increased activated cytotoxic T cell infiltration in vivo. Moreover, USP24-i-101 enhanced therapeutic effects in combination with anti-CTLA4 immunotherapy. Clinically, our in-house cohort revealed elevated USP24 expression in tumor-infiltrating lymphocytes or peripheral T cells, correlating with worse clinical outcomes and unfavorable responses to immunotherapy in lung cancer patients. This study uncovers USP24 as a novel PD-1 regulator, deubiquitinating PD-1 to enhance protein stability and suppress T cell function. In conclusion, USP24 emerges as a potential target for enhancing anti-tumor immunity and as a biomarker predicting clinical responses to immunotherapy in lung cancer. Citation Format: Hung-Chia Hsieh, Jan-Jong Hung, Yi-Ching Wang. USP24 suppresses T cell anti-tumor activity by enhancing the stability of the PD-1 protein [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB445.

Combining chemotherapy and immunotherapy for advanced anal cancer: are we ready?

Combining chemotherapy and immunotherapy for advanced anal cancer: are we ready?

88 Long-Term Responders to first-line single agent immunotherapy in advanced Non-Small Cell Lung Cancer. Real-world evidence from The Christie.

88 Long-Term Responders to first-line single agent immunotherapy in advanced Non-Small Cell Lung Cancer. Real-world evidence from The Christie.

New approaches and prospects of immunotherapy and gene therapy for prostate cancer

Prostate cancer stands as the most prevalent cancer globally, constituting 21% of all cancer diagnoses in male patients. Urgent optimization of prostate cancer care is essential, given that this disease claims 345,000 lives every year. These innovative approaches hold substantial promise for both researchers and patients, representing a beacon of hope in the inhibitory act against prostate cancer. Prostate cancer's gradual advancement deems it suitable for immune therapy, but trials in metastatic cases show limited effectiveness, likely due to compromised immunity. Hindered by defective cellular responses, an immune-suppressive microenvironment, emerging evidence and breakthroughs, such as CAR-T therapy, inspire cautious optimism for advanced prostate cancer immunotherapy. Tumors utilize tactics to escape immune recognition, promoting the proliferation of MDSCs, Treg cells, and TAMs. Immunotherapy targets prostate cancer by mostly expressed target proteins and overexpressed target proteins. Immune cells play a role in tumor development and metastasis in advanced prostate cancer. Modulating the tumor microenvironment presents therapeutic possibilities. Certain prostate cancer types exhibit potential responses to immune checkpoint inhibitors, yet obstacles remain, necessitating additional research for enhanced efficacy. Immunotherapy faces hurdles in prostate cancer—limited inflammation, scarce antigens, and a resistant microenvironment. Grasping resistance intricacies is pivotal. The identification of DNA's helical structure propelled global progress in disease treatment through gene therapy. Choosing gene therapy vectors is critical; viruses are potent but toxic, while nonviral options, though less toxic, encounter barriers affecting transfection. In the realm of prostate cancer treatment, immunotherapy and gene therapy are emerging as increasingly viable options.

Abstract 7521: Tumor NLRP3 inflammasome activity mediates resistance to Anti-PD-1 immunotherapy in advanced gastroesophageal cancer

Abstract The addition of anti-PD-1 immunotherapy to the therapeutic armamentarium of advanced gastroesophageal (GE) cancer patients has resulted in modest improvements in clinical outcomes for a subset of patients. More robust predictive biomarkers to guide patient management and to select optimal combination immunotherapy strategies for the individual patient are needed. Our previous studies indicate that the tumor-intrinsic NLRP3 inflammasome-HSP70 signaling axis promotes the recruitment of granulocytic myeloid-derived suppressor cells (PMN-MDSCs) and drives resistance to anti-PD-1 immunotherapy. The KEYLargo phase II clinical trial evaluated the efficacy of pembrolizumab (pembro) in combination with capecitabine/oxaliplatin (CAPOX) in HER2-negative advanced GE cancer patients. An 8-day lead-in period of pembro monotherapy in 36 advanced GE cancer patients allowed for the acquisition of blood and tumor tissue specimens to determine which immune-mediated alterations within the tumor microenvironment correlated with resistance to anti-PD-1 immunotherapy. Baseline and on-treatment specimens were collected for HSP70 ELISA, immunofluorescence microscopy, spatial transcriptomics, NLRP3 FISH, IHC, and NLRP3-ASC proximity ligation assays (PLA) to measure NLRP3 pathway activity levels. All data was correlated with best objective response, progression-free survival (PFS), and overall survival (OS). Tumor-infiltrating CD8+ T cells and PMN-MDSCs were increased in responders and non-responders, respectively. While PD-L1 CPS failed to associate with response, elevated baseline NLRP3 PLA activity correlated with increased tumor-infiltrating PMN-MDSCs (P = 0.001) and resistance to pembro/CAPOX therapy (P = 0.01). Only non-responding tumors exhibited an increase in NLRP3 PLA activity and NLRP3 amplification. Transcriptional studies revealed tumors with enhanced NLRP3 activity to exhibit decreased expression of the NLRC5 transactivator, MHC class I antigen presentation genes, and an increase in the NK cell negative regulator, HLA-G. Baseline plasma HSP70 levels correlated with tumor NLRP3 activity (P = 0.043) and with resistance to pembro/CAPOX therapy (P = 0.001). Elevated baseline NLRP3 PLA activity and amplification were associated with diminished PFS (P = 0.008) and OS (P = 0.009). In additional studies, pharmacologic inhibition of the NLRP3 inflammasome suppressed PMN-MDSC recruitment, upregulated MHC class I, and reversed anti-PD-1 resistance in an orthotopic model of GE cancer. Together, these findings implicate tumor-intrinsic NLRP3-HSP70 signaling as an important mediator of anti-PD-1 resistance in advanced GE cancer. The NLRP3-HSP70 pathway is a promising source of therapeutic targets and biomarkers capable of improving treatment outcomes for this patient population. Additional clinical studies are warranted. Citation Format: Nagendra Yarla, Kaylee Howell, Y-Van Nguyen, Donna Niedwiecki, Hope Uronis, John Strickler, Nicholas C. DeVito, Bala Theivanthiran, Brent A. Hanks. Tumor NLRP3 inflammasome activity mediates resistance to Anti-PD-1 immunotherapy in advanced gastroesophageal cancer [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 7521.

Abstract 3917: A CXCR4 partial agonist TFF2-MSA improves anti-PD-1 immunotherapy in advanced gastric cancer by selectively targeting PMN-MDSC

Abstract Introduction: Advanced gastric cancer poses a challenge for PD-1 immunotherapy due in part to the prevalence of polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs). PMN-MDSCs are mostly immature granulocytes but coexist with mature neutrophils, complicating their precise targeting. While PMN-MDSCs highly express CXCR4, recent clinical trials suggest that CXCR4 antagonists may provide limited additive efficacy to PD-1 blockade. This study explored the efficacy of a secreted CXCR4 partial agonist, trefoil factor family 2 (TFF2), in the context of anti-PD-1 refractory gastric cancer. Methods: We fused mouse TFF2 with murine serum albumin to generate a novel TFF2-MSA peptide with extended half-life, and evaluated its therapeutic effects with or without anti-PD-1 antibody. As histidine decarboxylase (HDC) is expressed in immature neutrophils, we used the HDC-GFP transgene to track PMN-MDSC in vivo. The HDC-GFP mice received subcutaneous or orthotopic implantation of murine syngeneic gastric cancer cells and subsequent treatments. Additionally, human blood was assessed for both serum TFF2 and immune profiles. Results: The combination of TFF2-MSA plus anti-PD-1 antibody displayed remarkable synergy, boosting intratumoral cytotoxic CD8 T cells by 50-fold, leading to tumor regression or eradication, 80% reduction of distant metastasis and 2-fold extension of mouse survival. The immunosuppressive HDC-GFP+ PMN-MDSCs expressed the highest level of CXCR4 among immune cells, and TFF2-MSA treatment systematically reduced HDC-GFP+ PMN-MDSCs in the tumor, blood, spleen and their myeloid progenitors in the bone marrow. In contrast, CXCR4 antagonist AMD3100 in combination with anti-PD-1 failed to restrict tumor growth or PMN-MDSCs. Further single-cell RNA-seq and functional assays revealed that combination of TFF2-MSA plus anti-PD-1 induced a skewing of remaining tumor HDC-GFP+PMN-MDSC compositions from highly immature CD300ld+ subsets to less immature subsets expressing interferon-stimulated genes, accompanied by reduced immunosuppression and increased antigen presentation functions. Rather than local reprogramming, this compositional shift stemmed from an IRF1-driven interferon response in splenic HDC-GFP+ PMN-MDSCs. In human, PMN-MDSCs marked by LOX1 significantly expanded in the blood of gastric cancer patients compared to healthy donors. Human LOX1+ PMN-MDSCs showed an inverse correlation with T cell number, activation, proliferation and the serum TFF2 level. Conclusions: TFF2-MSA synergizes with PD-1 blockade by selectively targeting CXCR4high PMN-MDSCs. This study provides a rational for a novel combination therapy of the CXCR4 partial agonist, TFF2-MSA, rather than CXCR4 antagonists, plus PD-1 blockade for treatment of advanced gastric cancer. Citation Format: Jin Qian, Chenkai Ma, Quin T. Waterbury, Christine S. Moon, Xiaofei Zhi, Feijing Wu, Ruhong Tu, Biyun Zheng, Hiroki Kobayashi, Leah B. Zamechek, Ryan H. Moy, Arnold Han, Bruce Daugherty, Seth Lederman, Timothy C. Wang. A CXCR4 partial agonist TFF2-MSA improves anti-PD-1 immunotherapy in advanced gastric cancer by selectively targeting PMN-MDSC [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 3917.

Abstract 7529: Harmonization radiomics model to predict immune checkpoint inhibitor-related pneumonitis (CIP) in non small cell lung cancer (NSCLC) in patients treated with immunotherapy

Abstract Background: With the increasing use of immunotherapy in advanced non-small cell lung cancer (NSCLC), managing adverse events, particularly checkpoint inhibitor-associated pneumonitis (CIP), poses a significant challenge. CIP often necessitates discontinuation of immunotherapy, even in cases of tumor response. Currently there are no effective models in predicting CIP. This study leverages artificial intelligence (AI) algorithms and the use of harmonization models to analyze radiomic features from chest CT scans, aiming to predict the occurrence of CIP in patients with NSCLC. Methods: This retrospective study examined data from 152 stage III-IV NSCLC patients undergoing immunotherapy. Tumor segmentation was performed using LIFEx software (IMIV/CEA, Orsay, France). 3D-radiomic features were extracted from both the tumor and the surrounding 1 cm thick peritumoral regions. The Random Forest (RF) algorithm was employed to develop a classification model to differentiate between CIP and non-CIP. A harmonization model was deployed to account for the scanner-related differences by using spleen and normal lung signals. The dataset was divided into a training set (75%) and a test set (25%). Bootstrapping with 1,000 iterations was performed to estimate the model's performance by calculating the median and 95% confidence interval (CI) estimate. The accuracy of the model's predictions was evaluated by creating a confusion matrix. The model's performance was assessed by calculating the sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and area under the ROC curve (AUC) for CIP prediction. Results: Among 152 patients, 87 (57.23%) are female and 65 (42.76%) are male. The median age was 59 years. Histology types included were Adenocarcinoma 111 (73%), Squamous cell carcinoma 27 (17.8%), and others 14 (9.2%). CIP was seen in 30 (19.73%) patients. Among the 30 patients with CIP, 17 (56.7%) patients had grade 1 pneumonitis, 11 (36.7%) patients had grade 2 pneumonitis, 2 (6.6%) patients had grade 3 pneumonitis, and none had grade 4 or grade 5 pneumonitis. The model achieved a sensitivity of 0.57, a specificity of 0.67, a PPV of 0.48, and NPV of 0.38 for predicting CIP. The AUC of 0.59 indicates that the model may predict checkpoint inhibitor-associated pneumonitis with an accuracy of 59%. Conclusions: The study provides insights into the potential of radiomic analysis coupled with AI algorithms and the use of harmonization model in predicting CIP among NSCLC patients treated with immunotherapy. Larger studies are needed to validate our findings and the utility of harmonization models in predicting CIP. Citation Format: Monica Yadav, Jeeyeon Lee, Peter Haseok Kim, Seyoung Lee, Taegyu Um, Salie Lee, Maria Jose Chuchuca, Trie Arni Djunadi, Liam Il-Young Chung, Jisang Yu, Darren Rodrigues, Nicolo Gennaro, Leeseul Kim, Myungwoo Nam, Youjin Oh, Sungmi Yoon, Zunairah Shah, Yuchan Kim, Ilene Hong, Jessica Jang, Grace Kang, Amy Cho, Soowon Lee, Timothy Hong, Cecilia Nam, Yury S Velichko, Young Kwang Chae. Harmonization radiomics model to predict immune checkpoint inhibitor-related pneumonitis (CIP) in non small cell lung cancer (NSCLC) in patients treated with immunotherapy [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 7529.

Abstract 2488: The penile cancer tumor microenvironment and immunotherapy response: Results from the PERICLES trial

Abstract Introduction: The phase II PERICLES trial investigated the efficacy of atezolizumab (anti-PD-L1) for advanced penile cancer, with or without radiotherapy. As previously published, durable responses (progression-free at 12 months) were observed in 4 out of 32 enrolled patients. Here, we present the final overall survival (OS) results and an analysis of potential biomarkers for immunotherapy response. Methods: Preplanned analysis projected that at 27/32 events, the study would have 80% power (2-sided α=0.05) to assess whether the OS for the entire cohort significantly differed from the hypothesized historical median for stage IV patients. Baseline tumor tissue samples were subjected to bulk-RNA sequencing (n=31), fluorescent (n=28) and chromogenic (n=30) multiplex immunohistochemistry. We quantified the densities of CD3+CD8+ cytotoxic T-cells, CD3+CD8−FoxP3− T-helper cells, CD3+CD8−FoxP3+ regulatory T-cells, CD68+ macrophages and CD20+ B-cells in both the tumor and stromal compartments and assessed spatial relationships. We also quantified CD8+PD1+ (potentially enriched for tumor reactivity) and CD8+PD1− T-cells. Differential expression and gene set enrichment analysis (GSEA) were performed using the hallmarks gene sets. Results: The median OS for the entire study cohort was 11.3 months (95% CI, 5.5-16.7), which is an improvement compared to the hypothesized historical median of 7.8 months for stage IV patients (one sample log-rank p=0.033). Biomarker analyses showed an increased density of stromal macrophages (p&amp;lt;0.001) and intratumoral cytotoxic T-cells (p=0.035) in durable responders compared to non-responders. Additionally, we observed an increased density of intratumoral CD8+PD1+ in durable responders (p&amp;lt;0.001). In contrast, intratumoral CD8+PD1− densities were comparable between durable and non-responders (p=0.057). Patients with a high density of intratumoral CD8+PD1+ also had an improved progression-free survival (PFS) (log-rank, p&amp;lt;0.001) and OS (log-rank, p=0.002). Analysis of the spatial relationships in the tumor microenvironment (TME) showed that durable responders had larger distances between cytotoxic T-cells and T-helper cells (p=0.034). GSEA revealed significant (FDR≤5%) up-regulation of IFN-α/γ responses in durable responders. In contrast, non-responders showed up-regulation of epithelial-mesenchymal transition, KRAS signaling and angiogenesis, suggesting potential barriers to an anti-tumor response. Conclusion: In the final clinical analysis, OS was improved with atezolizumab compared to the historical population of stage IV patients. CD8+PD1+ T-cells, a common proxy for tumor-reactive T-cells, and spatial relationships in the TME might serve as biomarkers of durable response to immunotherapy in advanced penile cancer. Citation Format: Tynisha S. Rafael, Alberto Gil-Jimenez, Hielke M. de Vries, Iris M. Seignette, Elise Bekers, Marta Lopez-Yurda, Dennis Peters, Erik Hooijberg, Annegien Broeks, Oscar R. Brouwer, Eva Schaake, Daniel J. Vis, Tanja D. de Gruijl, Lodewyk F.A. Wessels, Michiel S. van der Heijden. The penile cancer tumor microenvironment and immunotherapy response: Results from the PERICLES trial [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 2488.

Abstract 7249: Enhancing mRNA- lipid nanoparticles formulations to improve transfection efficiency in macrophages and dendritic cells in cancer immunotherapy

Abstract Cancer poses a global health challenge, driving the quest for innovative therapies. Messenger ribonucleic acid (mRNA) lipid nanoparticles (LNPs) are a promising strategy in cancer immunotherapy. However, a major obstacle lies in efficiently transfecting immune cells like macrophages and dendritic cells (DCs) with LNPs. This study seeks to improve cancer immunotherapy by optimizing mRNA-LNP formulations. Therefore, we systematically evaluated three components of LNPs, namely ionizable lipids, phospholipids, and sterols, and fine-tuned the components and their molar ratios. A comprehensive screening process was conducted to determine the efficiency of LNPs, involving in vitro experiments on macrophages and DCs, as well as in vivo assessments. Among six ionizable lipids assessed in different cell lines (RAW264.7 and DC2.4), SM-102 significantly enhanced the transfection efficiency in macrophages and DCs. Subsequently, we evaluated these LNPs in an in vivo setting. We quantified the bioluminescence signal after administering LNPs loaded with luciferase mRNA. The results demonstrated a significant increase in luciferase expression when using SM-102 and ALC-0315 lipids. To validate this finding, we conducted a T cell response study, which revealed an increased percentage of CD8+ T cells with SM-102-based LNPs compared to other formulations. Having identified SM-102 as a potent ionizable lipid, we proceeded to evaluate three phospholipids in vitro. The results indicated a significant enhancement in transfection efficiency with DOPE lipids compared to DSPC. Consequently, we selected DOPE as the phospholipid for subsequent screening. Lastly, we explored different types of sterols with varying molar ratios in macrophages and DC cells. Our findings unveiled a notable improvement in mRNA delivery, particularly in DCs, when the molar ratio of β-sitosterol was increased to 19.5%, while concurrently decreasing the molar ratio of cholesterol to 19% within the same formulation. It is noteworthy that the addition of β-sitosterol alone led to reduced transfection efficiency in DCs but resulted in a significant enhancement in macrophages. Lastly, we evaluated the top four formulations in vivo, and the results demonstrated a significant increase when β-sitosterol was added to the formulation with cholesterol, at molar ratios of 19.5% and 19%, respectively. Overall, altering lipid composition and their molar ratios profoundly impact mRNA-LNP transfection. The optimized formulations, comprising SM-102, DOPE, and cholesterol with or without β-sitosterol, outperformed the alternatives. These refined formulations hold promise for clinical applications, potentially enhancing passive therapeutic agent delivery into macrophages and DCs, offering promising prospects for advancing cancer immunotherapy. Citation Format: Yasir Alshehry, Matthew Fernandez, Raneem Aldaqqa, Asma Al-Terawi, Douglas Sweet, Sandro da Rocha. Enhancing mRNA- lipid nanoparticles formulations to improve transfection efficiency in macrophages and dendritic cells in cancer immunotherapy [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 7249.

Advancing cancer immunotherapy: the promise of self-photoconversion reporters for immune cell migration tracking

Advancing cancer immunotherapy: the promise of self-photoconversion reporters for immune cell migration tracking

Advances in nanotechnology-enabled drug delivery for combining PARP inhibitors and immunotherapy in advanced ovarian cancer.

Advanced ovarian cancer is a malignancy that spreads beyond the ovaries to the pelvis, abdomen, lungs, or lymph nodes. Effective treatment options are available to improve survival rates in patients with advanced ovarian cancer. These include radiation, surgery, chemotherapy, immunotherapy, and targeted therapy. Drug resistance, however, remains a significant challenge in pharmacotherapeutic interventions, leading to reduced efficacy and unfavorable patient outcomes. Combination therapy, which involves using multiple drugs with different mechanisms of action at their optimal dose, is a promising approach to circumvent this challenge and it involves using multiple drugs with different mechanisms of action at their optimal dose. In recent years, nanotechnology has emerged as a valuable alternative for enhancing drug delivery precision and minimize toxicity. Nanoparticles can deliver drugs to specific cancer cells, resulting in higher drug concentrations at the tumor site, and reducing overall drug toxicity. Nanotechnology-based drug delivery systems have the potential to improve the therapeutic effects of anti-cancer drugs, reduce drug resistance, and improve outcomes for patients with advanced ovarian cancer. This literature review aims to examine the current understanding of combining poly (ADP-ribose) polymerase (PARP) inhibitors and immunotherapy in treating advanced ovarian cancer and the potential impact of nanotechnology on drug delivery.

Chinese expert consensus on immunotherapy for advanced non-small cell lung cancer with oncogenic driver mutations (2023 edition).

Chinese expert consensus on immunotherapy for advanced non-small cell lung cancer with oncogenic driver mutations (2023 edition).

An integrative machine learning model for the identification of tumor T-cell antigens

The escalating global incidence of cancer poses significant health challenges, underscoring the need for innovative and more efficacious treatments. Cancer immunotherapy, a promising approach leveraging the body’s immune system against cancer, emerges as a compelling solution. Consequently, the identification and characterization of tumor T-cell antigens (TTCAs) have become pivotal for exploration. In this manuscript, we introduce TTCA-IF, an integrative machine learning-based framework designed for TTCAs identification. TTCA-IF employs ten feature encoding types in conjunction with five conventional machine learning classifiers. To establish a robust foundation, these classifiers are trained, resulting in the creation of 150 baseline models. The outputs from these baseline models are then fed back into the five classifiers, generating their respective meta-models. Through an ensemble approach, the five meta-models are seamlessly integrated to yield the final predictive model, the TTCA-IF model. Our proposed model, TTCA-IF, surpasses both baseline models and existing predictors in performance. In a comparative analysis involving nine novel peptide sequences, TTCA-IF demonstrated exceptional accuracy by correctly identifying 8 out of 9 peptides as TTCAs. As a tool for screening and pinpointing potential TTCAs, we anticipate TTCA-IF to be invaluable in advancing cancer immunotherapy.