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The following is a summary of “HLA-I levels correlate with survival outcomes in response to immune checkpoint inhibitors in non-small cell lung cancer,” published in the February 2024 issue of Pulmonology by Saigí et al.

The efficacy of immune checkpoint inhibitors (ICIs) in treating non-small cell lung cancer (NSCLC) varies among patients, underscoring the need for reliable predictive biomarkers. This study aimed to assess the correlation between human leukocyte antigen class I (HLA-I) levels and treatment outcomes in metastatic NSCLC patients receiving anti-PD-(L)1 therapy.

A cohort of 146 metastatic NSCLC patients treated with anti-PD-(L)1 therapy was analyzed. Immunohistochemistry was conducted on 122 tumor biopsies at diagnosis to assess HLA-I, PD-L1, and CD73 levels. Associations between these markers, patient characteristics, tumor parameters, and response to ICI treatment were evaluated.

High HLA-I, PD-L1, and CD73 levels were observed in 42%, 25%, and 21% of tumors, respectively. Lung adenocarcinomas exhibited elevated CD73 levels compared to lung squamous cell carcinomas (P = 0.026). Significant correlations were found between high PD-L1 expression and elevated levels of both HLA-I (P = 0.005) and CD73 (P = 0.025). Patients with high-level HLA-I tumors showed improved clinical outcomes following ICI treatment, with longer median overall survival (30.7) (95 % CI: 18.3 months-NE) vs. 18.2 months (95 % CI: 12.4–25.2 months)  (P = 0.016) and PFSl (18.5) (95 % CI: 11.1–57.1 months), vs. 9.2 months (95 % CI: 7.2–11.9 months) (P = 0.006) compared to patients with low-level HLA-I tumors. Multivariable analysis revealed that high-level HLA-I was independently associated with a lower risk of progression on ICI therapy (HR = 0.46, 95% CI 0.24–0.87; P = 0.018).

Elevated HLA-I levels were associated with improved clinical outcomes in NSCLC patients treated with ICIs, highlighting its potential as a predictive biomarker. Further validation and refinement of this biomarker in prospective studies involving larger patient cohorts are warranted to enhance its clinical utility.

Source: sciencedirect.com/science/article/pii/S0169500224000357