The following summary is “Mass Cytometry Reveals Classical Monocytes, NK Cells, and ICOS+ CD4+ T Cells Associated with Pembrolizumab Efficacy in Patients with Lung Cancer” published in the December 2022 issue of Oncology by Rochigneux et al.

The treatment of non–small cell lung cancer (NSCLC) has been transformed by immune checkpoint inhibitors (ICI), although predictive biomarkers of their efficiency are not yet perfect. The major goal of this study is to investigate the circulating immunological predictors of the efficacy of pembrolizumab in patients with advanced NSCLC. In the baseline blood samples of patients with advanced NSCLC who were being treated with pembrolizumab, researchers utilized high-dimensional mass cytometry, also known as CyTOF. 

The CyTOF data were analyzed using machine learning techniques (Citrus and tSNE), and the results were validated using manual gating and principal component analysis (between-group analysis). In addition, investigators conducted an analysis using 27 participants from the landmark KEYNOTE-001 research (median follow-up of 60.6 months). They show that enhanced objective response rates, progression-free survival, and overall survival are strongly linked with higher blood baseline frequencies of classical monocytes, natural killer (NK) cells, and ICOS+ CD4+ T cells (OS). 

In addition, the study group finds that the efficacy of pembrolizumab can be strongly predicted by a baseline immunological peripheral score incorporating all 3 of these populations (OS: HR=0.25; 95% CI = 0.12–0.51; P<0.0001). They believe that their findings may be able to enhance the prediction of ICI benefits in patients with advanced NSCLC. Immune surveillance is simple and may be done in typical clinical settings.

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