Korea University Guro Hospital Identifies Clues to Predicting Lung Cancer Immunotherapy Response

PET/CT scans may indicate the likelihood of cancer cell elimination
"Treatment responses vary with immune cell characteristics"

As responses to immunotherapy vary among lung cancer patients, a study has found that PET/CT measurements and the characteristics of immune cells in tumors may offer clues to predicting treatment outcomes.

Korea University Guro Hospital said on November 11 that, in a joint study with the University of Auckland in New Zealand, researchers identified imaging findings and immune cell characteristics associated with pathological complete response in lung cancer patients who received immunotherapy before surgery.

From left: Professors Lee Seung-ryong and Choi Joo-hwan of the Division of Pulmonology and Allergy at Korea University Guro Hospital; Professor Lee Eun-seong of Nuclear Medicine; Internal Medicine resident Lee Seung-hoon; and Professors P. Rod Dunbar and Park Saemmul of the Faculty of Life Sciences at the University of Auckland, New Zealand. Korea University Guro Hospital

Preoperative immunotherapy, in which immune checkpoint inhibitors are administered before surgery to help immune cells attack cancer cells, is increasingly being used to treat lung cancer. However, responses vary from patient to patient, making it difficult to predict treatment outcomes. Whether all cancer cells have been eliminated can also be confirmed only through an examination of tissue removed during surgery.

The research team analyzed PET/CT results from before and after treatment, as well as the characteristics of immune cells in tumor tissue, in 13 patients with stage II or III non-small cell lung cancer who were treated at Korea University Guro Hospital between December 2017 and November 2023.

The results showed that the tumor-to-liver uptake ratio (TLR), which compares glucose uptake in tumor tissue with that in the liver on PET/CT scans, decreased by 82% in the complete-response group and by 58% in the non-complete-response group. In tumor tissue, CD4 T cells, which help support immune responses, and T cells expressing the immunosuppressive protein TIGIT were observed more frequently in the complete-response group.

The research team said that changes in imaging measurements and the characteristics of immune cells in tumor tissue before treatment could provide clues to predicting pathological complete response after surgery.

Professor Lee Seunglyong of the Division of Pulmonology and Allergy at Korea University Guro Hospital said, "This study confirmed that preoperative imaging findings and the characteristics of immune cells in tumor tissue before treatment are associated with pathological complete response." He added, "If further research validates the usefulness of these indicators, they could help inform treatment strategies tailored to individual patients." The findings were recently published in the international journal Translational Lung Cancer Research.

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