Artificial Intelligence–Powered Spatial Analysis of Tumor-Infiltrating Lymphocytes as Complementary Biomarker for Immune Checkpoint Inhibition in Non–Small-Cell Lung Cancer. Issue 17 (10th June 2022)

• Record Type: Journal Article
• Authors: Park, Sehhoon; Ock, Chan-Young; Kim, Hyojin; Pereira, Sergio; Park, Seonwook; Ma, Minuk; Choi, Sangjoon; Kim, Seokhwi; Shin, Seunghwan; Aum, Brian Jaehong; Paeng, Kyunghyun; Yoo, Donggeun; Cha, Hongui; Park, Sunyoung; Suh, Koung Jin; Jung, Hyun Ae; Kim, Se Hyun; Kim, Yu Jung; Sun, Jong-Mu; Chung, Jin-Haeng; Ahn, Jin Seok; Ahn, Myung-Ju; Lee, Jong Seok; Park, Keunchil; Song, Sang Yong; Bang, Yung-Jue; Choi, Yoon-La; Mok, Tony S.; Lee, Se-Hoon
• Is Part Of: Journal of clinical oncology. Volume 40:Issue 17(2022)
• Page Start: 1916
• Page End: 1928
• Publication Date: 2022-06-10
• Subjects: Oncology -- Periodicals; Cancer -- Periodicals; Oncology; Medical Oncology; Cancérologie -- Périodiques; Cancer -- Périodiques; Cancérologie; Cancer; Oncology; Oncologia; Càncer; Periodicals; 616.994
• DOI: 10.1200/JCO.21.02010
• Languages: English
• ISSNs: 0732-183X

Abstract

Abstract : PURPOSE: Biomarkers on the basis of tumor-infiltrating lymphocytes (TIL) are potentially valuable in predicting the effectiveness of immune checkpoint inhibitors (ICI). However, clinical application remains challenging because of methodologic limitations and laborious process involved in spatial analysis of TIL distribution in whole-slide images (WSI). METHODS: We have developed an artificial intelligence (AI)–powered WSI analyzer of TIL in the tumor microenvironment that can define three immune phenotypes (IPs): inflamed, immune-excluded, and immune-desert. These IPs were correlated with tumor response to ICI and survival in two independent cohorts of patients with advanced non–small-cell lung cancer (NSCLC). RESULTS: Inflamed IP correlated with enrichment in local immune cytolytic activity, higher response rate, and prolonged progression-free survival compared with patients with immune-excluded or immune-desert phenotypes. At the WSI level, there was significant positive correlation between tumor proportion score (TPS) as determined by the AI model and control TPS analyzed by pathologists ( P < .001). Overall, 44.0% of tumors were inflamed, 37.1% were immune-excluded, and 18.9% were immune-desert. Incidence of inflamed IP in patients with programmed death ligand-1 TPS at < 1%, 1%-49%, and ≥ 50% was 31.7%, 42.5%, and 56.8%, respectively. Median progression-free survival and overall survival were, respectively, 4.1 months and 24.8 months with inflamed IP, 2.2 months and 14.0 months with immune-excluded IP, and 2.4 months and 10.6 months with immune-desert IP. CONCLUSION: The AI-powered spatial analysis of TIL correlated with tumor response and progression-free survival of ICI in advanced NSCLC. This is potentially a supplementary biomarker to TPS as determined by a pathologist.