A detailed smoking history and determination of MYC status predict response to checkpoint inhibitors in advanced non-small cell lung cancer
Michelle Chiu, Mary Beth Lipka, Priyanka Bhateja, Pingfu Fu, Afshin Dowlati
Abstract
BACKGROUND: Although many studies have determined that PD-L1 expression by immunohistochemistry can be somewhat predictive of a response to checkpoint inhibitor the impact of specific genomic changes and smoking history in the context of PD-L1 expression is limited. This single-center study examined clinical and genomic factors beyond STK11 and EGFR in patients with advanced non-small cell lung cancer (NSCLC) to determine which patients benefit from therapy with immune checkpoint inhibitors (ICIs). METHODS: Clinical and genomic features of patients with NSCLC treated with immunotherapy were compiled into a database. Genomic information collected included gene mutations via next generation sequencing, tumor mutation burden (TMB), and PD-L1 tumor proportional scores. RESULTS: amplification continued to be the only predictive genomic marker with a trend toward response to therapy (P=0.092) beyond the smoking history. CONCLUSIONS: amplification alone can predict response to ICI.