Intense Tumor Lymphocytic Infiltration Prognostic of Better Outcome in Resectable NSCLC


Key Points

  • Intense tumor lymphocytic infiltration was associated with improved outcome in patients with resectable NSCLC.
  • There was no significant treatment–tumor lymphocytic infiltration interaction for outcomes.

Intense tumor lymphocytic infiltration was associated with improved outcomes in patients with resectable non–small cell lung cancer, according to a study reported in the Journal of Clinical Oncology by Brambilla et al.

Study Details

The LACE-Bio (Lung Adjuvant Cisplatin Evaluation Biomarker) study involved data from a discovery set of 824 patients from 1 trial and a validation set of 984 patients from 3 trials evaluating platinum-based adjuvant chemotherapy in NSCLC. Tumor lymphocytic infiltration was defined as intense vs nonintense, with intense defined, as in breast cancer, as ≥ 50% stromal lymphocytes in tumor bulk compared with epithelial tumor cells.

Significant Prognostic Effect

Median follow-up was 4.8 and 6 years in the discovery and validation cohorts, respectively. Tumor lymphocytic infiltration was identified as intense in 11% and 6% (P < .001), respectively.

On multivariate analysis in the discovery set, intense tumor lymphocytic infiltration was prognostic for overall survival (hazard ratio [HR] = 0.56, P = .002), disease-free survival (HR = 0.59, P = .002), and specific disease-free survival (HR = 0.56, P = .003). These findings were confirmed in the validation set, with hazard ratios of 0.45 (P = .01), 0.44 (P = .005), and 0.42 (P = .008) for overall, disease-free, and specific disease-free survival, respectively. No heterogeneity was found across trials (P ≥ .38 for all endpoints). No significant treatment–tumor lymphocytic infiltration interaction was observed in the discovery or validation sets or in the combined set (P ≥ .78 for all endpoints in the combined set).

The investigators concluded: “Intense lymphocytic infiltration, found in a minority of tumors, was validated as a favorable prognostic marker for survival in resected non–small cell lung cancer.”

The study was supported by Ligue Nationale Contre le Cancer, Programme National d’Excellence Specialisé cancer du poumon de l’Institut National du Cancer, U.S. National Cancer Institute, Canadian Cancer Society Research Institute, Sanofi, personal funding from the investigators, Gustave Roussy Foundation, Princess Margaret Cancer Foundation, and European contract EU-FP7 Curelung, Plateforme Detection Moléculaire In Situ of Centre Hospitalier Universitaire Grenoble.

Elisabeth Brambilla, MD, of Centre Hospitalier Universitaire Albert Michallon, Grenoble, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.