A new study from Memorial Sloan-Kettering has shown that the presence or absence of certain kinds of immune cells in a lung tumor and in the tissue surrounding such a tumor might influence the likelihood that the tumor will recur after it is surgically removed.
The findings, published online December 26 in the Journal of Clinical Oncology, suggest how new tests could be developed to predict which patients are at a higher risk of recurrence after surgical removal of their lung tumor. In addition, the study confirms the important role the immune system plays in helping the body to fight cancer.
“Good” Immune Responses
The researchers looked at eight types of immune cells in tissue samples from 956 patients with stage I lung adenocarcinoma, one of the most common types of lung cancer, then studied patients to see how they fared after surgery. They found that the presence of certain immune cells and factors secreted by these immune cells indicated the patient was more likely to be cured, while the presence of other factors indicated the patient was more likely to have the cancer return.
“This research shows that with a certain type of immune response — a ‘good’ response — there is a benefit to patients, and it prevents the cancer from coming back,” says Prasad S. Adusumilli, a Memorial Sloan-Kettering scientist and thoracic surgeon who led the study. “If someone has a different type of immune response, that patient may be at much higher risk of having a recurrence.”
Currently, patients with stage I and stage II lung cancer do not receive any additional treatments, such as chemotherapy and radiation therapy, after surgery.
“These treatments have side effects, and they have not shown a benefit to patients with early-stage disease,” Dr. Adusumilli explains. “However, there is enthusiasm for developing immune therapies for these patients, which would be targeted and may improve the chance of cure.”
These immune therapies may include antibodies that improve the immune response or treatments in which patients’ own immune cells are engineered to be more effective at fighting cancer.
“In our study, we’ve identified factors that may be useful in predicting which patients might benefit from these new kinds of immune treatments,” he adds.
At present, only 20 to 25 percent of lung adenocarcinomas are detected at stage I. However, Dr. Adusumilli says that the proportion of cancers caught at an early stage is likely to increase due to new guidelines on screening smokers for lung cancer. With this anticipated increase in early detection, Nabil P. Rizk, a thoracic surgeon who is coordinating Memorial Sloan-Kettering’s lung cancer screening program, has emphasized the need for prediction biomarkers.
Dr. Adusumilli and his team, working in Memorial Sloan-Kettering’s Center for Cell Engineering (CCE), are currently developing clinical trials to test cell-based immune therapies in lung cancer patients. Michel Sadelain, Director of the CCE and a coauthor of the JCO study, is helping to initiate one such study that makes use of a technique called adoptive cell transfer and that will be part of a new Stand Up to Cancer (SU2C) Immunology Dream Team project, funded by SU2C and the Cancer Research Institute.