A domestic study has revealed that artificial intelligence (AI) can preemptively identify lung cancer patients who can expect the therapeutic effects of immunotherapy.
Among non-small cell lung cancer patients, which account for 85% of all lung cancers, 4 out of 5 exhibit genetic mutations. Among these, the epidermal growth factor receptor (EGFR) mutation is common, found in nearly half of Asian patients.
Patients with this mutation find it difficult for immune cells to recognize cancer cells, and immune cell responses are suppressed in the tumor microenvironment.
Since the development of EGFR-targeted therapies, the survival rates of these patients have significantly improved; however, the problem is that most patients develop resistance to targeted therapies within a few months to a few years. After developing resistance to targeted therapies, the effectiveness of immunotherapy is known to be more limited.
The joint research team from Samsung Medical Center, Asan Medical Center, and Lunit focused on cases where some patients showed very good responses to immunotherapy in actual clinical settings. To determine which patients could benefit from immunotherapy, they analyzed 143 patients who received immunotherapy after developing resistance to targeted therapies from 2015 to 2022.
The research team utilized Lunit's AI pathology analysis platform, ‘Lunit Scope IO’, to analyze the tumor tissues of the patients. As a result, it was found that patients with a high density of tumor-infiltrating lymphocytes within cancer cells had a higher response rate to immunotherapy and a longer survival period without cancer progression.
Tumor-infiltrating lymphocytes are special immune cells that move around cancer cells and directly attack them, unlike regular lymphocytes found in the blood. Patients with a high density of these cells had a response rate to immunotherapy that was 4.3 times higher than those without, and their progression-free survival period was also 2.7 times longer.
Additionally, patients with a high density of endothelial cells covering the inner walls of blood vessels and lymphatic vessels also showed a 5.2 times increase in response rate to immunotherapy and a 1.4 times longer progression-free survival period.
According to the research team, lung cancer patients who develop resistance to targeted therapies typically show a tendency for tumor-infiltrating lymphocytes to decrease, but it appears that patients who maintained a high density of these cells had better responses to immunotherapy despite these changes.
Professor Lee Se-hoon of the Department of Hematology and Oncology at Samsung Medical Center stated, “We have confirmed the possibility of opening the door to immunotherapy despite the limitations of resistance to targeted therapies,” and added, “I hope this study serves as a practical basis for providing personalized treatment to patients.”
The results of this study were published in the latest issue of the official journal of the American Association for Cancer Immunotherapy, 《Journal for ImmunoTherapy of Cancer》.
