Abstract 2012: Prognostic role of CD3+and CD8+cells density in resected stage IIIAN2 non-small cell lung cancer (NSCLC): A study from the randomized Lung ART IFCT 0503 trial

BACKGROUND: Immune cells (IC) density has a prognostic role in NSCLC1. Most results come from small cohorts with limited representation of stage III samples and show heterogeneity2-4. METHODS: The LungART trial (NCT00410683)5 randomized 501 patients (pts) with resected stage IIIAN2 NSCLC (AJCC 7th ed.) to adjuvant radiotherapy (ART) or observation. Up to 96% had (Neo)adjuvant chemotherapy (ChT). No disease-free survival (DFS) benefit was found for ART. For pts who consented, a primary tumor blocs was collected; CD3+/CD8+ cells were assessed by immunohistochemistry (DAKO/Roche). Automatic quantitative analysis of selected regions of interest was performed using the QuPath v.0.5.1 Bioimage software for assessment of IC density and correlated with outcomes. RESULTS: 272/501 pts had available samples; 47% received ART. Baseline characteristics were well balanced (table 1). A higher CD3+ cells density was found in non-squamous histology (p=0.003) and in pts receiving neoadjuvant ChT (p=0.03). Higher density of CD3 +and CD8 + cells correlated with the incidence of new events after 6 (p=0.0004 and 0.04, respectively) and 24 months (m) (p=0.003 and 0.04 respectively). High CD3 +cells density correlated with longer median DFS: 52 m (95% CI: 26.1 m-NR) vs 22 m (95% CI: 22.5-31.2 m,) as well as high CD8 + cells density (52.1 m; 95% CI: 34-NR vs 20.9 m; 95% CI: 16.9-28.8 m). A multivariate Cox model confirmed both high CD3 +and CD8 + cell density as independent prognostic factors for DFS (HR=0.68 [95%CI: 0.53-0.83], p=0.01 and HR=0.57 [95%CI: 0.38-0.86], p=0.07, respectively) and overall survival (HR=0.66; 95%CI: 0.49-0.88; p=0.005 and HR=0.5; 95%CI: 0,30-0.85; p=0.10, respectively). CONCLUSIONS: Our study is the largest cohort showing a prognostic role of IC density in resected stage IIIAN2 NSCLC, composed solely by surgical samples, which may identify a subset of poor prognosis pts who could benefit of an intensive therapeutic approach. Citation Format: Víctor Albarrán-Artahona, Maria-Rosa Ghigna, Wael Zrafi, Nicolas Signolle, Guillaume Granier, Nathalie Cozic, Julien Adam, Ludovic Lacroix, Benjamin Besse, Cécile Le Pechoux, Antonin Levy. Prognostic role of CD3and CD8cells density in resected stage IIIAN2 non-small cell lung cancer (NSCLC): A study from the randomized Lung ART IFCT 0503 trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 2012.