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Vascular endothelial growth factor receptor 2 expression and immunotherapy efficacy in non-small cell lung cancer

Cancer Sci. 2022 Jun 20. doi: 10.1111/cas.15464. Online ahead of print.

ABSTRACT

It is unclear whether tumor vascular endothelial growth factor receptor 2 expression affects the therapeutic efficacy of immune-checkpoint inhibitors and anti-angiogenic agents. This retrospective, multi-center study included patients with advanced non-small cell lung cancer who were treated with immune-checkpoint inhibitors. We constructed tissue microarrays and performed immunohistochemistry with an anti-vascular endothelial growth factor receptor 2 antibody. We analyzed immune and tumor cell staining separately in order to determine their correlation with the objective response rate, progression-free survival and overall survival in patients receiving immune-checkpoint inhibitors. Of 364 patients, 37 (10%) expressed vascular endothelial growth factor receptor 2 in immune cells and 165 (45%) in tumor cells. The objective response rate, progression-free survival and overall survival were significantly worse in patients treated with immune-checkpoint inhibitor monotherapy who expressed vascular endothelial growth factor receptor 2 in immune cells than those who did not (10% vs. 30%, p = 0.028; median = 2.2 vs. 3.6 months, p = 0.012; median = 7.9 vs. 17.0 months, p = 0.049, respectively), while there was no significant difference based on tumor cell expression (24% vs. 30%, p = 0.33; median = 3.1 vs 3.5 months, p = 0.55; median = 13.6 vs. 16.8 months, p = 0.31). There was no significant difference in overall survival between patients treated with and without anti-angiogenic agents in any treatment period based on vascular endothelial growth factor receptor 2 expression. Immune-checkpoint inhibitor efficacy was limited in patients expressing vascular endothelial growth factor receptor 2 in immune cells.

PMID:35722982 | DOI:10.1111/cas.15464

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