Endobronchial ultrasound-guided transbronchial needle injection of cisplatin results in dynamic changes in the tumor immune microenvironment

• Published in: Respiratory medicine and research 2023-11, Vol.84, p.100994-100994, Article 100994
• Main Authors: DuComb, Emily A, Collins, Cheryl C., Cupak, Dolores, Wagner, Sarah, Khan, Farrah B., Budd, Ralph C, Kinsey, C.Matthew
• Format: Article
• Language: English
• Subjects: Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - pathology; Cisplatin; Cisplatin - therapeutic use; Endoscopic Ultrasound-Guided Fine Needle Aspiration - methods; Humans; Intratumoral therapy; Lung Neoplasms - drug therapy; Lung Neoplasms - pathology; Tumor Microenvironment
• ISSN: 2590-0412; 2590-0412
• DOI: 10.1016/j.resmer.2023.100994

Direct intratumoral delivery of cisplatin via endobronchial ultrasound guided-transbronchial needle injections (EBUS-TBNI) is a novel approach for salvage treatment of advanced stage non-small cell lung cancer (NSCLC). The goal of this study was to evaluate changes in the tumor immune microenvironment during the course of EBUS-TBNI cisplatin therapy. Under an IRB approved protocol, patients with recurrence after radiation therapy who were not receiving other cytotoxic therapy, were prospectively enrolled, and underwent weekly treatments with EBUS-TBNI with additional biopsies obtained for research. Needle aspiration was performed prior to cisplatin delivery at each procedure. Samples were evaluated by flow cytometry for the presence of immune cell types. Three of the six patients responded to the therapy based on RECIST criteria. Compared to the pre-treatment baseline, intratumoral neutrophils increased in 5 of the 6 patients (p = 0.041), with an average increase of 27.1%, but was not associated with response. A lower pre-treatment CD8+/CD4+ ratio at baseline was associated with response (P = 0.01). Responders demonstrated a lower final proportion of PD-1+ CD8+ T cells compared to non-responders (8.6% vs. 62.3%, respectively, P