Dr. Mary Jo Fidler on the Role of Oligoclonal T Cell Expansion in NSCLC

Mary Jo Fidler, MD, associate professor, medical oncology, hematology, internal medicine, Rush University Medical Center, discusses how early and persistent oligoclonal T cell expansion correlates with durable response to anti-PD1 therapy in non-small cell lung cancer treatment (NSCLC).

There is a need for other ways to identify patients that will respond to PD-1 inhibitors beside PD-L1 testing. In one recent study, researchers found that both in the tumor cells and the circulating blood, there is an expansion of oligoclonal T cells in patients after they receive anti-PD1 therapy for NSCLC. These T cells were cloned or derived from one or a few cells.

These findings were significant, says Fidler, because in the patients that seem to derive benefit, researchers were able to detect these T cells, which presumably were released by adding the checkpoint inhibitor. However, patients that did not respond to the checkpoint inhibitors did not have the same uptake in these T cells, says Fidler.

Based on these findings, it is possible that oligoclonal T cells could become an alternative method for selecting which patients should continue on with checkpoint inhibitors, and which patients should receive other immunomodulators to try and increase their immune response.