Immune Infiltration and Clinical Outcome in Non-Small Cell Lung Cancer

Abstract

Lung cancer is the cancer responsible for the most deaths worldwide. Treatment is multimodal and based on information specific to the tumor (histology, stage, biology and genetics aberrations) and patient-related factors. During the last decade, the arrival of novel targeted therapies and immunotherapy, has led to a paradigm shift in the management of lung cancer. In this regard, assessment of tumor immunology is of great interest to researchers and clinicians. The immune system undoubtedly plays an important role in the progression and development of cancer. Although it is just a snap-shot picture, it is established that the local immune status, at the time of resection, can provide important prognostic information and influence the clinical management and survival of cancer patients. Currently, the most prominent examples, where immune cell assessment are clinically relevant, are colorectal and breast cancer. The immune infiltrate comprises adaptive and innate immune cell subsets in which lymphocytes, macrophages and neutrophils are the major populations orchestrating tumor immunity. Advancing the understanding of immune infiltration has significant potential for the development of clinical prognostic and predictive immune markers for patients with NSCLC. The ultimate goal in studying the in situ immunity of NSCLC is to apply this information for optimization of immunomodulation and immunotherapy. The present study was designed to study tumor-infiltrating lymphocytes, macrophages and neutrophils, which seems to represent a potential powerful prognostic instrument for NSCLC. In addition, this thesis emphasizes the importance of the choice of methodology for reliable identification of relevant immune biomarkers.