Prognostic Impact of PD-1 Polymorphisms in Non-small Cell Lung Cancer Receiving Dendritic Cell Vaccination

The prognosis of patients with non-small cell lung cancer (NSCLC) remains poor. This phase II clinical trial investigated the efficacy of dendritic cell (DC) vaccination using Wilms' tumor 1 (WT1) and/or mucin 1 (MUC1) peptides - universal tumor-associated antigens - in combination with chemotherapy in patients with advanced-stage NSCLC. Additionally, we examined whether single nucleotide polymorphisms (SNPs) in immune checkpoint genes could serve as prognostic markers for survival.

Forty-four eligible patients with metastatic, unresectable or recurrent NSCLC were enrolled. DCs were administered intradermally every two to four weeks in combination with chemotherapy.

Following the seventh vaccination, four patients achieved a partial response and 15 patients had stable disease. The median progression-free survival (PFS) and overall survival (OS) from the initiation of DC vaccination were 6.7 months and 12.3 months, respectively. Log-rank analysis revealed that neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, prognostic nutritional index (PNI) and the programmed cell death 1 (PD-1) rs36084323 SNP were significantly associated with both PFS and OS. Cox regression analysis identified the PD-1 rs36084323 SNP and PNI as independent prognostic factors for both PFS and OS.

DC vaccination with WT1 and/or MUC1 peptides combined with salvage chemotherapy appears to be a promising treatment strategy for patients with advanced or relapsed NSCLC. The PD-1 rs36084323 SNP, along with PNI, was identified as an independent prognostic factor, suggesting its potential utility as a biomarker for selecting appropriate candidates for this treatment approach.