Journal of Thoracic Oncology

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Journal of Thoracic Oncology Improved Prognosis and Increased Tumor-Infiltrating Lymphocytes in Patients Who Have SCLC With Neurologic Paraneoplastic Syndromes Wade T. Iams, MD, Eileen Shiuan, BS, Catherine B. Meador, MD, PhD, Marc Roth, MD, Jennifer Bordeaux, PhD, Christine Vaupel, PhD, Kelli L. Boyd, DVM, PhD, IlaSri B. Summitt, PhD, Lucy L. Wang, PhD, Joseph T. Schneider, MS, Jeremy L. Warner, MD, MS, Zhiguo Zhao, MS, Christine M. Lovly, MD, PhD Journal of Thoracic Oncology DOI: 10.1016/j.jtho.2019.05.042 Copyright © 2019 International Association for the Study of Lung Cancer Terms and Conditions

Figure 1 Progression-free survival (PFS) and overall survival (OS) according to the presence and type of paraneoplastic syndrome (PNS) in patients with SCLC. Kaplan-Meier estimates of (A) OS and (B) PFS in patients with SCLC according to the absence or presence of a PNS. Kaplan-Meier estimates of (C) OS and (D) PFS limited to only patients who received systemic therapy for SCLC. Journal of Thoracic Oncology DOI: (10.1016/j.jtho.2019.05.042) Copyright © 2019 International Association for the Study of Lung Cancer Terms and Conditions

Figure 2 Overall comparison of CD3, CD4, CD8, and programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) interaction scores. Tumors from patients with SCLC with neurologic paraneoplastic syndromes (PNS) had significantly increased PD-1/PD-L1 interaction scores (A) compared to tumors from patients with SCLC with endocrinologic PNS and tumors from patients with SCLC and no paraneoplastic syndrome (control). Tumors from patients with SCLC with neurologic PNS had a trend towards increased CD4 (B) and CD8 (C) infiltrates compared to tumors from patients with SCLC with endocrinologic PNS and tumors from patients with SCLC and no PNS (control). Tumors from patients with SCLC with neurologic PNS had significantly increased CD3 (D) infiltrates compared to tumors from patients with SCLC with endocrinologic PNS and tumors from patients with SCLC and no PNS (control). Journal of Thoracic Oncology DOI: (10.1016/j.jtho.2019.05.042) Copyright © 2019 International Association for the Study of Lung Cancer Terms and Conditions

Figure 3 Immunologic correlates by automated quantitative analysis with accompanying computed tomography (CT). (A) ×4 and ×20, 40,6-diamidino-2-phenylindole (DAPI) in blue, transcription termination factor 1 (TTF1) in green, programmed death 1 (PD-1) in yellow, and programmed death ligand 1 (PD-L1) in red. (B) ×20, DAPI in blue, CD3 in yellow, CD4 in red, and CD8 in green (first image with CD3 present, second image with CD3 removed). (C) CT scan shows the primary tumor at diagnosis (left) followed by progression of disease (right, red arrow indicates primary tumor in both panels). Journal of Thoracic Oncology DOI: (10.1016/j.jtho.2019.05.042) Copyright © 2019 International Association for the Study of Lung Cancer Terms and Conditions