Local researchers said the number of natural killer cells and their high activity could be a biomarker to predict the effectiveness of immunotherapy in patients with non-small cell lung cancer (NSCLC).

NKMAX, a biotech firm, said Friday the local researchers used their product NK Vue kit in the study, “Natural Killer Cells as a Potential Biomarker for Predicting Immunotherapy Efficacy in Patients with Non-Small Cell Lung Cancer,” published in Targeted Oncology.

Professor Choi Chang-min of Asan Medical Center led the study to analyze the correlation between immune cells and drug responsiveness in NSCLC patients before and after treatment with immune checkpoint inhibitors Keytruda or Opdivo. For the analysis of immune cells, the research team used 32 markers of mass cytometry (CyTOF) and used the NK Vue kit to analyze the NK cell activity.

The results showed that the activity and the number of NK cells were associated with immunotherapy responses in patients with NSCLC.

In the study, 44.5 percent (4 out of 9 patients) showed an immune checkpoint inhibitor response, and the rest did not respond to the immunotherapy. Patients who showed the therapeutic responses had a higher distribution of NK cells in the peripheral blood before the treatment. However, other immune cells, except for NK cells, did not show a meaningful difference between the response group and the non-response group.

Both groups did not show a change in the NK cell activity in the pre- and post-treatment. However, the two groups showed a stark contrast in NK cell activity. The response group had 1433.25pg/ml in NK cell activity, while the non-response group had 84.50pg/ml.

Keytruda, Opdivo, and Tecentriq are emerging as new anticancer therapies, but their response rates in NSCLC patients are as low as 20 percent, Choi said. The annual costs of immune checkpoint inhibitors are high at 70 million won to 100 million won, and doctors need to identify reliable biomarkers predicting response to immunotherapy to determine the treatment, he added.

“This study confirmed that only NK cells were related to the response rates of the immunotherapies,” Choi said. “The NK cell activity test could become a biomarker to predict immune checkpoint inhibitors and serve as criteria to provide various and reasonable cancer treatment options.”

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