The PhD defense will take place

Friday February 3rd, 2023
Time: 14.00
Place: Auditorium Syd, Aalborg University Hospital

After the defense a reception will be held. All are welcome.

About the PhD thesis

Since 2015, immune checkpoint inhibitors (ICIs) have revolutionized the treatment of patients with advanced non-small cell lung cancer (NSCLC), without targetable molecular alterations, based on improved response rates and overall survival (OS) in randomized controlled trials (RCTs). However, subgroups of patients with poor performance status (PS), high age and comorbidity are underrepresented in the RCTs but frequently treated in daily clinical cancer care. Therefore, the nationwide studies I and II investigated the ICI efficacy in patients with advanced NSCLC treated in daily clinical care. The selection of patients for ICI-treatment currently relies on the programmed death-ligand 1 (PD-L1) tumor proportion score, but the predictive value of PD-L1 is limited and complementary biomarkers are warranted. Therefore, study III investigated new predictive biomarkers of ICI efficacy.

In conclusion, this dissertation provides information on ICI efficacy in a nationwide cohort of Danish patients with advanced NSCLC treated with ICI in daily clinical cancer care. The OS significantly increased after the implementation of ICIs in Denmark. Furthermore, the survival was comparable to or slightly lower than the survival demonstrated in the RCTs, but subgroups of patients with poor PS, bone-, and liver metastases may not derive benefit. High absolute lymphocyte count was associated with durable clinical benefit (DCB), but the predictive value should be assessed in larger independent cohorts. Gene expression profiling (GEP) could be clinically relevant in PD-L1 assessment and four gene expression signatures were associated with DCB. However, the GEP-cohort was small, and the findings should be investigated in a larger prospective study.