Fig. 1
From: Persistent mutant oncogene specific T cells in two patients benefitting from anti-PD-1
Durable clinical benefit to PD-1 blockade in two patients without high mutational burden tumors. a, Patient LUAD-3001 – a 76 year old woman with metastatic non-small cell lung cancer. Selected cropped IV contrast enhanced CT images of the chest in lung window at four different timepoints. Baseline exam (11/25/13) demonstrates two left lower lobe solid nodules with surrounding ground glass opacities (red arrows) compatible with metastases. First followup exam while on nivolumab (2/10/14) demonstrates near complete resolution with minimal residual ground glass opacities (red arrows). Additional two and four year followup exams (7/14/16 and 2/21/18) demonstrate complete and durable resolution of metastases, with no evidence of progression elsewhere in the body (not shown). b, H&E staining (left panel), PD-L1 staining (center panel), and CD8 infiltration (right panel) of the primary tumor obtained from patient LUAD-3001 during surgical resection on 4/12/2012. c, Patient CRC-010 - a 69 year old woman with metastatic recurrent mismatch repair proficient colorectal cancer with locally invasive pancreatic metastasis. Selected IV contrast enhanced CT images of the abdomen in venous phase. Baseline exam (12/27/13) demonstrates a heterogeneous hypovascular mass with scattered calcifications (red arrow). Four month follow up exam on pembrolizumab (4/2/14) demonstrates slight enlargement without new metastases. Metastasis slowly decreased in size on 2 year follow up (2/23/16) and slightly increased on four year follow up exam (9/29/17). No new metastases are seen on interval or latest CT exam and disease remains stable. d, H&E staining (left panel), PD-L1 staining showing no expression on tumor cells (red arrow, center left panel) but high expression at the invasive front on a discrete immune cell aggregate and CD8 infiltration (center right panel) in the primary tumor obtained from patient CRC-010 during surgical resection on 9/29/2003. CD8 staining demonstrating a brisk CD8+ lymphocytic infiltrate is also shown on a fine needle aspiration of the pancreatic recurrence on 12/30/2013 (right panel)