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. 2022 Jun 8;10(6):e004495. doi: 10.1136/jitc-2022-004495

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© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See http://creativecommons.org/licenses/by-nc/4.0/.

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A patient with adenosquamous NSCLC (EGFR wild-type, ALK negative and PD-L1 TPS 60%) had previously received treatment with carboplatin and gemcitabine followed by pembrolizumab for 17 months (with radiotherapy for oligometastatic progression in brain and lung during pembrolizumab course) and achieved stable disease lasting for 52 weeks on trial. (A) On IHC analysis of intratumoral T-cell subsets, C2D8 biopsy showed increase in CD3⁺ cells from 2161.58/mm² to 2757.28/mm² (increase of 27.55%) from baseline. (B) On immunofluorescence analysis of intratumoral T-cell subsets C2D8 biopsy showed an increase in CD4⁺/FOXP3^- cells (T-helper cells) from 108.5/mm² to 135.24/mm² (increase of 24.65%), a decrease in CD4⁺ FOXP3⁺ cells (T-regulatory cells) from 79.57/mm² to 22.97/mm² (decrease of 71.13%) and an increase in CD8⁺ cells from 370.35/mm² to 890.53/mm² (increase of 140.46%) from baseline. Scale bar 100 µm. ALK, anaplastic lymphoma kinase; CD, cluster of differentiation; C2D8, cycle 2 day 8; EGFR, epidermal growth factor receptor; FOXP3, forkhead box P3; IHC, immunohistochemistry; NSCLC, non-small cell lung cancer; PanCK, pan cytokeratin; PD-L1, programmed death ligand 1; TPS, Tumor Proportion Score.