Fig. 7

Immunophenotypic changes of PBMCs in a patient who received ICI combination. A summarizes the key events in the clinical course of a patient with EGFR exon 19 deletion. A 72-year-old gentleman, never smoker was diagnosed with cT4N2M1c NSCLC adenocarcinoma with large tumor burden in April 2020 when he presented with worsening non-productive cough and shortness of breath for about 6 months. The tumor was stained negative for PD-L1 IHC stain (DAKO, clone 22C3). Tumor genomic profiling did not identify any driver oncogenes. The patient received PD-1 and CTLA-4 inhibitors for 3 cycles and was found to have tumor progression. The patient subsequently received carboplatin and pemetrexed for two cycles without significant clinical improvement. Repeat tumor genomic profiling test identified an EGFR E19Del. The patient had been in clinical PR to EGFR TKI osimertinib for over 10 months at the time of this report. The changes in ALCs, CD4, CD8, and CD4 plus CD8 cell counts during the treatment course (B). Heat mapping (C) and viSNE land (D) illustrate the immunophenotypic changes of PBMCs before and after ICI treatment