Abstract 5489: The spatial landscape of early-stage lung adenocarcinoma

Abstract Cellular and molecular basis of ground-glass opacities (GGO), which has been used as a screening indicator for lung cancer, remains a gray area. Our aim was to investigate the tumor-immune microenvironment (TIME) in a cohort of early-stage lung adenocarcinomas (LUAD) through imaging mass cytometry, enabling us to examine the TME spatial composition of nodules at single-cell resolution. We collected 354 imaging mass cytometry (IMC) regions of interest (ROI) from 135 early-stage lung adenocarcinoma patients to investigate the spatial and molecular profiles of early stage LUAD. Specifically, we gathered 27 solid (S), 39 part-solid (PS), 74 pure non-solid (PNS) patients and 89 matched adjacent-normal cases to profile the phenotype of 2.24 million cells across the two IMC panels to characterize the cellular and molecular composition of GGO nodules. Comparing progression from adjacent normal, pure non-solid, part-solid, to solid, we observed consistent reduction in RAGE+ AT1 cells (p*<1.6E-7) and a reciprocal increase in SFTPC+ AT2 cells (p*<1.3E-8) and PanCK+Ki67+ proliferative epithelial cells (p*<2.8E-7). We also report fibrogenesis and an increase in immune cell populations such as regulatory (p*<1.4E-5), CD4 (p*<0.0024), CD8 T (p*<0.017) cells, B (p*<5.5E-9) cells, and macrophages. Spatially, we quantify an upregulation of tumor-tumor and tumor-fibroblast interaction, and a downregulation of tumor-immune interaction. We believe this evidence suggests the role of fibroblasts as liner for tumors, barricading immune infiltration and harvesting uninterrupted tumorigenesis. In summary, we performed a highly multiplexed IMC data to analyze the TIME spatial profiles of GGO nodules in early-stage LUAD at a single-cell level. Spatial analysis of this integrated multidimensional omics dataset provides insight into the pivotal role of fibroblasts in early-stage LUAD in immune suppression, evasion, tumorigenesis, and potentially metastasis. Citation Format: Junbum Kim, Hiranmayi Ravichandran, Liron Yoffe, Bhavneet Binder, Timothy McGraw, Nasser K. Altorki, Vivek Mittel, Olivier Elemento. The spatial landscape of early-stage lung adenocarcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5489.