Fig. 4

Immune-modulatory effects of cetuximab plus avelumab in NSCLC patient-derived ex vivo 3D spheroid cultures. Cetuximab plus avelumab treatment for 5 days induced 10- to 20-fold increase in gene expression, as compared to untreated control samples, for the two STING downstream effector chemokines, CCL5 and CXCL10, and for IFNβ gene expression (A), and for biomarkers of NK cell activation, such as Granzyme B and Perforin(B). Conversely, decreased levels of PD-L1 and TIM-3 gene expression were observed following cetuximab plus avelumab treatment, suggesting CD8+ T cell activation (C). P-values were calculated by ANOVA test. **p < 0.01, *p < 0.05