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Peng J, Zou D, Zhang X, Ma H, Han L, Yao B. A novel sub-regional radiomics model to predict immunotherapy response in non-small cell lung carcinoma. J Transl Med 2024; 22:87. [PMID: 38254087 PMCID: PMC10802066 DOI: 10.1186/s12967-024-04904-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/14/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Identifying precise biomarkers of immunotherapy response for non-small cell lung carcinoma (NSCLC) before treatment is challenging. This study aimed to construct and investigate the potential performance of a sub-regional radiomics model (SRRM) as a novel tumor biomarker in predicting the response of patients with NSCLC treated with immune checkpoint inhibitors, and test whether its predictive performance is superior to that of conventional radiomics, tumor mutational burden (TMB) score and programmed death ligand-1 (PD-L1) expression. METHODS We categorized 264 patients from retrospective databases of two centers into training (n = 159) and validation (n = 105) cohorts. Radiomic features were extracted from three sub-regions of the tumor region of interest using the K-means method. We extracted 1,896 features from each sub-region, resulting in 5688 features per sample. The least absolute shrinkage and selection operator regression method was used to select sub-regional radiomic features. The SRRM was constructed and validated using the support vector machine algorithm. We used next-generation sequencing to classify patients from the two cohorts into high TMB (≥ 10 muts/Mb) and low TMB (< 10 muts/Mb) groups; immunohistochemistry was performed to assess PD-L1 expression in formalin-fixed, paraffin-embedded tumor sections, with high expression defined as ≥ 50% of tumor cells being positive. Associations between the SRRM and progression-free survival (PFS) and variant genes were assessed. RESULTS Eleven sub-regional radiomic features were employed to develop the SRRM. The areas under the receiver operating characteristic curve (AUCs) of the proposed SRRM were 0.90 (95% confidence interval [CI] 0.84-0.96) and 0.86 (95% CI 0.76-0.95) in the training and validation cohorts, respectively. The SRRM (low vs. high; cutoff value = 0.936) was significantly associated with PFS in the training (hazard ratio [HR] = 0.35 [0.24-0.50], P < 0.001) and validation (HR = 0.42 [0.26-0.67], P = 0.001) cohorts. A significant correlation between the SRRM and three variant genes (H3C4, PAX5, and EGFR) was observed. In the validation cohort, the SRRM demonstrated a higher AUC (0.86, P < 0.001) than that for PD-L1 expression (0.66, P = 0.034) and TMB score (0.54, P = 0.552). CONCLUSIONS The SRRM had better predictive performance and was superior to conventional radiomics, PD-L1 expression, and TMB score. The SRRM effectively stratified the progression-free survival (PFS) risk among patients with NSCLC receiving immunotherapy.
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Affiliation(s)
- Jie Peng
- Department of Oncology, The Second Affiliated Hospital, Guizhou Medical University, Kaili, China.
| | - Dan Zou
- Department of Oncology, The Second Affiliated Hospital, Guizhou Medical University, Kaili, China
| | - Xudong Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Honglian Ma
- Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China
| | - Lijie Han
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Biao Yao
- Department of Oncology, Tongren People's Hospital, Tongren, China
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Yolchuyeva S, Giacomazzi E, Tonneau M, Ebrahimpour L, Lamaze FC, Orain M, Coulombe F, Malo J, Belkaid W, Routy B, Joubert P, Manem VSK. A Radiomics-Clinical Model Predicts Overall Survival of Non-Small Cell Lung Cancer Patients Treated with Immunotherapy: A Multicenter Study. Cancers (Basel) 2023; 15:3829. [PMID: 37568646 PMCID: PMC10417039 DOI: 10.3390/cancers15153829] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/14/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) are a great breakthrough in cancer treatments and provide improved long-term survival in a subset of non-small cell lung cancer (NSCLC) patients. However, prognostic and predictive biomarkers of immunotherapy still remain an unmet clinical need. In this work, we aim to leverage imaging data and clinical variables to develop survival risk models among advanced NSCLC patients treated with immunotherapy. METHODS This retrospective study includes a total of 385 patients from two institutions who were treated with ICIs. Radiomics features extracted from pretreatment CT scans were used to build predictive models. The objectives were to predict overall survival (OS) along with building a classifier for short- and long-term survival groups. We employed the XGBoost learning method to build radiomics and integrated clinical-radiomics predictive models. Feature selection and model building were developed and validated on a multicenter cohort. RESULTS We developed parsimonious models that were associated with OS and a classifier for short- and long-term survivor groups. The concordance indices (C-index) of the radiomics model were 0.61 and 0.57 to predict OS in the discovery and validation cohorts, respectively. While the area under the curve (AUC) values of the radiomic models for short- and long-term groups were found to be 0.65 and 0.58 in the discovery and validation cohorts. The accuracy of the combined radiomics-clinical model resulted in 0.63 and 0.62 to predict OS and in 0.77 and 0.62 to classify the survival groups in the discovery and validation cohorts, respectively. CONCLUSIONS We developed and validated novel radiomics and integrated radiomics-clinical survival models among NSCLC patients treated with ICIs. This model has important translational implications, which can be used to identify a subset of patients who are not likely to benefit from immunotherapy. The developed imaging biomarkers may allow early prediction of low-group survivors, though additional validation of these radiomics models is warranted.
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Affiliation(s)
- Sevinj Yolchuyeva
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois-Rivières, QC G8Z 4M3, Canada
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
| | - Elena Giacomazzi
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois-Rivières, QC G8Z 4M3, Canada
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
| | - Marion Tonneau
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, QC H2X 0A9, Canada
- Université de Médecine de Lille—Université Henri Warembourg, 59020 Lille, France
| | - Leyla Ebrahimpour
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
- Department of Physics, Engineering Physics and Optics, Laval University, Quebec City, QC G1V 4G5, Canada
| | - Fabien C. Lamaze
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
| | - Michele Orain
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
| | - François Coulombe
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
| | - Julie Malo
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, QC H2X 0A9, Canada
| | - Wiam Belkaid
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, QC H2X 0A9, Canada
| | - Bertrand Routy
- Centre de Recherche du Centre Hospitalier Universitaire de Montréal, Montréal, QC H2X 0A9, Canada
| | - Philippe Joubert
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
- Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Québec City, QC G1V 0A6, Canada
| | - Venkata S. K. Manem
- Department of Mathematics and Computer Science, Université du Québec à Trois Rivières, Trois-Rivières, QC G8Z 4M3, Canada
- Quebec Heart & Lung Institute Research Center, Québec City, QC G1V 4G5, Canada (M.O.)
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Gümüş M, Chen C, Ivanescu C, Kilickap S, Bondarenko I, Özgüroğlu M, Gogishvili M, Turk HM, Cicin I, Harnett J, Mastey V, Naumann U, Reaney M, Konidaris G, Sasane M, Brady KJS, Li S, Gullo G, Rietschel P, Sezer A. Patient-reported outcomes with cemiplimab monotherapy for first-line treatment of advanced non-small cell lung cancer with PD-L1 of ≥50%: The EMPOWER-Lung 1 study. Cancer 2023; 129:118-129. [PMID: 36308296 PMCID: PMC10092585 DOI: 10.1002/cncr.34477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/11/2022] [Accepted: 06/23/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND In the EMPOWER-Lung 1 trial (ClinicalTrials.gov, NCT03088540), cemiplimab conferred longer survival than platinum-doublet chemotherapy for advanced non-small cell lung cancer (NSCLC) with programmed cell death-ligand 1 (PD-L1) ≥50%. Patient-reported outcomes were evaluated among trial participants. METHODS Adults with NSCLC and Eastern Cooperative Oncology Group performance status 0 to 1 were randomly assigned cemiplimab 350 mg every 3 weeks or platinum-doublet chemotherapy. At baseline and day 1 of each treatment cycle, patients were administered the European Organization for Research and Treatment of Cancer Quality of Life-Core 30 (QLQ-C30) and Lung Cancer Module (QLQ-LC13) questionnaires. Mixed-model repeated measures analysis estimated overall change from baseline for PD-L1 ≥50% and intention-to-treat populations. Kaplan-Meier analysis estimated time to definitive deterioration. RESULTS In PD-L1 ≥50% patients (cemiplimab, n = 283; chemotherapy, n = 280), baseline QLQ-C30 and QLQ-LC13 scores showed moderate-to-high functioning and low symptom burden. Change from baseline favored cemiplimab on global health status/quality of life (GHS/QOL), functioning, and most symptom scales. Risk of definitive deterioration across functioning scales was reduced versus chemotherapy; hazard ratios were 0.48 (95% CI, 0.32-0.71) to 0.63 (95% CI, 0.41-0.96). Cemiplimab showed lower risk of definitive deterioration for disease-related (dyspnea, cough, pain in chest, pain in other body parts, fatigue) and treatment-related symptoms (peripheral neuropathy, alopecia, nausea/vomiting, appetite loss, constipation, diarrhea) (nominal p < .05). Results were similar in the intention-to-treat population. CONCLUSIONS Results support cemiplimab for first-line therapy of advanced NSCLC from the patient's perspective. Improved survival is accompanied by improvements versus platinum-doublet chemotherapy in GHS/QOL and functioning and reduction in symptom burden.
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Affiliation(s)
- Mahmut Gümüş
- Istanbul Medeniyet University, Faculty of MedicineIstanbulTurkey
| | - Chieh‐I Chen
- Regeneron Pharmaceuticals, IncTarrytownNew YorkUSA
| | | | - Saadettin Kilickap
- Department of Medical OncologyIstinye University Faculty of Medicine Liv HospitalAnkaraTurkey
| | - Igor Bondarenko
- Dnipropetrovsk State Medical AcademyCity Multifield Clinical HospitalDnipropetrovskUkraine
| | - Mustafa Özgüroğlu
- Cerrahpaşa Medical FacultyIstanbul University‐CerrahpaşaIstanbulTurkey
| | | | - Haci M. Turk
- Department of Medical OncologyBezmialem Vakif UniversityMedical FacultyIstanbulTurkey
| | - Irfan Cicin
- Department of Medical OncologyTrakya Universityİskender/Edirne Merkez/EdirneTurkey
| | | | - Vera Mastey
- Regeneron Pharmaceuticals, IncTarrytownNew YorkUSA
| | | | | | | | | | | | - Siyu Li
- Regeneron Pharmaceuticals, IncTarrytownNew YorkUSA
| | | | | | - Ahmet Sezer
- Department of Medical OncologyBaşkent UniversityEtimesgutAnkaraTurkey
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Cuppens K, Baas P, Geerdens E, Cruys B, Froyen G, Decoster L, Thomeer M, Maes B. HLA-I diversity and tumor mutational burden by comprehensive next-generation sequencing as predictive biomarkers for the treatment of non-small cell lung cancer with PD-(L)1 inhibitors. Lung Cancer 2022; 170:1-10. [DOI: 10.1016/j.lungcan.2022.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 05/26/2022] [Accepted: 05/28/2022] [Indexed: 10/18/2022]
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Sezer A, Kilickap S, Gümüş M, Bondarenko I, Özgüroğlu M, Gogishvili M, Turk HM, Cicin I, Bentsion D, Gladkov O, Clingan P, Sriuranpong V, Rizvi N, Gao B, Li S, Lee S, McGuire K, Chen CI, Makharadze T, Paydas S, Nechaeva M, Seebach F, Weinreich DM, Yancopoulos GD, Gullo G, Lowy I, Rietschel P. Cemiplimab monotherapy for first-line treatment of advanced non-small-cell lung cancer with PD-L1 of at least 50%: a multicentre, open-label, global, phase 3, randomised, controlled trial. Lancet 2021; 397:592-604. [PMID: 33581821 DOI: 10.1016/s0140-6736(21)00228-2] [Citation(s) in RCA: 432] [Impact Index Per Article: 144.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/04/2020] [Accepted: 01/04/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND We aimed to examine cemiplimab, a programmed cell death 1 inhibitor, in the first-line treatment of advanced non-small-cell lung cancer with programmed cell death ligand 1 (PD-L1) of at least 50%. METHODS In EMPOWER-Lung 1, a multicentre, open-label, global, phase 3 study, eligible patients recruited in 138 clinics from 24 countries (aged ≥18 years with histologically or cytologically confirmed advanced non-small-cell lung cancer, an Eastern Cooperative Oncology Group performance status of 0-1; never-smokers were ineligible) were randomly assigned (1:1) to cemiplimab 350 mg every 3 weeks or platinum-doublet chemotherapy. Crossover from chemotherapy to cemiplimab was allowed following disease progression. Primary endpoints were overall survival and progression-free survival per masked independent review committee. Primary endpoints were assessed in the intention-to-treat population and in a prespecified PD-L1 of at least 50% population (per US Food and Drug Administration request to the sponsor), which consisted of patients with PD-L1 of at least 50% per 22C3 assay done according to instructions for use. Adverse events were assessed in all patients who received at least one dose of the assigned treatment. This study is registered with ClinicalTrials.gov, NCT03088540 and is ongoing. FINDINGS Between June 27, 2017 and Feb 27, 2020, 710 patients were randomly assigned (intention-to-treat population). In the PD-L1 of at least 50% population, which consisted of 563 patients, median overall survival was not reached (95% CI 17·9-not evaluable) with cemiplimab (n=283) versus 14·2 months (11·2-17·5) with chemotherapy (n=280; hazard ratio [HR] 0·57 [0·42-0·77]; p=0·0002). Median progression-free survival was 8·2 months (6·1-8·8) with cemiplimab versus 5·7 months (4·5-6·2) with chemotherapy (HR 0·54 [0·43-0·68]; p<0·0001). Significant improvements in overall survival and progression-free survival were also observed with cemiplimab in the intention-to-treat population despite a high crossover rate (74%). Grade 3-4 treatment-emergent adverse events occurred in 98 (28%) of 355 patients treated with cemiplimab and 135 (39%) of 342 patients treated with chemotherapy. INTERPRETATION Cemiplimab monotherapy significantly improved overall survival and progression-free survival compared with chemotherapy in patients with advanced non-small-cell lung cancer with PD-L1 of at least 50%, providing a potential new treatment option for this patient population. FUNDING Regeneron Pharmaceuticals and Sanofi.
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Affiliation(s)
- Ahmet Sezer
- Department of Medical Oncology, Başkent University, Adana, Turkey.
| | - Saadettin Kilickap
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mahmut Gümüş
- Department of Medical Oncology, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Igor Bondarenko
- Department of Oncology and Medical Radiology; Dnipropetrovsk Medical Academy, Dnipro, Ukraine
| | - Mustafa Özgüroğlu
- Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | | | - Haci M Turk
- Department of Medical Oncology, Bezmialem Vakif University, Medical Faculty, Istanbul, Turkey
| | - Irfan Cicin
- Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - Dmitry Bentsion
- Radiotherapy Department, Sverdlovsk Regional Oncology Centre, Sverdlovsk, Russia
| | | | - Philip Clingan
- Southern Medical Day Care Centre and Illawarra Health and Medical Research Institute, University of Wollongong-Illawarra Cancer Centre, Wollongong Hospital, Wollongong, NSW, Australia
| | - Virote Sriuranpong
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Naiyer Rizvi
- Division of Hematology-Oncology, Columbia University Medical Center, New York, New York, NY, USA
| | - Bo Gao
- Regeneron Pharmaceuticals, Basking Ridge, New Jersey, USA
| | - Siyu Li
- Regeneron Pharmaceuticals, Basking Ridge, New Jersey, USA
| | - Sue Lee
- Regeneron Pharmaceuticals, Basking Ridge, New Jersey, USA
| | | | - Chieh-I Chen
- Regeneron Pharmaceuticals, Basking Ridge, New Jersey, USA
| | | | - Semra Paydas
- Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | | | - Frank Seebach
- Regeneron Pharmaceuticals, Tarrytown, New York, NY, USA
| | | | | | | | - Israel Lowy
- Regeneron Pharmaceuticals, Tarrytown, New York, NY, USA
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Park R, Shaw JW, Korn A, McAuliffe J. The value of immunotherapy for survivors of stage IV non-small cell lung cancer: patient perspectives on quality of life. J Cancer Surviv 2020; 14:363-376. [PMID: 31950409 PMCID: PMC7256093 DOI: 10.1007/s11764-020-00853-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/03/2020] [Indexed: 12/26/2022]
Abstract
Purpose The aim of this study was to examine what personally mattered to 24 patients who received immuno-oncology (IO) therapy for stage IV non-small cell lung cancer (NSCLC), as well as their families and friends, to understand how they evaluated their cancer treatments and the determinants of the quality of life (QoL) of long-term survivors. Methods Ethnographic research was conducted with 24 patients who had responded to IO (pembrolizumab, nivolumab, atezolizumab, or durvalumab) for stage IV NSCLC, and their families and friends, evenly split among field sites in Denmark, the USA, and the UK. Data were collected using in-depth qualitative interviews, written exercises, and participant observation. Data analysis methods included interpretative phenomenological analysis, coding, and the development of grounded theory. Researchers spent 2 days with participants in their homes and accompanied them on health-related outings. Results Our findings reveal that long-term survivors on IO experienced their journey in two phases: one in which their cancer had taken over their lives mentally, physically, and spiritually, and another in which their cancer consumed only a part of their everyday lives. Patients who survived longer than their initial prognosis existed in a limbo state in which they were able to achieve some semblance of normalcy in spite of being identified as having a terminal condition. This limbo state impacted their life priorities, decision-making, experience of patient support, and health information-seeking behaviors, all of which shaped their definitions and experience of QoL. Conclusions The results of this study, which identify the specific challenges of living in limbo, where patients are able to reclaim a portion of their pre-cancer lives while continuing to wrestle with a terminal prognosis, may inform how cancer research can more effectively define and measure the QoL impacts of IO treatments. Also, they may identify approaches that the cancer community can use to support the needs of patients living in a limbo state. These experiences may not be adequately understood by the cancer community or captured by existing QoL measures, which were designed prior to the emergence of IO and without sufficient incorporation of contextual, patient-driven experience. Implications for Cancer Survivors Increased awareness of the specific experiences that come with long-term survival on IO may direct how resources should be spent for cancer support for patients and their families. Expanding how QoL is evaluated based on patients’ lived experiences of IO can reflect a more accurate depiction of the treatment’s benefits and harms.
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Affiliation(s)
- Rebekah Park
- ReD Associates, 26 Broadway Ste. 2505, New York, NY, 10004, USA.
| | - James W Shaw
- Worldwide Health Economics and Outcomes Research, Bristol-Myers Squibb, 3401 Princeton Pike, Lawrenceville, NJ, USA
| | - Alix Korn
- ReD Associates, 26 Broadway Ste. 2505, New York, NY, 10004, USA
| | - Jacob McAuliffe
- ReD Associates, 26 Broadway Ste. 2505, New York, NY, 10004, USA
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Wei S, Liu J, Li X, Liu X. Repression of lncRNA-SVUGP2 mediated by EZH2 contributes to the development of non-small cell lung cancer via brisking Wnt/β-catenin signal. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2020; 47:3400-3409. [PMID: 31401873 DOI: 10.1080/21691401.2019.1648279] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
To grab the possible impact of lncRNA-SVUGP2 in the biology and process of non-small cell lung cancer (NSCLC). Sixty paired NSCLC tumour and the adjacent non-tumour lung tissues were collected for detection of lncRNA-SVUGP2. lncRNA-SVUGP2 expression in NSCLC cells (SK-MES-1, A549, SPC-A1, and NCI-H1975) was also detected. lncRNA-SVUGP2 was overexpressed and depressed in A549 and H1975 cells, and the effects of lncRNA-SVUGP2 dysregulation on cell biological performances including viability, colony formation, apoptosis, migration and invasion were grabbed. Furthermore, the regulatory association of lncRNA-SVUGP2 vs. EZH2 in H1975 cells, as well as the association between lncRNA-SVUGP2 and Wnt/β-catenin pathway, was explored. lncRNA-SVUGP2 was depressed in NSCLC tissues and cells. Overexpression of lncRNA-SVUGP2 depressed proliferation, induced apoptosis, and suppressed migration and invasion of A549 and H1975 cells. In addition, lncRNA-SVUGP2 was repressed by EZH2 and was inversely correlated with EZH2 levels in H1975 cells. Repression of lncRNA-SVUGP2 potentially participated in the oncogenic function of EZH2. Besides, overexpression of lncRNA-SVUGP2 depressed the briskness of Wnt/β-catenin signal in H1975 cells. Our data reveal that lncRNA-SVUGP2 is under-expressed in NSCLC cells and the reduced expression of lncRNA-SVUGP2 may enhance the development and process of NSCLC by interacting with EZH2 and activating Wnt/β-catenin pathway.
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Affiliation(s)
- Sen Wei
- a Department of Lung Cancer Surgery, General Hospital of Tianjin Medical University , Tianjin 300052 , China
| | - Jinghao Liu
- a Department of Lung Cancer Surgery, General Hospital of Tianjin Medical University , Tianjin 300052 , China
| | - Xin Li
- a Department of Lung Cancer Surgery, General Hospital of Tianjin Medical University , Tianjin 300052 , China
| | - Xingyu Liu
- a Department of Lung Cancer Surgery, General Hospital of Tianjin Medical University , Tianjin 300052 , China
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A review of predictive, prognostic and diagnostic biomarkers for non-small-cell lung cancer: towards personalised and targeted cancer therapy. JOURNAL OF RADIOTHERAPY IN PRACTICE 2019. [DOI: 10.1017/s1460396919000876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AbstractIntroduction:Lung cancer has a high mortality rate mainly due to the lack of early detection or outward signs and symptoms, thereby often progressing to advanced stages (e.g., stage IV) before it is diagnosed. However, if lung cancers can be diagnosed at an early stage and also if clinicians can prospectively identify patients likely to respond to specific treatments, then there is a very high potential to increase patients’ survival. In recent years, several investigations have been conducted to identify cancer biomarkers for lung cancer risk assessment, early detection and diagnosis, the likelihood of identifying the group of patients who will benefit from a particular treatment and monitoring patient response to treatment.Materials and Methods:This paper reports on the review of 19 current clinical and emerging biomarkers used in risk assessment, screening for early detection and diagnosis and monitoring the response of treatment of non-small-cell lung cancers.Conclusion:The future holds promise for personalised and targeted medicine from prevention, diagnosis to treatment, which take into account individual patient’s variability, though it depends on the development of effective biomarkers interrogating the key aberrant pathways and potentially targetable with molecular targeted or immunologic therapies. Lung cancer biomarkers have the potential to guide clinical decision-making since they can potentially detect the disease early, measure the risk of developing the disease and the risk of progression, provide accurate information of patient response to a specific treatment and are capable of informing clinicians about the likely outcome of a cancer diagnosis independent of the treatment received. Moreover, lung cancer biomarkers are increasingly linked to specific molecular pathway deregulations and/or cancer pathogenesis and can be used to justify the application of certain therapeutic or interventional strategies.
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Klein M, Scaria G, Ganti AK. Utilization of the Veterans Affairs Central Cancer Registry to evaluate lung cancer outcomes. Semin Oncol 2019; 46:321-326. [PMID: 31690464 DOI: 10.1053/j.seminoncol.2019.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 10/03/2019] [Indexed: 11/11/2022]
Abstract
Lung cancer is one of the most common and difficult to treat cancers. Veterans are disproportionately affected by lung cancer, as approximately 20% of all cancers diagnosed within the Veteran Affairs health system are lung cancers. Many Veterans have extensive comorbidities, and thus they are often excluded from clinical trials based on this and other eligibility criteria. Thus, while clinical trials are the gold standard to guide treatment decisions, many Veterans' clinical situations will not align with clinical trial criteria. The Department of Veterans Affairs has established a Central Cancer Registry to aid in evaluation of cancer outcomes and other studies, and data in the registry date back to 1995. This has provided a rich source of data for outcome-based and other research. Here, we highlight studies that utilized the Veterans Affairs Central Cancer Registry to analyze lung cancer outcomes in Veterans treated within the Veterans Affairs health system.
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Affiliation(s)
- Mark Klein
- Hematology/Oncology Section, Primary Care Service Line, Minneapolis VA Health Care System, Minneapolis, Minnesota; Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
| | - George Scaria
- Research Service, Minneapolis VA Health Care System, Minneapolis, Minnesota.
| | - Apar Kishor Ganti
- Division of Oncology, Hematology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska; Hematology/Oncology Section, Omaha VA Medical Center-VA Nebraska-Western Iowa Healthcare System, Omaha, Nebraska.
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Boothman AM, Scott M, Ratcliffe M, Whiteley J, Dennis PA, Wadsworth C, Sharpe A, Rizvi NA, Garassino MC, Walker J. Impact of Patient Characteristics, Prior Therapy, and Sample Type on Tumor Cell Programmed Cell Death Ligand 1 Expression in Patients with Advanced NSCLC Screened for the ATLANTIC Study. J Thorac Oncol 2019; 14:1390-1399. [PMID: 31063864 DOI: 10.1016/j.jtho.2019.04.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/28/2019] [Accepted: 04/19/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION We evaluated the impact of patient characteristics, sample types, and prior non-immunotherapy treatment on tumor cell (TC) programmed cell death ligand 1 (PD-L1) expression using samples from patients with advanced NSCLC. METHODS Patients (N = 1590) screened for the ATLANTIC study submitted a recently acquired (≤3 months) or archival (>3 months to >3 years old) tumor sample for PD-L1 assessment using the VENTANA PD-L1 (SP263) Assay with a cutoff of ≥25% of TCs expressing PD-L1 (TC ≥25%). Samples were acquired either before or after the two or more treatment regimens required for study entry and sample age varied among patients. A subset of patients (n = 123) provided both recent and archival samples. RESULTS A total of 517 of 1590 (32.5%) patients had TC greater than or equal to 25%: prevalence was greater in smokers versus nonsmokers (p = 0.0005) and those with EGFR- versus EGFR+ tumors (p = 0.0002); these effects were independent. Prevalence of TC greater than or equal to 25% was increased in recent metastatic versus primary (p = 0.005) and recent versus archival (p = 0.039) samples. Chemotherapy or radiotherapy, but not tyrosine kinase inhibition, before sampling was associated with significantly increased PD-L1 prevalence. PD-L1 status (TC ≥25% cutoff) remained unchanged in 74.0% of patients with recent and archival samples; where PD-L1 status changed, it was more likely to increase than decrease over time or with intervening treatment. CONCLUSIONS Several factors potentially impact PD-L1 TC greater than or equal to 25% prevalence in advanced NSCLC; however, no characteristic can be considered a surrogate for PD-L1 expression. Fresh biopsy may provide more accurate assessment of current tumoral PD-L1 expression where a low/negative result is seen in an archival sample, especially if the patient has received intervening therapy.
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Affiliation(s)
- Anne-Marie Boothman
- Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Cambridge, United Kingdom.
| | - Marietta Scott
- Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Cambridge, United Kingdom
| | - Marianne Ratcliffe
- Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Cambridge, United Kingdom
| | - Jessica Whiteley
- Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Cambridge, United Kingdom
| | - Phillip A Dennis
- Global Medicines Development, AstraZeneca, Gaithersburg, Maryland
| | | | - Alan Sharpe
- Discovery Sciences, IMED Biotech Unit, AstraZeneca, Cambridge, United Kingdom
| | - Naiyer A Rizvi
- Division of Hematology and Oncology, Columbia University Medical Center, New York, New York
| | - Marina Chiara Garassino
- Thoracic Oncology Unit, Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Jill Walker
- Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Cambridge, United Kingdom
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Katoh M. Combination immuno-oncology therapy with pembrolizumab, an anti-PD-1 monoclonal antibody targeting immune evasion, and standard chemotherapy for patients with the squamous and non-squamous subtypes of non-small cell lung cancer. J Thorac Dis 2018; 10:5178-5183. [PMID: 30416762 DOI: 10.21037/jtd.2018.08.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Masaru Katoh
- Department of Omics Network, National Cancer Center, Tokyo 104-0045, Japan
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Cao D, Xu H, Xu X, Guo T, Ge W. A reliable and feasible way to predict the benefits of Nivolumab in patients with non-small cell lung cancer: a pooled analysis of 14 retrospective studies. Oncoimmunology 2018; 7:e1507262. [PMID: 30377569 PMCID: PMC6205035 DOI: 10.1080/2162402x.2018.1507262] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/26/2018] [Accepted: 07/29/2018] [Indexed: 12/12/2022] Open
Abstract
Objective: Nivolumab has been used for treating non-small cell lung cancer (NSCLC) worldwide. Whether neutrophil-lymphocyte ratio (NLR) can predict the prognosis of NSCLC treated with Nivolumab is still under debate. This meta-analysis was to assess the significance of NLR as a predictive factor in NSCLC patients receiving Nivolumab. Methods: Databases including PubMed, Embase, and the Cochrane library were searched to identify eligible studies evaluating the role of NLR in predicting prognosis of NSCLC treated with Nivolumab until March 2018 without language restrictions. The meta-analysis was performed using hazard ratio (HR) of progression free survival (PFS) and overall survival (OS) in NSCLC patients with various NLR. Results: A total of 14 retrospective studies consisting of 1225 NSCLC patients were included. The combined results showed that relatively higher baseline NLR was associated with poor PFS (HR = 1.44; 95% confidence interval (CI):1.18-1.77; p < 0.05) and OS (HR = 1.75; 95% CI: 1.33-2.30; p < 0.05) after treatment of Nivolumab. Subgroup analysis suggested that NLR ≥ 5 was more reliable for PFS (HR = 1.73; 95%CI: 1.14, 2.62; p < 0.05) and OS (HR = 1.76; 95%CI: 1.47, 2.10; p < 0.05). In addition, post-treatment NLR also had predictive roles for PFS (HR = 3.17; 95%CI: 1.48, 6.82; p < 0.05) and OS (HR = 2.26; 95%CI: 1.05, 4.86; p < 0.05). Conclusion: Our findings suggest that NLR can be used as a prognostic biomarker for NSCLC treating with Nivolumab, and the recommended cutoff value of NLR is 5.
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Affiliation(s)
- Dedong Cao
- Department of Oncology, RenMin Hospital of WuHan University, WuHan, Hubei, China
| | - Huilin Xu
- Department of Oncology, The Fifth Hospital of WuHan, WuHan, Hubei, China
| | - Ximing Xu
- Department of Oncology, RenMin Hospital of WuHan University, WuHan, Hubei, China
| | - Tao Guo
- Department of Hematology, The Union Hospital, Tongji Medical College, HuaZhong University of Science and Technology, WuHan, Hubei, China
- Collaborative Innovation Center of Hematology, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wei Ge
- Department of Oncology, RenMin Hospital of WuHan University, WuHan, Hubei, China
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