Dados do Trabalho

Título

Reproducibility of a 12-gene expression signature for predicting ACT-benefit in surgically resected NSCLC patients

Introdução

The recommendation of adjuvant chemotherapy(ACT) is based on tumor size and lymph node invasion for early-stage surgically resected non-small cell lung cancer(NSCLC) patients. Specific criteria lack to define who will benefit from ACT.

Objetivo

To evaluate the reproducibility of a 12-gene panel to predict ACT benefit for resected NSCLC patients.

Métodos

Formalin-fixed paraffin-embedded(FFPE) samples from surgically resected patients(n=172) were retrospectively included. This study was approved by the local ethics committee (Barretos Cancer Hospital IRB/Project No4411/2021). The expression of ATP8A1, AURKA, C1orf116, COL4A3, DOCK9, HOPX, HSD17B6, IFT57, MBIP, NKX2-1, RRM2 and TTC37 was evaluated by the NanoString nCounter Elements XT technology. Patients were grouped as low-risk(ACT non-benefit) and high-risk (ACT-benefit). Overall(OS) and event-free survival(EFS) benefits were assessed through Kaplan-Meier curves and log-rank tests.

Resultados

The gene expression panel presents a 0.8% failure rate. This panel successfully stratified patients(n=172) as low- and high-risk regardless of ACT treatment. Low-risk patients presented an improvement of 10.8 months in OS and 13.4 months in EFS compared with high-risk(pOS<0.0001, pEFS<0.0001). Median survival was not reached. Regarding the predictive performance, ACT-treated high-risk(n=71) patients had an improvement of 3.6months of OS(x͂OS=22.2 months; p=0.065) and 4.1 months of EFS(x͂EFS=20.7months; p=0.211) compared with untreated patients(x͂OS=18.6 months, x͂EPFS=16.6 months). Low-risk patients(n=101) had similar outcomes for ACT-treated and ACT-untreated patients for both OS and EFS.

Conclusões

The 12-gene expression panel successfully stratifies low- and high-risk patients, and shows a promising predictive value for identifying high-risk patients who benefit from ACT.

Palavras-chave

Non-small cell lung cancer, Gene expression signature, Adjuvant chemotherapy.

Financiador do resumo

Barretos Cancer Hospital, CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior).