Abstract

Platinum-based chemotherapy remains the cornerstone of treatment for most people with non-small cell lung cancer (NSCLC), either as adjuvant therapy in combination with a second cytotoxic agent or in combination with immunotherapy. Resistance to therapy, either in the form of primary refractory disease or evolutionary resistance, remains a significant issue in the treatment of NSCLC. Hence, predictive biomarkers and novel combinational strategies are required to improve the effectiveness and durability of treatment response 6for people with NSCLC. The aim of this study was to identify novel biomarkers and/or druggable proteins from deregulated protein networks within non-oncogene driven disease that are involved in the cellular response to cisplatin. Following exposure of NSCLC cells to cisplatin, in vitro quantitative mass spectrometry was applied to identify altered protein response networks. A total of 65 proteins were significantly deregulated following cisplatin exposure. These proteins were assessed to determine if they are druggable targets using novel machine learning approaches and to identify whether these proteins might serve as prognosticators of platinum therapy. Our data demonstrate novel candidates and drug-like molecules warranting further investigation to improve response to platinum agents in NSCLC.

Highlights

  • Lung cancer is a significant health care burden, accounting for 18.4% of all cancer-related deaths [1]

  • The top three proteins based on log2 fold change and FDR significance were the ALDH3A1, TP53I3 and ferredoxin reductase (FDXR) upregulated proteins (Figure 1C), whereas the top three downregulated proteins were sulfiredoxin-1 (SRXN1), heat shock protein 90a (HSP90AA1) and phosphoglycerate dehydrogenase (PHGDH) (Figure 1D)

  • Novel therapeutic strategies combined with predictive biomarkers of platinum-based chemotherapy response are needed to transform the clinical management of non-small cell lung cancer (NSCLC)

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Summary

Introduction

Lung cancer is a significant health care burden, accounting for 18.4% of all cancer-related deaths [1]. Treatment options for NSCLC include front-line immune checkpoint inhibitors as monotherapy, in patients with programmed death receptor ligand (PD-L1) expression in >50% of tumor cells detected by immunohistochemistry [2], or in combination with platinum-based chemotherapy in the advanced setting [2,3,4], maintenance immunotherapy for unresectable stage III disease after radical chemoradiotherapy [5] or adjuvant platinum-based chemotherapy for those with high risk resected early stage NSCLC [6]. Patients with resected stage II or III disease receive adjuvant platinum-based chemotherapy with the aim of reducing risk of future recurrence. In this setting, meta-analysis data suggest a benefit in terms of survival of 5% at 5 year with the addition of chemotherapy after a successful complete surgical resection. Further strategies are warranted to amplify/ complement the effects of platinum-based chemotherapy

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