Abstract
BackgroundImmune checkpoint inhibitors prolong the survival of non-small cell lung cancer (NSCLC) patients. Although it has been acknowledged that there is some correlation between the efficacy of anti-programmed cell death-1 (PD-1) antibody therapy and immunohistochemical analysis, this technique is not yet considered foolproof for predicting a favorable outcome of PD-1 antibody therapy. We aimed to predict the efficacy of nivolumab based on a comprehensive analysis of RNA expression at the gene level in advanced NSCLC.MethodsThis was a retrospective study on patients with NSCLC who were administered nivolumab at the Kansai Medical University Hospital. To identify genes associated with response to anti-PD-1 antibodies, we grouped patients into responders (complete and partial response) and non-responders (stable and progressive disease) to nivolumab therapy. Significant genes were then identified for these groups using Welch’s t-test.ResultsAmong 42 analyzed cases (20 adenocarcinomas and 22 squamous cell carcinomas), enhanced expression of MAGE-A4, BBC3, and OTOA genes was observed in responders with adenocarcinoma, and enhanced expression of DAB2, HLA-DPB,1 and CDH2 genes was observed in responders with squamous cell carcinoma.ConclusionsThis study predicted the efficacy of nivolumab based on a comprehensive analysis of mRNA expression at the gene level in advanced NSCLC. We also revealed different gene expression patterns as predictors of the effectiveness of anti PD-1 antibody therapy in adenocarcinoma and squamous cell carcinoma.
Highlights
Immune checkpoint inhibitors prolong the survival of non-small cell lung cancer (NSCLC) patients
Full list of author information is available at the end of the article
Four cases with low quantities of mRNA or abnormal signals were excluded, and the final cohort consisted of 42 cases (20 adenocarcinomas and 22 squamous cell carcinomas)
Summary
Immune checkpoint inhibitors prolong the survival of non-small cell lung cancer (NSCLC) patients. Surgical resection is the most effective therapy for early-stage NSCLC, up to two-thirds of NSCLCs are inoperable. This implies that histological and molecular diagnosis should be established using tiny specimens, such as small biopsy specimens and/or cytological materials, obtained via Kaneda et al BMC Cancer (2022) 22:154 transbronchial biopsy, fine-needle aspiration or computed tomography (CT) guided biopsy. A portion of patients without druggable driver oncogenic alterations show dramatic durable responses to immune checkpoint inhibitors (ICIs) [4, 5]. Appropriate patient selection is imperative [6]
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