Abstract
Aims: Our goal is to find predictive genomic biomarkers in order to identify subgroups of early-stage lung cancer patients that are most likely to benefit from adjuvant chemotherapy with surgery (ACT). Background: Receiving ACT appears to have a better prognosis for more severe early-stage non-small cell lung cancer patients than surgical resection only. However, not all patients benefit from chemotherapy. Objective: Preliminary studies suggest that the application of ACT is associated with a better prognosis for more severe NSCLC patients compared to those who only underwent surgical resection. Given the immense personal and financial costs associated with ACT, finding the patients who are most likely to benefit from ACT is paramount. Thus, the purpose of this research is to utilize gene expression and clinical data from lung cancer patients to find treatment-associated genomic biomarkers. Methods: To investigate the treatment effect, a modified-covariate regularized Cox regression model with lasso penalty is implemented using National Cancer Institute gene expression data to find genomic biomarkers. Results: This research utilized an independent validation dataset involving 318 lung cancer patients to validate the models. In the validation set with 318 patients, the modified covariate Cox model with lasso penalty were able to show patients who followed their predicted recommendation (either ACT for low-risk group or OBS for the high-risk group, n = 171) have higher survival benefits than 147 patients who did not follow the recommendations (p < .0001). Conclusion: Based on validation data, patients who follow our predicted recommendation by genomic biomarkers selected from the proposed model will likely benefit from ACT.
Highlights
Based on validation data, patients who follow our predicted recommendation by genomic biomarkers selected from the proposed model will likely benefit from adjuvant chemotherapy (ACT)
The DNA molecules attached to each slide act as probes to detect gene expression from incoming samples, which is known as the transcriptome or the set of messenger RNA transcripts expressed by a group of genes
Determining NRF2 status is vital because activation of the NRF2 pathway has been previously discovered to be correlated with benefit from adjuvant chemotherapy for Non-Small Cell Lung Cancer (NSCLC) patients [18]
Summary
For early-stage lung cancer patients, surgical resection only is the most common treatment. Toxic side effects occurred from chemotherapy treatment in a large portion of ACT-treated patients in a study [2, 3]. This included neutropenia (88%), fatigue (81% of patients), nausea (80%), and anorexia (55%). Neutropenia was the most common severe side effect of the ACT treatment; 73% of patients had grade 3 or grade 4 neutropenia These typical side effects of chemotherapy again emphasize the need for careful consideration to ensure patients who will benefit from chemotherapy and should receive ACT. Receiving ACT appears to have a better prognosis for more severe early-stage non-small cell lung cancer patients than surgical resection only.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
