Unmet needs in squamous cell carcinoma of the lung: potential role for immunotherapy.
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ABSTRACT:
SUBMITTER: Stinchcombe TE
PROVIDER: S-EPMC4006124 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Two subclasses of lung squamous cell carcinoma with different gene expression profiles and prognosis identified by hierarchical clustering and validated by non-negative matrix factorization . BACKGROUND: Current clinical and histopathological criteria used to define lung squamous cell carcinomas (SCCs) are insufficient to predict clinical outcome. We attempted to make a clinically-useful classification based on gene expression profiling. METHODS: We used cDNA microarrays with 40386 elements to analyze the gene expression profiles of 48 surgically resected samples of lung SCC. 9 samples of lung adenocarcinoma and 30 of normal lung were also included to give a total of 87 samples analyzed. After gene filtering, the data were subjected to hierarchical clustering and consensus clustering with the non-negative matrix factorization (NMF) approach. FINDINGS: Initial analysis by hierarchical clustering allowed division of SCCs into two distinct subclasses. An additional independent round of hierarchical clustering and consensus clustering with the NMF approach provided a validation for the classification. Kaplan-Meier analysis with the log rank test pointed to a non-significant difference in survival (p=0.071) but the likelihood of survival to 6 years was significantly different between the two groups (40.5% vs 81.8%, p=0.014, Z-test). Biological process categories characteristic for each subclass were identified statistically and up-regulation of cell-proliferation related genes was evident in the subclass with a poor prognosis. In the subclass with the better survival, genes involved in differentiated intracellular functions, such as the MAPKKK cascade, ceramide metabolism, or regulation of transcription, were up-regulated. Keywords: repeat sample
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Project description:Immuno checkpoint inhibitors have ushered in a new era with respect to the treatment of advanced non-small-cell lung cancer. Many patients are not suitable for treatment with epidermal growth factor receptor tyrosine kinase inhibitors (eg, gefitinib, erlotinib, and afatinib) or with anaplastic lymphoma kinase inhibitors (eg, crizotinib and ceritinib). As a result, anti-PD-1/PD-L1 and CTLA-4 inhibitors may play a novel role in the improvement of outcomes in a metastatic setting. The regulation of immune surveillance, immunoediting, and immunoescape mechanisms may play an interesting role in this regard either alone or in combination with current drugs. Here, we discuss advances in immunotherapy for the treatment of metastatic non-small-cell lung cancer as well as future perspectives within this framework.
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Project description:PurposeThe role of serum thymidine kinase 1 (STK1) in predicting the prognosis of T4-stage lung squamous cell carcinoma (LUSC) with immunotherapy is the focus of our work.MethodsA total of 180 LUSC patients were enrolled. In this study, according to the T stage, the patients were divided into two groups: the T1-T2 stage and the T3-T4 stage. Receiver operating characteristic (ROC) curves were used to determine the best cutoff value for predicting overall survival (OS) outcomes. The next step is to use this cutoff value to introduce univariate and multivariate Cox regression models to screen the prognostic factors in different T stages of LUSC. The association of STK1 with other clinicopathological factors was also determined. Finally, to further explore the link between STK1 and the staging of LUSC patients, we have further divided the staging into T1-3 and T4 stages. We identified factors influencing the prognosis of patients who received immunotherapy in T4 stage LUSC.ResultsFirst, we determined that the optimal cutoff for STK1 for predicting OS outcome was 1.165 pmol/L. Correlation analysis revealed that STK1 was over-expressed in LUSC patients at the T3-4 stage. Univariate and multivariate analysis showed that immunotherapy was an independent prognostic factor in patients with T4 stage LUSC. In the group of patients who received immunotherapy or not, the STK1 expression level was found to be an independent prognostic factor in T4 LUSC patients receiving PD-1/PD-L1 inhibitor treatment; patients with high levels of STK1 had an increased risk of death (95%CI = 1.028-2.04).ConclusionSTK1 is associated with a higher T stage and may be an effective prognostic marker for advanced LUSC immunotherapy patients.
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