A recently published study set out to discover whether an immune signature can be used to provide a reliable prognosis for patients with early-stage lung cancer.
Of all lung cancer cases, 85% are attributable to non-small cell lung cancer (NSCLC), the leading cause of cancer deaths worldwide. Many patients with early-stage lung cancer do not receive additional systemic treatment following local therapy. This is due to the fact that recent studies have not been able to prove that the increase in the survival rate justifies the risks associated with chemotherapy. This means that a reliable prognostic biomarker would be invaluable in the management of lung cancer.
This recent U.S. study, published in JAMA Oncology, highlights the need to identify patients at risk of cancer reoccurring which could lead to death. These patients would thus require additional therapy. Many studies have suggested that gene expression-based signatures could be used to stratify survival rates for patients with NSCLC. What this means is that by having certain gene expressions, a patient’s immune system will respond in a certain manner which could affect the growth of cancer or response to therapy, and thereby can give a reliable prognosis for that particular patient. Despite the logic behind this approach it has not yet been used in clinical practice, due to difficulties such as limited validation of these techniques.
The findings from this study, which involved the analysis of tumour tissue samples from 2,414 patients, demonstrated an immune signature of 25 gene pairs that could separate patients into low and high-risk groups, with regards to overall survival at various tumour stages. Even following a surgical resection, patients with early-stage NSCLC remain at risk of cancer recurrence and death. However, the use of additional therapy in these patients remains debatable due to the lack of evidence. This is why the authors of this study stress the need for a reliable biomarker to reach an accurate prognosis so that patients in need of additional therapy can be identified during the early stages of the disease.
The authors of this study conclude that this immune-related gene pair-based signature could provide a valuable prognostic biomarker in NSCLC during the early stages of the disease. Further studies need to be carried out to further evaluate the accuracy and reliability of this prognostic tool and to investigate its clinical value in the management of NSCLC.
Written by Jade Marie Evans, MPharm, Medical Writer
Bailiang Li et al . (2017 ). Development and Validation of an IndividualizedImmune Prognostic Signature in Early-Stage Nonsquamous Non–Small Cell Lung Cancer. Available: http://jamanetwork.com. Last accessed 17th Jul 2017.