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DOI: 10.1055/s-0045-1808003
-gene signature as a prognostic and predictive tool for adjuvant chemotherapy response in non-small cell lung cancer patients: a multicentric study
Early-stage patients with non-small cell lung cancer (NSCLC) are mostly eligible for curative treatments, including both surgery and adjuvant chemotherapy. However, not all patients benefit from adjuvant treatment. Currently, there are no specific criteria to define who will benefit from adjuvant chemotherapy (ACT). We aimed to assess the prognostic and predictive potential of a 12-gene expression panel for ACT benefit in patients with surgically resected NSCLC patients. This is a retrospective multicentric study that included resectable NSCLC cases from different centers (n = 209). Tumor RNA was isolated from routinely collected samples (FFPE). From 100ng of RNA, gene expression of the 12 genes (ATP8A1, AURKA, C1orf116, COL4A3, DOCK9, HOPX, HSD17B6, IFT57, MBIP, NKX2-1, RRM2, and TTC37) was assessed using the Custom nCounter® Elements XT panel. Raw counts were normalized by 7 housekeeping genes, and superpc survival-based model was applied to predict prognosis and ACT benefit.
Results: Patients were stratified into two groups: high-risk (unfavorable prognosis; ACT benefit), and low-risk (favorable prognosis; ACT non-benefit). Cases classified as high-risk presented decreased overall (HR=4.16; CI=2.06-8.43; p<0.001) and event-free survival (HR=3.40; CI=1.88-6.16; p<0.001) compared with those classified as low-risk. High-risk patients who received ACT showed increased event-free survival (HR=1.98; CI=1.02-3.84; p = 0.04) compared with those high-risk who did not receive ACT. Low-risk patients who received ACT and those who did not received ACT exhibited similar survival rates – overall and event-free survival (p = 0.88 and p = 0.3, respectively).
Conclusion: The 12-gene expression panel succesfully stratified NSCLC patients with distintive outcomes and shows a promising predictive value for identifying high-risk patients who will benefit from ACT. Our 12-gene panel might be a promising predictive tool for guiding adjuvant treatment in resectable NSCLC cases.
Corresponding author: Letícia Ferro Leal (e-mail: leticiaferroleal@gmail.com).
No conflict of interest has been declared by the author(s).
Publication History
Article published online:
06 May 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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Maria Fernanda Santiago Gonçalves, Aléxia Polo Siqueira, Isabella Lemuqui Tegami, Keila Cristina Miranda, Ícaro Alves Pinto, Wellinton Hirai, Pedro de Marchi, Josiane Mourão Dias, Rachid Eduardo Noleto da Nobrega Oliveira, Vinicius Duval da Silva, Sabrina Setembre Batah, Alexandre Fabro, Conceição Souto-Moura, Susana Guimarães, Fátima Carneiro, Cláudia Freitas, Helder Novais e Bastos, Paola de La Iglesia Niveyro, Hernan Garcia Rivello, Ignacio Wistuba, Yang Xie, Luciane Sussuchi da Silva, Rui Manuel Reis, Leticia Ferro Leal. -gene signature as a prognostic and predictive tool for adjuvant chemotherapy response in non-small cell lung cancer patients: a multicentric study. Brazilian Journal of Oncology 2025; 21.
DOI: 10.1055/s-0045-1808003