WCLC 2022 | Tumor bulk-RNA seq identifies patients at high-risk of progression from NADIM trial
Pathological response has been suggested as a surrogate for survival in patients with non-small cell lung cancer treated with neoadjuvant chemoimmunotherapy. As such, patients with non-complete pathological response (non-CPR) are at higher risk of disease progression compared to complete pathological responders (CPR). Marta Casarrubios, MSc, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain, shares insight into the identification of gene expression patterns that may effect long-term outcomes in the non-CPR population. Surgical tissue samples from patients with resectable stage IIIA NSCLC from NADIM trial (NCT03081689) were investigated. 22 genes were upregulated in non-CPR patients compared to CPR, most of them related to proliferation, among others. Additionally, patients with high AKT expression present a higher risk of progression and death. This interview took place at the IASLC 2022 World Conference on Lung Cancer congress in Vienna, Austria.
Transcript (edited for clarity)
As you may know, non-small cell lung cancer patients with locally advanced disease have a lower overall-survival. So that’s why our group initiated the NADIM clinical trial some years ago. In this trial, patients were treated with neoadjuvant chemoimmunotherapy and then underwent surgery. So in these specific results that we presented today were centered in the post-treatment tumor samples of the NADIM clinical trial that we found...
As you may know, non-small cell lung cancer patients with locally advanced disease have a lower overall-survival. So that’s why our group initiated the NADIM clinical trial some years ago. In this trial, patients were treated with neoadjuvant chemoimmunotherapy and then underwent surgery. So in these specific results that we presented today were centered in the post-treatment tumor samples of the NADIM clinical trial that we found. We first analyzed the two different states, complete pathological response and non-complete pathological response. We also noticed that patients with non-complete pathological response have a higher risk of relapse over complete pathological response patients which is why we decided to center our attention into the tumor microenvironment on non-CPR patients that did not experience any relapses after this therapy. We discovered that there are 10 differentially expressed genes between the two patients, the ones that didn’t progress with therapy and the ones that made progress on therapy. Most of them were related to proliferation markers and tumor markers. We also saw that patients whose tumors have a higher expression of AKT1 had worse outcomes and also for the patients whose tumor have a higher infiltration of dendritic cells activated and neutral files.
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