Validation of the prognostic value of tumor asphericity and an extracellular matrix-related prognostic gene signature in non-small cell lung cancer patients

Ziel/Aim The aim of the study was an independent evaluation of the prognostic value of a gene expression signature (EPPI) and the PET-derived tumor asphericity (ASP) in non-small cell lung cancer (NSCLC) patients.

Methodik/Methods This was a retrospective evaluation of PET imaging and gene expression data from three public databases and two institutional datasets. Altogether 253 NSCLC patients were included, all treated with curative intent surgery. Clinical parameters, standard PET parameters and ASP were evaluated in all patients. Additional gene expression data was available for 120 patients. Univariate and multivariate Cox regression and Kaplan-Meier analysis were calculated for the primary endpoint progression-free survival (PFS) and additional endpoints.

Ergebnisse/Results In the whole cohort a significant association with PFS was observed for ASP (p<0.001) and EPPI (p=0.012). On multivariate testing, EPPI remained significantly associated with PFS (p=0.018) in the subgroup of patients with additional gene expression data, while ASP was significantly associated with PFS in the whole cohort (p=0.012). In stage II patients, ASP was significantly associated with PFS (p=0.009) and a previously published cutoff value for ASP (19.5%) was successfully validated (p=0.008). In patients with additional gene expression data, EPPI showed a significant association with PFS, too (p=0.033). Exploratory combination of ASP and EPPI showed that the combinatory approach has potential to further improve patient stratification compared to the use of only one parameter.

Schlussfolgerungen/Conclusions The combination of EPPI and ASP seems to be a very promising approach for improvement of risk stratification in a group of patients with urgent need for a more personalized treatment approach.