Tumour response heterogeneity as a powerful independent predictor of treatment outcome in advanced lung adenocarcinoma: a retrospective analysis

Tumour response heterogeneity to treatment is common across different foci in the same patient with cancer. However, the effect of heterogeneity on clinical outcome remains unclear. Here, we developed a quantitative assessment of tumour response heterogeneity and explored the correlation of tumour r...

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Veröffentlicht in:The lancet oncology 2022-07, Vol.23, p.S13-S13
Hauptverfasser: Zheng, Xinlong, Lu, Tao, Wu, Shiwen, Peng, Wenying, Miao, Qian, Jiang, Kan, Zhang, Longfeng, Zheng, Xiaobing, Xu, Yiquan, Lin, Gen
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Sprache:eng
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Zusammenfassung:Tumour response heterogeneity to treatment is common across different foci in the same patient with cancer. However, the effect of heterogeneity on clinical outcome remains unclear. Here, we developed a quantitative assessment of tumour response heterogeneity and explored the correlation of tumour response heterogeneity with the clinical outcome. Patients eligible for this retrospective study had advanced lung adenocarcinoma, with 3–10 measured foci, an Eastern Cooperative Oncology Group status of 0–1, and received first-line chemotherapy or targeted therapy. Percent change of the longest diameter in each measurable lesion were assessed as per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. The tumour response heterogeneity score was the absolute value of the dispersion coefficient of the percentage value of each target lesion. Patients were randomly divided (1:1) into a learning and a validation set. The optimal cutoff value of tumour response heterogeneity score was identified according to progression-free survival information in the discovery cohort. We then confirmed and analysed the correlation of tumour response heterogeneity scores with clinicopathological features in the validation cohort. Next-generation sequencing was used to investigate a potential mechanism linking tumour response heterogeneity scores to clinical outcomes. Data from 174 patients were collected between Jan 1, 2016, and Dec 30, 2020. 101 (58%) patients had been treated with platinum-based doublet chemotherapy and 73 (42%) with targeted therapy. Median follow-up was 19·8 months (IQR 3·71–13·75). In the discovery cohort (n=85), the optimal cutoff point of tumour response heterogeneity score was defined as 0·46. Patients with high tumour response heterogeneity score had worse progression-free survival than patients with low tumour response heterogeneity (median 4·5 months [95% CI 3·6–8·6] vs 15·8 months (12·8—not reached), hazard ratio [HR] 4·43 [95% CI 2·14–9·16]; p
ISSN:1470-2045
1474-5488
DOI:10.1016/S1470-2045(22)00412-0