Blood-Based Biomarker Analysis for Predicting Efficacy of Chemoradiotherapy and Durvalumab in Patients with Unresectable Stage III Non-Small Cell Lung Cancer

• Published in: Cancers Vol. 15; no. 4; p. 1151
• Main Authors: Park, Cheol-Kyu, Lee, Sung-Woo, Cho, Hyun-Ju, Oh, Hyung-Joo, Kim, Young-Chul, Kim, Yong-Hyub, Ahn, Sung-Ja, Cho, Jae-Ho, Oh, In-Jae
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 10.02.2023; MDPI
• Subjects: Apoptosis; Biological markers; Biomarkers; Biopsy; Blood; Blood cells; Blood platelets; Blood tests; Cancer; Cancer therapies; Care and treatment; CD45 antigen; Chemoradiotherapy; Chemotherapy; Diagnosis; Feasibility studies; Health aspects; Lung cancer; Lung cancer, Non-small cell; Lymphocytes; Medical imaging; Medical prognosis; Mutation; Neutrophils; Non-small cell lung carcinoma; Patient outcomes; Patients; PD-L1 protein; Peripheral blood; Phenotypes; Platelets; Radiation; Radiotherapy; Risk factors; Small cell lung carcinoma; Tumor cells; South Korea; United States > US; non-small cell lung cancer; durvalumab; circulating tumor cells; concurrent chemoradiotherapy; biomarkers; platelets
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers15041151

We recruited 50 patients with unresectable stage III NSCLC who received CCRT between March 2020 and March 2021. Durvalumab consolidation (DC) was administered to patients ( = 23) without progression after CCRT and programmed death-ligand 1 (PD-L1) ≥ 1%. Blood samples were collected before (C0) and after CCRT (C1) to calculate PBC counts and analyze CTCs. CTCs, isolated by the CD-PRIME system, exhibited EpCAM/CK+/CD45- phenotype in BioViewCCBS . At median follow-up of 27.4 months, patients with residual CTC clusters at C1 had worse median PFS than those without a detectable CTC cluster (11.0 vs. 27.8 months, = 0.032), and this trend was noted only in the DC group ( = 0.034). Patients with high platelets at C1 (PLT , >252 × 10 /µL) had worse median PFS than those with low platelets (PLT ) (5.9 vs. 17.1 months, < 0.001). In multivariable analysis, PLT and residual CTC clusters at C1 were independent risk factors for PFS, and DC group with PLT and residual CTC clusters at C1 showed the worst median PFS (2.6 months, HR 45.16, = 0.001), even worse than that of the CCRT alone group with PLT (5.9 months, HR 15.39, = 0.001). The comprehensive analysis of CTCs and PBCs before and after CCRT revealed that the clearance of CTC clusters and platelet counts at C1 might be potential biomarkers for predicting survival.