Can Circulating Biomarkers Predict Survival Outcomes in Advanced NSCLC?

Specific tumor outcomes in non-small cell lung cancer (NSCLC) might be successfully predicted through circulating biomarkers of hypercoagulation and inflammation, according to a recent study.

“The hemostatic system and tumor biology display a tight and reciprocal interaction where clotting products enhance tumor growth and dissemination, and tumor, in turn, triggers a hypercoagulable and inflammatory state,” the researchers said.

In the prospective study, presented during the European Hematology Association 2024 Congress in Madrid, Spain, the researchers evaluated if hypercoagulable and inflammatory biomarkers could predict disease progression and death within 6 months after an advanced NSCLC diagnosis.

More than 700 patients with newly diagnosed, advanced-stage NSCLC (568 metastatic and 151 locally advanced) were included. The population was mostly men (n=489) with a median age of 66 years.

Before the start of chemotherapy, whole blood and platelet-free plasma samples were collected from patients and tested for complete blood cell count, fibrinogen, factor VIII (FVIII), D-dimer, and prothrombin fragment 1+2 (F1+2) levels.

At 6 months, there was a cumulative incidence of disease progression of 38% in a median time of 144 days (55-180 days). Furthermore, patients whose disease progressed during that time frame had significantly higher levels of leukocytes, D-dimer, FVIII, and fibrinogen compared with patients whose disease had not progressed.

The researchers observed a mortality rate of 27% in a median time of 149 days (8-180 days). By Kaplan-Meier, the 6-month cumulative incidence of disease progression was 59% in the high-risk group and 30% in the low-risk (hazard ratio [HR] 2.21; log-rank P < .001). The cumulative incidence of mortality was 33% in the high-risk group and 12% in the low-risk group (HR 3.33; P < .001).

In recent years, liquid biopsies have been developed to explore potential circulating tumor biomarkers in patients with cancer using a noninvasive approach.

“If externally validated, our score, by classifying patients in risk categories, will help clinicians in the selection of patients who might require more frequent clinical surveillance and a more intensive therapeutic regimen,” the researchers said.

Reference

Gomez Rosas P, Russo L, Verzeroli C, et al. Contribution of hypercoagulation and inflammatory biomarkers in the progression and mortality of non-small cell lung cancer (NSCLC) patients. P1655. Presented at the European Hematology Association 2024 Congress; June 13-16; Madrid, Spain.