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Prognostic and Predictive Value of Blood Tumor Mutational Burden in Patients With Lung Cancer Treated With Docetaxel.

Identifieur interne : 000176 ( Main/Exploration ); précédent : 000175; suivant : 000177

Prognostic and Predictive Value of Blood Tumor Mutational Burden in Patients With Lung Cancer Treated With Docetaxel.

Auteurs : Wei Nie ; Jie Qian ; Mi-Die Xu ; Kai Gu [République populaire de Chine] ; Fang-Fei Qian ; Jun Lu ; Xue-Yan Zhang ; Hui-Min Wang ; Bo Yan ; Bo Zhang ; Shu-Yuan Wang ; Fang Hu ; Chang-Hui Li ; Hua Zhong ; Bao-Hui Han

Source :

RBID : pubmed:32380463

Abstract

BACKGROUND

Biomarkers for chemotherapy efficacy in non-small cell lung cancer (NSCLC) are lacking. This retrospective study assesses the association between blood-based tumor mutational burden (bTMB) and clinical benefit of chemotherapy.

METHODS

Clinical and targeted next-generation sequencing data from the OAK trial (training set; n=318) and POPLAR trial (validation set; n=106) in the docetaxel arm were analyzed. The cutoff value of bTMB for outcome prediction was determined based on a time-dependent receiver operating characteristic curve in the training set, and propensity score matching (PSM) was conducted. The primary outcome was overall survival (OS). Durable clinical benefit (DCB) was defined as OS lasting >12 months. Interaction between treatment and bTMB was assessed in the combined set.

RESULTS

A lower bTMB was observed in patients with DCB compared with no durable benefit, and in those with a partial response and stable disease compared with progressive disease. The optimized cutoff value of bTMB for predicting OS was 7 single-nucleotide variants per megabase. In the training set, a low bTMB was significantly associated with longer OS and progression-free survival (PFS). The prognostic value of bTMB was confirmed in the validation set and PSM set. The interaction between bTMB and treatment was significant for PFS (interaction P=.043) in the combined set. Mutations in KEAP1 were associated with high bTMB and a lack of benefit from chemotherapy.

CONCLUSIONS

Low bTMB is associated with a survival advantage in patients with NSCLC treated with docetaxel, suggesting the prognostic and predictive potential of bTMB for determining chemotherapy efficacy.


DOI: 10.6004/jnccn.2019.7383
PubMed: 32380463


Affiliations:


Links toward previous steps (curation, corpus...)


Le document en format XML

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<p>
<b>BACKGROUND</b>
</p>
<p>Biomarkers for chemotherapy efficacy in non-small cell lung cancer (NSCLC) are lacking. This retrospective study assesses the association between blood-based tumor mutational burden (bTMB) and clinical benefit of chemotherapy.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>Clinical and targeted next-generation sequencing data from the OAK trial (training set; n=318) and POPLAR trial (validation set; n=106) in the docetaxel arm were analyzed. The cutoff value of bTMB for outcome prediction was determined based on a time-dependent receiver operating characteristic curve in the training set, and propensity score matching (PSM) was conducted. The primary outcome was overall survival (OS). Durable clinical benefit (DCB) was defined as OS lasting >12 months. Interaction between treatment and bTMB was assessed in the combined set.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>A lower bTMB was observed in patients with DCB compared with no durable benefit, and in those with a partial response and stable disease compared with progressive disease. The optimized cutoff value of bTMB for predicting OS was 7 single-nucleotide variants per megabase. In the training set, a low bTMB was significantly associated with longer OS and progression-free survival (PFS). The prognostic value of bTMB was confirmed in the validation set and PSM set. The interaction between bTMB and treatment was significant for PFS (interaction P=.043) in the combined set. Mutations in KEAP1 were associated with high bTMB and a lack of benefit from chemotherapy.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSIONS</b>
</p>
<p>Low bTMB is associated with a survival advantage in patients with NSCLC treated with docetaxel, suggesting the prognostic and predictive potential of bTMB for determining chemotherapy efficacy.</p>
</div>
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<AbstractText Label="BACKGROUND">Biomarkers for chemotherapy efficacy in non-small cell lung cancer (NSCLC) are lacking. This retrospective study assesses the association between blood-based tumor mutational burden (bTMB) and clinical benefit of chemotherapy.</AbstractText>
<AbstractText Label="METHODS">Clinical and targeted next-generation sequencing data from the OAK trial (training set; n=318) and POPLAR trial (validation set; n=106) in the docetaxel arm were analyzed. The cutoff value of bTMB for outcome prediction was determined based on a time-dependent receiver operating characteristic curve in the training set, and propensity score matching (PSM) was conducted. The primary outcome was overall survival (OS). Durable clinical benefit (DCB) was defined as OS lasting >12 months. Interaction between treatment and bTMB was assessed in the combined set.</AbstractText>
<AbstractText Label="RESULTS">A lower bTMB was observed in patients with DCB compared with no durable benefit, and in those with a partial response and stable disease compared with progressive disease. The optimized cutoff value of bTMB for predicting OS was 7 single-nucleotide variants per megabase. In the training set, a low bTMB was significantly associated with longer OS and progression-free survival (PFS). The prognostic value of bTMB was confirmed in the validation set and PSM set. The interaction between bTMB and treatment was significant for PFS (interaction P=.043) in the combined set. Mutations in KEAP1 were associated with high bTMB and a lack of benefit from chemotherapy.</AbstractText>
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<name sortKey="Han, Bao Hui" sort="Han, Bao Hui" uniqKey="Han B" first="Bao-Hui" last="Han">Bao-Hui Han</name>
<name sortKey="Hu, Fang" sort="Hu, Fang" uniqKey="Hu F" first="Fang" last="Hu">Fang Hu</name>
<name sortKey="Li, Chang Hui" sort="Li, Chang Hui" uniqKey="Li C" first="Chang-Hui" last="Li">Chang-Hui Li</name>
<name sortKey="Lu, Jun" sort="Lu, Jun" uniqKey="Lu J" first="Jun" last="Lu">Jun Lu</name>
<name sortKey="Nie, Wei" sort="Nie, Wei" uniqKey="Nie W" first="Wei" last="Nie">Wei Nie</name>
<name sortKey="Qian, Fang Fei" sort="Qian, Fang Fei" uniqKey="Qian F" first="Fang-Fei" last="Qian">Fang-Fei Qian</name>
<name sortKey="Qian, Jie" sort="Qian, Jie" uniqKey="Qian J" first="Jie" last="Qian">Jie Qian</name>
<name sortKey="Wang, Hui Min" sort="Wang, Hui Min" uniqKey="Wang H" first="Hui-Min" last="Wang">Hui-Min Wang</name>
<name sortKey="Wang, Shu Yuan" sort="Wang, Shu Yuan" uniqKey="Wang S" first="Shu-Yuan" last="Wang">Shu-Yuan Wang</name>
<name sortKey="Xu, Mi Die" sort="Xu, Mi Die" uniqKey="Xu M" first="Mi-Die" last="Xu">Mi-Die Xu</name>
<name sortKey="Yan, Bo" sort="Yan, Bo" uniqKey="Yan B" first="Bo" last="Yan">Bo Yan</name>
<name sortKey="Zhang, Bo" sort="Zhang, Bo" uniqKey="Zhang B" first="Bo" last="Zhang">Bo Zhang</name>
<name sortKey="Zhang, Xue Yan" sort="Zhang, Xue Yan" uniqKey="Zhang X" first="Xue-Yan" last="Zhang">Xue-Yan Zhang</name>
<name sortKey="Zhong, Hua" sort="Zhong, Hua" uniqKey="Zhong H" first="Hua" last="Zhong">Hua Zhong</name>
</noCountry>
<country name="République populaire de Chine">
<noRegion>
<name sortKey="Gu, Kai" sort="Gu, Kai" uniqKey="Gu K" first="Kai" last="Gu">Kai Gu</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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