An epithelial-to-mesenchymal transition induced extracellular vesicle prognostic signature in non-small cell lung cancer.
Richard J LobbKekoolani S VisanLi-Ying WuEmma L NorrisMarcus L HastieSarah EverittIan A YangRayleen V BowmanShankar SivaJill E LarsenJeffrey J GormanMichael MacManusAntoine LeimgruberKwun M FongAndreas MöllerPublished in: Communications biology (2023)
Despite significant therapeutic advances, lung cancer remains the leading cause of cancer-related death worldwide 1 . Non-small cell lung cancer (NSCLC) patients have a very poor overall five-year survival rate of only 10-20%. Currently, TNM staging is the gold standard for predicting overall survival and selecting optimal initial treatment options for NSCLC patients, including those with curable stages of disease. However, many patients with locoregionally-confined NSCLC relapse and die despite curative-intent interventions, indicating a need for intensified, individualised therapies. Epithelial-to-mesenchymal transition (EMT), the phenotypic depolarisation of epithelial cells to elongated, mesenchymal cells, is associated with metastatic and treatment-refractive cancer. We demonstrate here that EMT-induced protein changes in small extracellular vesicles are detectable in NSCLC patients and have prognostic significance. Overall, this work describes a novel prognostic biomarker signature that identifies potentially-curable NSCLC patients at risk of developing metastatic NSCLC, thereby enabling implementation of personalised treatment decisions.
Keyphrases
- small cell lung cancer
- end stage renal disease
- ejection fraction
- chronic kidney disease
- prognostic factors
- advanced non small cell lung cancer
- stem cells
- healthcare
- primary care
- induced apoptosis
- brain metastases
- dna methylation
- gene expression
- lymph node
- young adults
- quality improvement
- high glucose
- free survival
- patient reported
- endoplasmic reticulum stress