Combination of tumor asphericity and an extracellular matrix-related prognostic gene signature in non-small cell lung cancer patients

The aim of this retrospective multicenter study was an independent validation of a gene expression signature ECM-related prognostic and predictive indicator (EPPI) and the novel positron emission tomography (PET) parameter tumor asphericity (ASP) in non-small cell lung cancer (NSCLC) patients. The whole cohort comprised 253 NSCLC patients, all treated with surgery. Clinical and PET parameters were available for all patients, additional gene expression data for 120 patients. Univariate and multivariate Cox regression and Kaplan-Meier analyses were calculated for progression-free survival (PFS).
A significant association with PFS was observed for ASP (p < 0.001) and EPPI (p = 0.012). Upon multivariate testing, ASP was significantly associated with PFS (p = 0.012), and EPPI (p = 0.018) in patients with additional gene data. In stage II patients, ASP was significantly associated with PFS (p = 0.009) and a previously published cutoff value for ASP (19.5%) was successfully validated (p = 0.008). EPPI showed a significant association with PFS in stage II patients, too (p = 0.033). Exploratory combination of ASP and EPPI showed potentially improved stratification.
We report the first successful validation of EPPI and ASP in stage II NSCLC patients, combination of both parameters seems encouraging.