title: Peripheral immune cell gene expression predicts survival of patients with non-small cell lung cancer.
abstract: Prediction of cancer recurrence in patients with non-small cell lung cancer (NSCLC) currently relies on the assessment of clinical characteristics including age, tumor stage, and smoking history. A better prediction of early stage cancer patients with poorer survival and late stage patients with better survival is needed to design patient-tailored treatment protocols. We analyzed gene expression in RNA from peripheral blood mononuclear cells (PBMC) of NSCLC patients to identify signatures predictive of overall patient survival. We find that PBMC gene expression patterns from NSCLC patients, like patterns from tumors, have information predictive of patient outcomes. We identify and validate a 26 gene prognostic panel that is independent of clinical stage. Many additional prognostic genes are specific to myeloid cells and are more highly expressed in patients with shorter survival. We also observe that significant numbers of prognostic genes change expression levels in PBMC collected after tumor resection. These post-surgery gene expression profiles may provide a means to re-evaluate prognosis over time. These studies further suggest that patient outcomes are not solely determined by tumor gene expression profiles but can also be influenced by the immune response as reflected in peripheral immune cells.
authors.affiliation: The Wistar Institute, Philadelphia, Pennsylvania, United States of America.
authors.forename: Andrew V
authors.initials: AV
authors.lastname: Kossenkov
authors.forename: Noor
authors.initials: N
authors.lastname: Dawany
authors.forename: Tracey L
authors.initials: TL
authors.lastname: Evans
authors.forename: John C
authors.initials: JC
authors.lastname: Kucharczuk
authors.forename: Steven M
authors.initials: SM
authors.lastname: Albelda
authors.forename: Louise C
authors.initials: LC
authors.lastname: Showe
authors.forename: Michael K
authors.initials: MK
authors.lastname: Showe
authors.forename: Anil
authors.initials: A
authors.lastname: Vachani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D005260:Female; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000378:metabolism* / Q000473:pathology; D008168:Lung / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis