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The prognostic value of TMB in early-stage non-small cell lung cancer: a systematic review and meta-analysis
BACKGROUND: Tumor mutation burden (TMB) has been validated as a predictive biomarker for immunotherapy response and survival in numerous cancer types. Limited data is available on the inherent prognostic role of TMB in early-stage tumors. OBJECTIVE: To evaluate the prognostic role of TMB in early-st...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10475237/ https://www.ncbi.nlm.nih.gov/pubmed/37667779 http://dx.doi.org/10.1177/17588359231195199 |
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author | Wankhede, Durgesh Grover, Sandeep Hofman, Paul |
author_facet | Wankhede, Durgesh Grover, Sandeep Hofman, Paul |
author_sort | Wankhede, Durgesh |
collection | PubMed |
description | BACKGROUND: Tumor mutation burden (TMB) has been validated as a predictive biomarker for immunotherapy response and survival in numerous cancer types. Limited data is available on the inherent prognostic role of TMB in early-stage tumors. OBJECTIVE: To evaluate the prognostic role of TMB in early-stage, resected non-small cell lung cancer (NSCLC). DESIGN: Systematic review and meta-analysis of pertinent prospective and retrospective studies. DATA SOURCES AND METHODS: Publication search was performed in PubMed, Embase, Cochrane Library, and Web of Science databases. Based on the level of heterogeneity, a random- or fixed-effects model was used to calculate pooled effects of hazard ratio (HR) for overall survival (OS) and disease-free survival (DFS). The source of heterogeneity was investigated using sensitivity analysis, subgroup analysis, and publication bias assessment. RESULTS: Ten studies comprising 2520 patients were included in this analysis. There was no statistically significant difference in OS (HR, 1.18, 95% CI, 0.70, 1.33; p 0.53, I(2) = 80%; p(het) < 0.0001) and DFS (HR, 1.18, 95% CI, 0.91, 1.52; p = 0.53, I(2) = 75%; p(het) = 0.0001) between the high-TMB and low-TMB group. Subgroup analyses indicated that East Asian ethnicity, and TMB detected using whole exome sequencing, and studies with <100 patients had poor DFS in the high-TMB group. CONCLUSION: The inherent prognostic role of TMB is limited in early-stage NSCLC. Ethnic differences in mutation burden must be considered while designing future trials on neoadjuvant immunotherapy. Further research in the harmonization and standardization of panel-based TMB is essential for its widespread clinical utility. Registration: CRD42023392846. |
format | Online Article Text |
id | pubmed-10475237 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-104752372023-09-04 The prognostic value of TMB in early-stage non-small cell lung cancer: a systematic review and meta-analysis Wankhede, Durgesh Grover, Sandeep Hofman, Paul Ther Adv Med Oncol Controversies in Immunotherapy for Patients with Lung Cancer: Pragmatic Solutions BACKGROUND: Tumor mutation burden (TMB) has been validated as a predictive biomarker for immunotherapy response and survival in numerous cancer types. Limited data is available on the inherent prognostic role of TMB in early-stage tumors. OBJECTIVE: To evaluate the prognostic role of TMB in early-stage, resected non-small cell lung cancer (NSCLC). DESIGN: Systematic review and meta-analysis of pertinent prospective and retrospective studies. DATA SOURCES AND METHODS: Publication search was performed in PubMed, Embase, Cochrane Library, and Web of Science databases. Based on the level of heterogeneity, a random- or fixed-effects model was used to calculate pooled effects of hazard ratio (HR) for overall survival (OS) and disease-free survival (DFS). The source of heterogeneity was investigated using sensitivity analysis, subgroup analysis, and publication bias assessment. RESULTS: Ten studies comprising 2520 patients were included in this analysis. There was no statistically significant difference in OS (HR, 1.18, 95% CI, 0.70, 1.33; p 0.53, I(2) = 80%; p(het) < 0.0001) and DFS (HR, 1.18, 95% CI, 0.91, 1.52; p = 0.53, I(2) = 75%; p(het) = 0.0001) between the high-TMB and low-TMB group. Subgroup analyses indicated that East Asian ethnicity, and TMB detected using whole exome sequencing, and studies with <100 patients had poor DFS in the high-TMB group. CONCLUSION: The inherent prognostic role of TMB is limited in early-stage NSCLC. Ethnic differences in mutation burden must be considered while designing future trials on neoadjuvant immunotherapy. Further research in the harmonization and standardization of panel-based TMB is essential for its widespread clinical utility. Registration: CRD42023392846. SAGE Publications 2023-08-31 /pmc/articles/PMC10475237/ /pubmed/37667779 http://dx.doi.org/10.1177/17588359231195199 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Controversies in Immunotherapy for Patients with Lung Cancer: Pragmatic Solutions Wankhede, Durgesh Grover, Sandeep Hofman, Paul The prognostic value of TMB in early-stage non-small cell lung cancer: a systematic review and meta-analysis |
title | The prognostic value of TMB in early-stage non-small cell lung cancer: a systematic review and meta-analysis |
title_full | The prognostic value of TMB in early-stage non-small cell lung cancer: a systematic review and meta-analysis |
title_fullStr | The prognostic value of TMB in early-stage non-small cell lung cancer: a systematic review and meta-analysis |
title_full_unstemmed | The prognostic value of TMB in early-stage non-small cell lung cancer: a systematic review and meta-analysis |
title_short | The prognostic value of TMB in early-stage non-small cell lung cancer: a systematic review and meta-analysis |
title_sort | prognostic value of tmb in early-stage non-small cell lung cancer: a systematic review and meta-analysis |
topic | Controversies in Immunotherapy for Patients with Lung Cancer: Pragmatic Solutions |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10475237/ https://www.ncbi.nlm.nih.gov/pubmed/37667779 http://dx.doi.org/10.1177/17588359231195199 |
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