Pre-operative clonal hematopoiesis is related to adverse outcome in lung cancer after adjuvant therapy
Abstract Background Clonal hematopoiesis (CH) frequently progresses after chemotherapy or radiotherapy. We evaluated the clinical impact of preoperative CH on the survival outcomes of patients with non-small cell lung cancer (NSCLC) who underwent surgical resection followed by adjuvant therapy. Meth...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Genome Medicine |
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| Online Access: | https://doi.org/10.1186/s13073-023-01266-4 |
| _version_ | 1797388104954281984 |
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| author | Jae Kwang Yun Sugyeong Kim Hongyul An Geun Dong Lee Hyeong Ryul Kim Yong-Hee Kim Dong Kwan Kim Seung-Il Park Sehoon Choi Youngil Koh |
| author_facet | Jae Kwang Yun Sugyeong Kim Hongyul An Geun Dong Lee Hyeong Ryul Kim Yong-Hee Kim Dong Kwan Kim Seung-Il Park Sehoon Choi Youngil Koh |
| author_sort | Jae Kwang Yun |
| collection | DOAJ |
| description | Abstract Background Clonal hematopoiesis (CH) frequently progresses after chemotherapy or radiotherapy. We evaluated the clinical impact of preoperative CH on the survival outcomes of patients with non-small cell lung cancer (NSCLC) who underwent surgical resection followed by adjuvant therapy. Methods A total of 415 consecutive patients with NSCLC who underwent surgery followed by adjuvant therapy from 2011 to 2017 were analyzed. CH status was evaluated using targeted deep sequencing of blood samples collected before surgery. To minimize the possible selection bias between the two groups according to CH status, a propensity score matching (PSM) was adopted. Early-stage patients were further analyzed with additional matched cohort of patients who did not receive adjuvant therapy. Results CH was detected in 21% (86/415) of patients with NSCLC before adjuvant therapy. Patients with CH mutations had worse overall survival (OS) than those without (hazard ratio [95% confidence interval] = 1.56 [1.07–2.28], p = 0.020), which remained significant after the multivariable analysis (1.58 [1.08–2.32], p = 0.019). Of note, the presence of CH was associated with non–cancer mortality (p = 0.042) and mortality of unknown origin (p = 0.018). In patients with stage IIB NSCLC, there was a significant interaction on OS between CH and adjuvant therapy after the adjustment with several cofactors through the multivariable analysis (HR 1.19, 95% CI 1.00–1.1.41, p = 0.041). Conclusions In resected NSCLC, existence of preoperative CH might amplify CH-related adverse outcomes through adjuvant treatments, resulting in poor survival results. |
| first_indexed | 2024-03-08T22:36:01Z |
| format | Article |
| id | doaj.art-065f322994904423957a1de576f48fc0 |
| institution | Directory Open Access Journal |
| issn | 1756-994X |
| language | English |
| last_indexed | 2024-03-08T22:36:01Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Genome Medicine |
| spelling | doaj.art-065f322994904423957a1de576f48fc02023-12-17T12:25:53ZengBMCGenome Medicine1756-994X2023-12-0115111110.1186/s13073-023-01266-4Pre-operative clonal hematopoiesis is related to adverse outcome in lung cancer after adjuvant therapyJae Kwang Yun0Sugyeong Kim1Hongyul An2Geun Dong Lee3Hyeong Ryul Kim4Yong-Hee Kim5Dong Kwan Kim6Seung-Il Park7Sehoon Choi8Youngil Koh9Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of MedicineGenome Opinion Inc., Sungsu SKV1 CenterGenome Opinion Inc., Sungsu SKV1 CenterDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of MedicineDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of MedicineDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of MedicineDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of MedicineDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of MedicineDepartment of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of MedicineGenome Opinion Inc., Sungsu SKV1 CenterAbstract Background Clonal hematopoiesis (CH) frequently progresses after chemotherapy or radiotherapy. We evaluated the clinical impact of preoperative CH on the survival outcomes of patients with non-small cell lung cancer (NSCLC) who underwent surgical resection followed by adjuvant therapy. Methods A total of 415 consecutive patients with NSCLC who underwent surgery followed by adjuvant therapy from 2011 to 2017 were analyzed. CH status was evaluated using targeted deep sequencing of blood samples collected before surgery. To minimize the possible selection bias between the two groups according to CH status, a propensity score matching (PSM) was adopted. Early-stage patients were further analyzed with additional matched cohort of patients who did not receive adjuvant therapy. Results CH was detected in 21% (86/415) of patients with NSCLC before adjuvant therapy. Patients with CH mutations had worse overall survival (OS) than those without (hazard ratio [95% confidence interval] = 1.56 [1.07–2.28], p = 0.020), which remained significant after the multivariable analysis (1.58 [1.08–2.32], p = 0.019). Of note, the presence of CH was associated with non–cancer mortality (p = 0.042) and mortality of unknown origin (p = 0.018). In patients with stage IIB NSCLC, there was a significant interaction on OS between CH and adjuvant therapy after the adjustment with several cofactors through the multivariable analysis (HR 1.19, 95% CI 1.00–1.1.41, p = 0.041). Conclusions In resected NSCLC, existence of preoperative CH might amplify CH-related adverse outcomes through adjuvant treatments, resulting in poor survival results.https://doi.org/10.1186/s13073-023-01266-4Clonal hematopoiesisNon–small cell lung cancerAdjuvant therapyPrognosis |
| spellingShingle | Jae Kwang Yun Sugyeong Kim Hongyul An Geun Dong Lee Hyeong Ryul Kim Yong-Hee Kim Dong Kwan Kim Seung-Il Park Sehoon Choi Youngil Koh Pre-operative clonal hematopoiesis is related to adverse outcome in lung cancer after adjuvant therapy Genome Medicine Clonal hematopoiesis Non–small cell lung cancer Adjuvant therapy Prognosis |
| title | Pre-operative clonal hematopoiesis is related to adverse outcome in lung cancer after adjuvant therapy |
| title_full | Pre-operative clonal hematopoiesis is related to adverse outcome in lung cancer after adjuvant therapy |
| title_fullStr | Pre-operative clonal hematopoiesis is related to adverse outcome in lung cancer after adjuvant therapy |
| title_full_unstemmed | Pre-operative clonal hematopoiesis is related to adverse outcome in lung cancer after adjuvant therapy |
| title_short | Pre-operative clonal hematopoiesis is related to adverse outcome in lung cancer after adjuvant therapy |
| title_sort | pre operative clonal hematopoiesis is related to adverse outcome in lung cancer after adjuvant therapy |
| topic | Clonal hematopoiesis Non–small cell lung cancer Adjuvant therapy Prognosis |
| url | https://doi.org/10.1186/s13073-023-01266-4 |
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