Chromosome Instability: Potential Prognostic Predictor in Lung Cancer
Intratumor heterogeneity mediated through chromosome instability seems to be linked to an increased risk of recurrence or death among patients with non–small cell lung cancer (NSCLC). This finding from the Cancer Research UK–funded TRACERx prospective study was recently reported in The New England Journal of Medicine.
Jamal-Hanjani and colleagues performed multiregion whole-exome sequencing on 100 early-stage NSCLC tumors that had been resected before systemic therapy. A total of 327 tumor regions were sequenced and analyzed to define evolutionary histories, obtain a census of clonal and subclonal events, and assess the relationship between intratumor heterogeneity and recurrence-free survival.
They found that intratumor heterogeneity and branched evolution were almost universal across the cohort of NSCLC tumors. Although further studies are needed to obtain a clearer understanding of chromosomal instability, the investigators consider these data to have clinical implications in terms of therapeutic control of NSCLC in the future.