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RBM17 Expression Is Associated With the Efficacy of ICI Monotherapy in NSCLC With Low PD-L1 Expression
Hiroaki Nagamine1, Masakazu Yashiro2, Naoki Yoshimoto3
1Department of Respiratory Medicine, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Background/Aim:
Immune checkpoint inhibitors (ICIs) are currently a standard treatment tool for non-small cell lung cancer (NSCLC). RNA-binding motif protein 17 (RBM17), a splicing factor, is frequently over-expressed in NSCLC, but little is known about the role of RBM17 in the efficacy of ICIs for NSCLC. Thus, we investigated the correlation between RBM17 expression and ICI efficacy in NSCLC.
Patients And Methods:
Biopsy or surgical specimens were collected from patients with advanced or recurrent NSCLC who received ICI monotherapy or chemo-immunotherapy in a first-line setting. RBM17 expression was examined using immunohistochemistry. The correlation between the efficacy of ICI monotherapy or chemo-immunotherapy and RBM17 expression was evaluated.
Results:
Among the 218 cases, 115 (52.8%) cases were positive for RBM17 expression. RBM17 expression was not associated with the objective response rate (ORR) or progression-free survival (PFS) in either of the ICI monotherapy or chemo-immunotherapy groups. However, among those with a low PD-L1 expression level (PD-L1 <50%; n=86), RBM17 expression was significantly associated with a better ORR (p=0.045) and a better PFS (p<0.001) in the ICI monotherapy group, and was significantly associated with a poor ORR in the chemo-immunotherapy group (p=0.041).
Conclusion:
RBM17 might be a useful predictive marker for a higher efficacy of ICI monotherapy in NSCLC patients with a low PD-L1 expression level.
Insights
RNA-binding motif protein 17 (RBM17) expression may predict immune checkpoint inhibitor (ICI) response in non-small cell lung cancer (NSCLC). In patients with low PD-L1 expression, RBM17 predicts better ICI monotherapy efficacy.
Area of Science:
- Oncology
- Immunotherapy
- Molecular Biology
Background:
- Immune checkpoint inhibitors (ICIs) are a standard treatment for non-small cell lung cancer (NSCLC).
- RNA-binding motif protein 17 (RBM17), a splicing factor, is over-expressed in NSCLC.
- The role of RBM17 in ICI efficacy for NSCLC remains unclear.
Purpose of the Study:
- To investigate the correlation between RBM17 expression and ICI efficacy in NSCLC patients.
- To determine if RBM17 can serve as a predictive biomarker for ICI treatment response.
Main Methods:
- Collected biopsy/surgical specimens from advanced/recurrent NSCLC patients receiving first-line ICI monotherapy or chemo-immunotherapy.
- Assessed RBM17 expression using immunohistochemistry.
- Evaluated the correlation between RBM17 expression and treatment efficacy (ORR, PFS).
Main Results:
- RBM17 expression was not associated with ORR or PFS in overall ICI monotherapy or chemo-immunotherapy groups.
- In patients with low PD-L1 expression (<50%), RBM17 predicted better ORR and PFS with ICI monotherapy (p=0.045, p<0.001).
- RBM17 predicted poor ORR with chemo-immunotherapy in the low PD-L1 subgroup (p=0.041).
Conclusions:
- RBM17 may be a predictive marker for enhanced ICI monotherapy efficacy.
- This is particularly relevant for NSCLC patients with low PD-L1 expression levels.
- RBM17's predictive role differs between ICI monotherapy and chemo-immunotherapy in specific subgroups.
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