JoVE - Journal of Visualized Experiments
JoVE Visualize
Contact Us

On-treatment dynamics of circulating extracellular vesicles in the first-line setting of patients with advanced non-small cell lung cancer: the LEXOVE prospective study

  • 0Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Italy.
Molecular Oncology +

|

January 9, 2025

|

January 9, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Monitoring extracellular vesicles (EVs) can predict treatment response in non-small cell lung cancer (NSCLC). A decrease in cell-free EVs (cfEV) correlated with better outcomes for patients on targeted therapies and immunotherapy.

Area Of Science

  • Oncology
  • Biochemistry
  • Nanotechnology

Background

  • Clinical assessment of cancer treatment response can be complemented by monitoring extracellular vesicles (EVs).
  • Non-small cell lung cancer (NSCLC) patients often receive targeted therapies, immunotherapies, or chemotherapy, necessitating reliable response monitoring.
  • Circulating EVs offer a minimally invasive biomarker for evaluating treatment efficacy.

Purpose Of The Study

  • To investigate the utility of monitoring circulating extracellular vesicle (EV) protein content (cfEV) for assessing treatment response in advanced non-small cell lung cancer (NSCLC).
  • To correlate changes in cfEV levels with clinical outcomes in NSCLC patients treated with osimertinib, alectinib, pembrolizumab, or chemotherapy ± pembrolizumab.

Main Methods

  • Collected 135 plasma samples from 27 advanced NSCLC patients at baseline (T0) and first radiological restaging (T1).
  • Quantified circulating cell-free EV protein content (cfEV) using Bradford assay.
  • Assessed EV characteristics including hydrodynamic diameter and polydispersity index using dynamic light scattering.

Main Results

  • A decrease in cfEV (<20%) was associated with improved median progression-free survival (mPFS) in responders versus non-responders.
  • cfEV responders on pembrolizumab showed significantly better mPFS (25.2 months) than those on chemotherapy plus pembrolizumab (6.1 months).
  • EGFR-positive cfEV responders had longer mPFS (35.1 months) compared to cfEV non-responders (20.8 months).

Conclusions

  • Monitoring circulating EVs, specifically cfEV levels, provides valuable insights into treatment efficacy in NSCLC.
  • EV monitoring may be particularly useful for patients receiving pembrolizumab or osimertinib.
  • Changes in cfEV can serve as an early indicator of treatment response and prognosis in NSCLC.

Keywords: