Comparative analysis of therapeutic target protein expression in de novo and transformed small cell lung carcinomas

Saori Murata1, Jumpei Kashima2, Hidehito Horinouchi3

  • 1Department of Thoracic Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Cancer Medicine, Cooperative Graduate School, The Jikei University Graduate School of Medicine, Minato-ku, Tokyo, Japan.

Abstract

Insights

Therapeutic targets like DLL3 in small cell lung cancer (SCLC) change during treatment. Rebiopsy can guide decisions for antibody-drug conjugates (ADCs) and bispecific antibodies (BiAbs) in SCLC patients.

Area of Science:

  • Oncology
  • Translational Research

Background:

  • Emerging treatments for small cell lung cancer (SCLC) include antibody-drug conjugates (ADCs) and bispecific antibodies (BiAbs).
  • Optimal patient selection for these therapies is unclear, with limited data on key targets like Delta-like ligand 3 (DLL3), trophoblast cell-surface antigen 2 (TROP2), and B7-H3.
  • This study is the first to assess multiple therapeutic targets in SCLC patients before and after treatment.

Purpose of the Study:

  • To investigate the dynamic changes of therapeutic target proteins in de novo and transformed SCLC.
  • To evaluate the clinical utility of assessing multiple targets, including DLL3, TROP2, B7-H3, MET, and HER2, over the course of SCLC treatment.
  • To inform biomarker-driven strategies for patient selection in SCLC therapy.

Main Methods:

  • Retrospective analysis of tumor biopsies from 15 SCLC patients (9 de novo, 6 transformed) at diagnosis and progression.
  • Immunohistochemistry was used to assess the expression levels of DLL3, TROP2, B7-H3, MET, and HER2.
  • Significant changes in H-score were defined as a difference of ≥100 points.

Main Results:

  • In de novo SCLC, DLL3 expression fluctuated in 3/9 cases, while B7-H3 and MET increased in 2/9 and 1/9 cases, respectively. HER2 expression became negative in 1/9 case.
  • Transformed SCLC showed increased DLL3 expression in all 6 cases, with downregulation of TROP2 and HER2. B7-H3 and MET generally decreased.
  • Protein co-expression patterns varied, with DLL3 and B7-H3 frequently co-expressed in transformed SCLC.

Conclusions:

  • Therapeutic target protein expression in SCLC is dynamic and changes throughout treatment.
  • Biomarker-driven strategies are essential for optimizing patient selection for ADCs and BiAbs.
  • Rebiopsy may be a valuable tool to guide therapeutic decisions in SCLC management.

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