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Predictive Immune Modeling of Solid Tumors
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Prognostic Significance and Biomarker Identification by Progression Patterns in Patients With Small Cell Lung Cancer

Paresh Kumar1, James E Slaven2, Tianhao Zhou1

  • 1Division of Hematology/Oncology, Indiana University School of Medicine, Indianapolis, IN.

Clinical Lung Cancer
|April 29, 2026
PubMed
Summary

Progression patterns in relapsed small cell lung cancer (SCLC) after chemoimmunotherapy can predict outcomes. Oligoprogression (OP) indicates better survival, while non-oligoprogression (non-OP) suggests poor prognosis and identifies HOXA5 hypermethylation as a potential biomarker.

Keywords:
Disease progressionHOXA5Liquid biopsyOligoprogressionPTENSCLC

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Area of Science:

  • Oncology
  • Translational Research
  • Biomarkers

Background:

  • Chemoimmunotherapy is initially effective for small cell lung cancer (SCLC) but often leads to relapse.
  • Understanding progression patterns is crucial for prognostication and identifying biomarkers in relapsed SCLC.

Purpose of the Study:

  • To investigate the prognostic value of progression patterns in patients with relapsed SCLC.
  • To identify potential biomarkers associated with different progression patterns and patient outcomes.

Main Methods:

  • Retrospective review of electronic medical records for SCLC patients post-chemoimmunotherapy.
  • Classification of progression into oligoprogression (OP) and non-oligoprogression (non-OP).
  • Analysis of tissue and liquid biopsies for biomarker identification, including HOXA5 methylation.

Main Results:

  • Oligoprogression (OP) was associated with significantly improved overall survival, survival after progression, and progression-free survival with subsequent therapy.
  • Patients with non-OP experienced higher rates of hospitalization, hospice transition, and received fewer subsequent therapies.
  • HOXA5 hypermethylation correlated with non-OP and predicted inferior survival in an independent cohort.

Conclusions:

  • Progression patterns effectively identify relapsed SCLC patients at high risk for mortality and clinical decline.
  • Patients with non-OP patterns should be prioritized for clinical trials.
  • Prospective validation of HOXA5 status for predicting chemoimmunotherapy outcomes is warranted.