Journal
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
Volume 148, Issue 10, Pages 2867-2879Publisher
SPRINGER
DOI: 10.1007/s00432-022-04071-5
Keywords
Anti-angiogenic therapy; Drug resistance; NSCLC; Exosome; LncRNA
Categories
Funding
- Natural Science Foundation of China [8170130783]
- Natural Science Foundation of Jiangsu Province, China [BK20191211]
- 521 talent project of Lianyungang city [LYG06521202158]
- The technology project of the High-tech Zone of Lianyungang city [ZD201930]
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This study identified plasma exosomal lnc-SNAPC5-3:4 as a potential biomarker for monitoring the efficacy of anlotinib.
Purpose Anlotinib is an oral small-molecule multitarget tyrosine kinase inhibitor that hampers neovascularization thus providing antitumor effect. The ALTER 0303 trial was a multicenter, double-blind, phase 3 randomized clinical study to evaluate the efficacy of anlotinib in patients with advanced non-small cell lung cancer (NSCLC). The ALTER 0303 results showed that patients in the anlotinib group had a median progression-free survival of 5.4 months, a significant improvement compared with 1.4 months in the placebo group; however, median overall survival was only extended by 3.3 months (9.6 vs 6.3 months). The problem of anlotinib resistance cannot be ignored, and an in-depth exploration of biomarkers of anlotinib treatment response is urgently needed to further improve the efficacy of anlotinib in the treatment of NSCLC. This study aimed to identify plasma exosome markers that could be used to monitor the efficacy of anlotinib. Methods We enrolled 5 patients with advanced NSCLC, and 15 blood samples were collected before anlotinib treatment, when the treatment was effective, and when the treatment was ineffective. The plasma exosomal RNA profiles were analyzed by whole-transcriptome sequencing at three different stages. The expression of dysregulated exosomal RNAs in 43 additional patients was also verified by real-time quantitative PCR. Results In the plasma exosomal RNA profiles of the 5 patients with advanced NSCLC during treatment with anlotinib, 7 miRNAs, 3 lncRNAs, and 83 mRNAs were significantly dysregulated. The regulation trend was opposite when the treatment was effective and ineffective, showing dynamic changes. After validation, we finally found that plasma exosomal lncSNAPCS-3:4 was significantly upregulated when anlotinib treatment was effective, and it was significantly downregulated when the treatment failed (p < 0.05). Thus, it can be used as a potential biomarker for monitoring the efficacy of anlotinib. Conclusion Our results demonstrate the potential of plasma exosomal lnc-SNAPC5-3:4 as a biomarker for monitoring anlotinib efficacy.
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