Annals of Oncology 25 (Supplement 4): iv417–iv425, 2014
doi:10.1093/annonc/mdu348.17
NSCLC, locally advanced
1211P
CLINICAL RELEVANCE OF CD133 POSITIVE CELLS IN
LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER
abstracts
Aim: CD133 positive cells have been identified as tumor initiating cells in non-small
cell lung cancer (NSCLC) and have been shown to be resistant to conventional
cytotoxic chemotherapy in experimental studies, suggesting a possible role in
chemoresistance and disease relapse. However their prognostic relevance in the context
of clinical treatment of NSCLC has not been fully investigated.
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E.R. Haspinger1, M. Platania1, G. Bertolini2, R. Caserini2, E. Landoni3, E. Roz4, M.
C. Garassino1, N. Zilembo1, F. Agustoni1, M. Vitali1, D. Serpico1, R. Giovannetti5,
F. Gelsomino1, P. Scanagatta5, L. Taveccio5, R. Gallucci1, U. Pastorino5, F.G.M.
De Braud1, G. Sozzi2, L. Roz2
1
Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, ITALY
2
Department of Experimental Oncology and Molecular Medicine, Fondazione
IRCCS - Istituto Nazionale dei Tumori, Milan, ITALY
3
Medical Statistics, Biometry and Bioinformatics, Unit of Clinical Epidemiology and
Trial Organization, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, ITALY
4
Pathology Unit, Oncologic Department, Casa di Cura “La Maddalena”, Palermo,
ITALY
5
Surgery Thoracic Unit, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan,
ITALY
Methods: We analyzed tumor samples from 60 consecutive NSCLC patients with stage
IIIA-B undergoing neo-adjuvant chemotherapy with platinum-based regimens
followed by radically surgery. Tumor specimen collection included pre-treatment
mediastinal lymph-node biopsies (n = 23) and post-treatment surgical specimens (25
from lymph-nodes and 52 from primary tumors). CD133 status was determined by
immunohistochemistry and correlations with clinico-pathological variables were
evaluated using univariable and multivariable Cox models.
Results: CD133 positive cells (mean 5% of total tumor cells, range 1-40%) were
detected in 35% of pre-treatment samples and after chemotherapy in 38% and 32% of
resected primary tumors and metastatic lymph-nodes, respectively. When both lymph
nodes and primary tumor were available (24 patients) no correlation was found
between CD133 status, possibly indicating different dynamics in primary tumor
maintenance and dissemination. CD133 positive cells were detected more frequently in
tumors with best response to chemotherapy (by ≥30% size reduction: 14/28, 50% vs. 6/
24, 25%) suggesting enrichment of chemoresistant cells after treatment. CD133
positivity after induction chemotherapy was correlated with higher risk of local and
distant recurrence (73% vs 53%), especially in patients with pre-treatment CD133+
lymph nodes (87% vs. 53%). Finally, positivity for CD133 after treatment seems to be
correlated with worse overall survival (HR 2.42, 95% CI: 0.93-6.32, p = 0.184).
Conclusions: Investigation of tumors after chemotherapy provides indirect evidence of
chemoresistance of CD133+ cells. CD133 positive cells are correlated with worse
prognosis in neo-adjuvant treatment of locally advanced NSCLC and could provide
clinical relevant information for personalized therapies.
Disclosure: All authors have declared no conflicts of interest.
© European Society for Medical Oncology 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology.
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