Serum Exosomal miRNA Predicting the Therapeutic Efficiency in Lung Squamous Carcinoma

Study Overview
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Brief Summary
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This is an observational prospective bi-center study of 50 patients operated on advanced squamous cell carcinoma. The main aim is to investigate the efficacy of serum exosomal miRNA as a biomarker for predicting the therapeutic effect of immunotherapy combined with chemotherapy.

Detailed Description
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PD-L1 Testing in guiding patient selection for PD-1/PD-L1 inhibitor therapy in Lung Cancer exhibits insufficient sensitivity and efficacy. The investigators aimed to identify specific serum exosomal miRNA biomarkers that are highly sensitive and stable for predicting the therapeutic effect of immunotherapy combined with chemotherapy. So that the clinicians could use the biomarker to better stratify patients and select potential immunotherapy-beneficial subgroups before clinical decisions. We plan to enroll 50 patients with advanced treatment-naïve squamous cell carcinoma and 10 healthy people in the present study. Peripheral blood from the plasma of 10 healthy individuals and 50 pulmonary squamous cell carcinoma (SCC) patients will be collected before first-line treatment and after 2 cycles of anti-PD-L1 immunotherapy combined with chemotherapy. Firstly, exosomal miRNAs extracted from peripheral blood will be analyzed through high-throughput RNA sequencing to identify specific exosomal miRNAs. Secondly, through analyzing the PFS and OS follow-up data of patients, they are divided into different subgroups. We explore the value of early predicting efficacy of exosome miRNA basing on sequencing results. Thirdly, we compared the exo-miRNA biomarker with the value of PD-L1 expression in predicting the efficacy of immunotherapy. Lastly, we suggest exo-miRNA combined with PD-L1 as a biomarker combination in predicting anti-PD-L1 immunotherapy efficacy to better select the potential benefit population suitable for immunotherapy.

Official Title
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A Study on Serum Exosomal miRNA Predicting the Effective and Prognosis of Immunotherapy Combined With Chemotherapy in Pulmonary Squamous Carcinoma

Conditions
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Lung Neoplasm, Squamous Cell Carcinoma, Exosomes

Intervention / Treatment
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* Diagnostic Test: collect plasma samples and clinical features


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Histology or cytology confirmed patients with stage IV squamous cell carcinoma of IASLC TNM (8th edition); Patients have not previously received first-line anti-tumor systemic therapy for advanced lung cancer; At least one measurable lesion according to the irRECIST 1.1 standard; Physical condition and organ function allow for systemic antitumor therapy, including standard chemotherapy and immunotherapy; Age ≥ 18 years at the time of signing the informed consent form; Estimated survival≥ 3 months; Patients can follow the planned schedule and actively cooperate in returning to the hospital for regular clinical follow-up and necessary treatment; It can provide the clinical data required for research and is willing to use the test data for further scientific research and commercial product development. Exclusion Criteria: Other malignancies within the last 5 years (except adequately treated carcinoma in situ and basal or squamous cell skin cancer); The investigators judged that the patient also had other serious medical conditions that could affect follow-up and short-term survival; Any other medical condition and social/psychological problems which the investigator determines that the patient is not suitable to participate in this study; Contrast-enhanced MRI or contrast-enhanced CT for clinical follow-up is not acceptable; Have an active or previous auto-immune disease that is likely to recur; Other antineoplastic therapies were planned for the duration of the study.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| advanced lung squamous carcinoma<br>advanced pulmonary carcinoma with pathological diagnosis of squamous cell and are applied with first line treatment of anti-PD-L1 combined with chemotherapy | Diagnostic Test: collect plasma samples and clinical features<br>* 8ml of peripheral blood need to be collected from pre- and post-treatment advanced pulmonary squamous carcinoma separately<br>|
| normol volunteers<br>10 normol volunteers will be enrolled in the group | Diagnostic Test: collect plasma samples and clinical features<br>* 8ml of peripheral blood need to be collected from pre- and post-treatment advanced pulmonary squamous carcinoma separately<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| plasma exosomal miRNA level | The expression levels of serum exosome micro RNA | Baseline up to 21 days | 
| PD-L1 | the expression levels of PD-L1 | Baseline up to 21 days | 
| Imaging data of lesions | Imaging data of the pulmonary and metastatic lesions of the patients are collected | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months | 
| Objective response rate |  | From the start of systemic treatment date until the date of first documented disease progression or date of death from any cause, whichever came first, assessed up to 100 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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biomarker