On‐treatment dynamics of circulating extracellular vesicles in the first‐line setting of patients with advanced non‐small cell lung cancer: the <scp>LEXOVE</scp> prospective study
Extracellular vesicle (EV) monitoring can complement clinical assessment of cancer response. In this study, patients with advanced non-small cell lung cancer (NSCLC) undergoing osimertinib, alectinib, pembrolizumab or platinum-based chemotherapy ± pembrolizumab were enrolled. EVs were characterized using Bradford assay to quantify the circulating cell-free EV protein content (cfEV), and dynamic light scattering to assess Rayleigh ratio excess at 90°, z-averaged hydrodynamic diameter and polydispersity index. A total of 135 plasma samples from 27 patients were collected at baseline (T0) and at the first radiological restaging (T1). A ∆cfEV < 20% was associated with improved median progression-free survival (mPFS) in responders versus non-responders. Specifically, cfEV responders on pembrolizumab had a significantly better mPFS (25.2 months) compared to those on chemotherapy plus pembrolizumab (6.1 months). EGFR-positive cfEV responders also experienced longer mPFS compared to cfEV non-responders (35.1 months, 95% CI: 14.9-35.5 vs. 20.8 months, 95% CI: 11.2-30.4). This study suggested that monitoring circulating EV could provide valuable insights into treatment efficacy in NSCLC, particularly for patients receiving pembrolizumab or osimertinib.
Authors
- Marco Bono (ORCID: https://orcid.org/0000-0001-7169-3463)
- Tancredi Didier Bazan Russo (ORCID: https://orcid.org/0009-0007-5595-3924)
- Valerio Gristina (ORCID: https://orcid.org/0000-0002-2392-0470)
- Umberto Malapelle (ORCID: https://orcid.org/0000-0003-3211-9957)
- Giancarlo Troncone (ORCID: https://orcid.org/0000-0003-1630-5805)
- Viviana Bazan (ORCID: https://orcid.org/0000-0003-0939-255X)
- Nadia Barraco
- Francesco Pepe (ORCID: https://orcid.org/0000-0001-9688-6376)
- Samuele Raccosta (ORCID: https://orcid.org/0000-0001-7775-5928)
- Giuseppe Badalamenti (ORCID: https://orcid.org/0000-0002-2478-8838)
- Lorena Incorvaia (ORCID: https://orcid.org/0000-0002-1199-7286)
- Simona Taverna (ORCID: https://orcid.org/0000-0002-2192-8938)
- Pasquale Pisapia (ORCID: https://orcid.org/0000-0002-6429-0620)
- Antonio Galvano (ORCID: https://orcid.org/0000-0003-4365-5683)
- Mauro Manno (ORCID: https://orcid.org/0000-0001-9843-0428)
- Anna Paola Carreca (ORCID: https://orcid.org/0000-0002-7389-7555)
- Daniele Santini (ORCID: https://orcid.org/0000-0002-9118-3337)
- Antonio Dello Russo (ORCID: https://orcid.org/0000-0002-4370-2008)
Institutions
- Policlinico Umberto I (IT)
- Federico II University Hospital (IT)
- Istituto di Farmacologia Traslazionale (IT)
- Ri.MED (IT)
- National Research Council (IT)
- University of Naples Federico II (IT)
- University of Palermo (IT)
Publication Details
- Journal
- Molecular Oncology
- Published
- 2025-01-09
- DOI
- https://doi.org/10.1002/1878-0261.13737
- Citations
- 6
- Primary Topic
- Extracellular vesicles in disease
- Type
- article
- Field-Weighted Citation Impact
- 4.84
Funders
- Università degli Studi di Palermo