Neutrophil extracellular trap-related signature predicts the prognosis and immunotherapy outcome of lung adenocarcinoma

Neutrophil extracellular traps (NETs) are a kind of DNA reticular structure that can capture and kill pathogenic microorganisms. NETs are closely related to the progression of tumors, but the role of NETs in the immunotherapy of lung adenocarcinoma (LUAD) remains unclear. We constructed a NETs-related prognosis signature based on ATG7, BST1, CEACAM3 and TNFRSF10C, and the prognosis of LUAD patients in the NET-high group was worse than NET-low group. At the same time, we constructed a nomogram to improve the validity of NETs-related signature and achieved good results in external datasets. The NET-high group was associated with a higher mutation burden, higher TIDE predicted MSI score and a poorer immunotherapy outcome. Finally, we found that MEK inhibitors (selumetinib and trametinib) were more sensitive in the NET-high group and can inhibit the invasion and migration of LUAD cells. The NETs-related signature was able to predict the prognosis and immunotherapy outcome of LUAD patients.