1
|
Rotem O, Zer A, Yosef L, Beery E, Goldvaser H, Gutkin A, Levin R, Dudnik E, Berger T, Feinmesser M, Levy-Barda A, Lahav M, Raanani P, Uziel O. Blood-Derived Exosomal hTERT mRNA in Patients with Lung Cancer: Characterization and Correlation with Response to Therapy. Biomedicines 2023; 11:1730. [PMID: 37371825 DOI: 10.3390/biomedicines11061730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Background: Telomerase (human telomerase reverse transcriptase (hTERT) is considered a hallmark of cancer, being active in cancer cells but repressed in human somatic cells. As such, it has the potential to serve as a valid cancer biomarker. Exosomal hTERT mRNA can be detected in the serum of patients with solid malignancies but not in healthy individuals. We sought to evaluate the feasibility of measuring serum exosomal hTERT transcripts levels in patients with lung cancer. Methods: A prospective analysis of exosomal hTERT mRNA levels was determined in serum-derived exosomes from 76 patients with stage III-IV lung cancer (11 SCLC and 65 NSCLC). An hTERT level above RQ = 1.2 was considered "detectable" according to a previous receiver operating characteristic curve (ROC) curve. Sequential measurements were obtained in 33 patients. Demographic and clinical data were collected retrospectively from patients' charts. Data on response to systemic therapy (chemotherapy, immunotherapy, and tyrosine kinase inhibitors) were collected by the treating physicians. Results: hTERT was detected in 53% (40/76) of patients with lung cancer (89% of SCLC and 46% of NSLCC). The mean hTERT levels were 3.7 in all 76 patients, 5.87 in SCLC patients, and 3.62 in NSCLC patients. In total, 25 of 43 patients with sequential measurements had detectable levels of hTERT. The sequential exosomal hTERT mRNA levels reflected the clinical course in 23 of them. Decreases in hTERT levels were detected in 17 and 5 patients with partial and complete response, respectively. Eleven patients with a progressive disease had an increase in the level of exosomal hTERT, and seven with stable disease presented increases in its exosomal levels. Another patient who progressed on the first line of treatment and had a partial response to the second line of treatment exhibited an increase in exosomal hTERT mRNA levels during the progression and a decrease during the response. Conclusions: Exosomal hTERT mRNA levels are elevated in over half of patients with lung cancer. The potential association between hTERT levels and response to therapy suggests its utility as a promising cancer biomarker for response to therapy. This issue should be further explored in future studies.
Collapse
Affiliation(s)
- Ofer Rotem
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva 49100, Israel
| | - Alona Zer
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva 49100, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Lilach Yosef
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva 49100, Israel
| | - Einat Beery
- The Felsenstein Medical Research Center, Rabin Medical Center, Petah Tikva 49100, Israel
| | - Hadar Goldvaser
- Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University, Rehovot 7612001, Israel
| | - Anna Gutkin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- The Felsenstein Medical Research Center, Rabin Medical Center, Petah Tikva 49100, Israel
| | - Ron Levin
- Sheba Medical Center, Ramat Gan 5262000, Israel
| | - Elizabeth Dudnik
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva 49100, Israel
| | - Tamar Berger
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Institute of Hematology, Rabin Medical Center, Petah Tikva 49100, Israel
| | - Meora Feinmesser
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Biobank, Department of Pathology, Rabin Medical Center, Petah Tikva 49100, Israel
| | - Adva Levy-Barda
- Biobank, Department of Pathology, Rabin Medical Center, Petah Tikva 49100, Israel
| | - Meir Lahav
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- The Felsenstein Medical Research Center, Rabin Medical Center, Petah Tikva 49100, Israel
- Institute of Hematology, Rabin Medical Center, Petah Tikva 49100, Israel
| | - Pia Raanani
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- The Felsenstein Medical Research Center, Rabin Medical Center, Petah Tikva 49100, Israel
- Institute of Hematology, Rabin Medical Center, Petah Tikva 49100, Israel
| | - Orit Uziel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- The Felsenstein Medical Research Center, Rabin Medical Center, Petah Tikva 49100, Israel
- Institute of Hematology, Rabin Medical Center, Petah Tikva 49100, Israel
| |
Collapse
|