WCLC 2025 - Posters & ePosters-EP.16.04 Relationship Between Telomere Length and Pulmonary Toxicity in Patients With Locally Advanced Unresectable Lung Cancer

EP.16.04 Relationship Between Telomere Length and Pulmonary Toxicity in Patients With Locally Advanced Unresectable Lung Cancer

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This prospective unicentric study (2018-2021) investigated the relationship between telomere length (TL) and pulmonary toxicity (PT) from radiotherapy (RT) in 90 patients with unresectable locally advanced non-small cell lung cancer (NSCLC) treated with concurrent chemoradiotherapy, some receiving immunotherapy (IT). TL was measured from buccal samples and patients classified by TL percentiles. PT severity was graded per CTCAE v4.0 into mild-moderate (G1-G2) and severe (G3-G4).<br /><br />Results showed that cancer patients had shorter TL compared to a healthy population (indirect comparison). No significant association was observed between overall PT and TL across all patients in either univariate or multivariate analyses. Dosimetry parameters, specifically lung radiation exposure (V5, V20), correlated significantly with PT severity. However, a subgroup analysis revealed that patients with TL above the 25th percentile who also received immunotherapy had a lower risk of developing severe PT. Other clinical characteristics (age, sex, smoking status, COPD, lung function, histology, inflammatory ratios) did not differ significantly between PT severity groups.<br /><br />In conclusion, TL was not predictive of pulmonary toxicity in the entire cohort but might have a protective association against severe toxicity in patients treated with immunotherapy. These preliminary findings suggest TL's potential as a biomarker for pulmonary toxicity risk stratification in NSCLC patients undergoing RT with IT, but further studies are required to validate this relationship.<br /><br />Keywords: telomere length, pulmonary toxicity, radiotherapy, non-small cell lung cancer, immunotherapy, chemoradiotherapy, biomarker.

Asset Subtitle

Alfredo Marín-Muñiz

Meta Tag

Speaker Alfredo Marín-Muñiz

Topic Patient Advocacy

Keywords

telomere length

pulmonary toxicity

radiotherapy

non-small cell lung cancer

immunotherapy

chemoradiotherapy

biomarker

lung radiation exposure

CTCAE grading

telomere length percentile