WCLC 2025 - Posters & ePosters-P2.08 .60 Telomere Length and Survival in Patients With Locally Advanced Unresectable Lung Cancer: Is There a Relationship?

P2.08 .60 Telomere Length and Survival in Patients With Locally Advanced Unresectable Lung Cancer: Is There a Relationship?

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This unicentric prospective study investigated the relationship between telomere length (TL) and overall survival (OS) in patients with unresectable locally advanced non-small cell lung cancer (NSCLC) who are PD-L1 positive and treated with concurrent chemoradiotherapy (CCRT) followed by immunotherapy (IT). <br /><br />A total of 90 patients (90% men, median age 72) were enrolled from 2018 to 2021. Clinical, analytical, tumor, and treatment data were collected, and TL was measured from buccal swabs. Patients were stratified based on the 25th percentile of TL into two groups (above and below p25), and OS was analyzed using Kaplan-Meier methods during follow-up.<br /><br />Key findings include that NSCLC patients exhibited shorter TL compared to healthy populations by indirect comparison. Overall survival did not differ significantly between patients with longer or shorter TL overall. However, in multivariate analysis adjusting for variables including lung function and dosimetry, patients receiving immunotherapy with TL above the 25th percentile had significantly improved OS compared to those with TL below the 25th percentile. No OS differences were observed in patients who did not receive immunotherapy based on TL.<br /><br />Telomerase overexpression in tumors prevents telomere shortening, facilitating cellular immortality, and while IT after CCRT improves survival in this patient subgroup, TL appears to modulate this benefit.<br /><br />The study concludes that longer telomere length may predict better survival outcomes in NSCLC patients treated with immunotherapy, but further validation studies are necessary. These findings suggest TL could potentially serve as a biomarker for selecting NSCLC patients more likely to benefit from IT following CCRT.<br /><br />Funding was provided by the SEPAR 2019 Research Grant and the Spanish “Fondo de Investigación Sanitaria” (FIS) PI17/01401.

Asset Subtitle

Alfredo Marín-Muñiz

Meta Tag

Speaker Alfredo Marín-Muñiz

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

telomere length

overall survival

non-small cell lung cancer

NSCLC

PD-L1 positive

concurrent chemoradiotherapy

immunotherapy

biomarker

telomerase overexpression

Kaplan-Meier analysis