Expression of extracellular HSP90α in pre- and post-treatment samples of driver-gene-negative non-small cell lung cancer.

Purpose: This study aimed to explore the significance of the expression of pre- and post-treatment eHSP90α in the treatment response evaluation and prognosis of driver-gene-negative non-small cell lung cancer (NSCLC), as well as the significance of eHSP90α expression in the prognosis of immunotherapy.

Methods: We collected pre-treatment eHSP90α in 330 driver-gene-negative NSCLC patients and analyzed its relationship with efficacy evaluation and prognosis. Survival curves were used to determine their respective critical values and the relationship between eHSP90α expression and OS and PFS was analyzed. Then, univariable and multivariable Cox regression analyses and LASSO multivariable logistic regression analyses were used to establish the prognostic and efficacy evaluation models.

Results: High expression of pre-treatment eHSP90α in driver-gene-negative NSCLC patients is associated with shorter OS. Pre-treatment eHSP90α, immunotherapy, TTF-1, CA125, and age influence OS in NSCLC patients. In the stratified analysis of immunotherapy, pre-treatment eHSP90α in immunotherapy is an independent influencing factor of OS in NSCLC patients, and pre-treatment eHSP90α, age, CA125, and B lymphocytes in non-immunotherapy are independent influencing factors of OS in NSCLC patients. High expression of pre-treatment eHSP90α in NSCLC patients is associated with shorter PFS. Pre-treatment eHSP90α, M1, Ki-67, and immunotherapy are independent influencing factors of PFS in NSCLC patients. In the stratified analysis of immunotherapy, pre-treatment eHSP90α and CEA in immunotherapy are independent influencing factors of PFS in NSCLC patients, and pre-treatment eHSP90α, M1, Ki-67, CA125, Th/Ts, and age in non-immunotherapy are independent factors affecting PFS in NSCLC patients. Pre-treatment eHSP90α was one of the influencing factors in the efficacy evaluation model.

Conclusions: The expression of pre-treatment eHSP90α has significant significance for the prognosis and efficacy evaluation of driver-gene-negative NSCLC.