The following is a summary of “Circulating Fatty Acid Profile as a Biomarker for Immunotherapy in Advanced Non-Small Cell Lung Cancer,” published in the November 2022 issue of Clinical Lung Cancer by Galli, et al.

The composition of cell membranes, the balance of energy production and consumption, and the production of inflammatory mediators are all influenced by lipid metabolism, which in turn affects immune cell development, activation, and activities. Human data on malignancies and immunotherapy (IO) are few, despite promising preclinical results. This study aimed to examine whether or not circulating lipids were linked to survival in patients with non-small cell lung cancer (NSCLC) who were treated with IO. At the institution, researchers tracked down all advanced NSCLC patients who were treated with IO and had baseline plasma samples available for analysis. Gas chromatography was used to determine the fatty acid (FA) content. Survival curves were computed by the Kaplan-Meier method. Cox multivariate models were developed by a stepwise process, with entry and exit P value set at .2.

We identified 112 individuals, predominantly with performance status 1 (65.2%) and PD-L1 more than equal to 1% (75.3%). Median progression-free survival (PFS) and overall survival (OS) were 2.8 and 11.0 months, respectively. Multivariable model for survival identified a positive association of circulating free (FFA) C16:0 (P .005) and esterified (EFA) C16:1 (P .030) with PFS, and a positive connection of EFA C16:1 (P .001) and EFA C18:0 (P .020) with OS. C16:0 EFA was correlated negatively with poor prognosis (P .008).

The longer chain lengths of the unsaturated fatty acid (EFA) C16:1 and the elongated fatty acid (EFA) C18:0 are related to a better prognosis in IO-treated NSCLC patients compared to those with shorter chains. It is plausible that the ratio among such FAs may affect membrane fluidity and receptor activation, influencing IO efficacy. These findings open the door for further study into the potential of IO in conjunction with lipid-modulating therapies in NSCLC.