Table 1 Biomarkers predicting outcome and toxicity in radiotherapy for NSCLC
Types of Biomarkers | Outcome predictors | Toxicity predictors |
|---|---|---|
Panomics | ||
 Genomics | Genomic predicting scores: Radiosensitiviy Index (RSI), Genomic-adjusted radiation dose (GARD) Lung adenocarcinoma associated gene: KRAS Squamous cell carcinoma associated genes: KEAP1, NFE2L2 | DAN repair genes: ATM Other mutated genes: PTEN, RB1, TP53 … |
 SNPs | DNA repair gene sites: XRCC1, BRCA1, and ERCC1 | DNA repair gene sites: ATM, RAD51, XRCC family, LIG4, MTHFR Inflammatory gene sites: TGFβ1 Immune modulated gene sites: CBLB |
 Epigenetics | DNA methylation profile, IGFBP-3 Micro RNA: p53 regulation, RAD51 regulation (MiR-34a) | – |
 Proteome /Metabolome | – | Serum inflammatory biomarkers: TGFβ, IL-1, KL-6, IL-6 IL-8, PDGF, TGFα, TNFα, CXCL10 (IP-10), CCL2 (MCP-1), Eotaxin, and TIMP-1 Novel proteins identified by mass spectroscopy:C4BPA, VTN, α2M, CO4A, CO5 |
 Immunological markers | Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil count, lymphocyte count | Neutrophil-to-lymphocyte ratio (NLR) |
Radiomics | ||
 CT scan | Post SABR local recurrence prediction: enlarging opacity at 12 months after SABR, bulging margin, loss of linear margin and air bronchogram lossPost SABR recurrence free survival: tumor size, pleural retraction, vessel attachment For adaptive RT during chemoradiation: LARTIA trial | Combination of radiomic signatures predict radiation pneumonitis |
 PET | FDG-PET: Max SUV, metabolic volume, total lesion glycolysis FLT-PET: sensitive than FDG-PET to predict tumor response F-MISO-PET: identify radioresistant area for adaptive treatment | FLT-PET: predict hematological toxicity (bone marrow) |
 Dosiomics |  | Dosiomic information + dosimetric information (DVH) + clinical factors better predict radiation pneumonitis |