Club cell secretory protein (CCSP) serum concentration is a prognostic factor after surgical resection of localized non-small cell lung cancer in patients in the IFCT-0302 trial.

[INTRODUCTION] No specific follow-up strategy has shown to improve overall survival (OS) after surgical resection of non-small cell lung cancer (NSCLC). Club cell secretory protein (CCSP) is produced by bronchiolar club cells and shows promise as a survival biomarker as its concentration depends on degree of lung inflammation. Our objective was to evaluate prognostic impact of postoperative serum CCSP concentration on OS after resection of stage I to IIIA NSCLC in a post hoc ancillary analysis of the IFCT-0302 trial.

[METHODS] Patients with at least 1 postoperative serum sample were included. The primary and secondary endpoints were OS and disease-free survival (DFS) as function of serum CCSP concentration.

[RESULTS] The IFCT-0302 trial included 1775 patients. Among them, 946 patients (77% male, age 63.3 ± 9.3 years) with postoperative serum collection were divided into quartiles according to CCSP concentration: Q1 (CCSP < 4.72 ng/mL), Q2 (4.72 ≤ CCSP < 7.93 ng/mL), Q3 (7.93 ≤ CCSP < 13.73 ng/mL), Q4 (CCSP ≥ 13.73 ng/mL. Patients with CCSP ≥ 13.73 ng/mL had greater risk of death than patients with CCSP < 4.72 ng/mL according to univariable (HR 1.31 [95% CI 1.01-1.70]; p = 0.046) and multivariable analyses (HR 1.30 [95% CI 1.00-1.70]; p = 0.05). Patients with high CCSP experienced a greater risk of recurrence or death than patients with low CCSP according to univariable (HR 1.34 [95% CI 1.05-1.70], p = 0.017) and multivariable analyses (HR 1.32 [95% CI 1.04-1.68], p = 0.025]).

[CONCLUSION] Post hoc analysis revealed that postoperative CCSP serum concentration was associated with OS and DFS in NSCLC resected patients. This finding provides insights for the development of personalized follow-up after surgical resection of NSCLC.