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Article Open Access

A novel prognostic biomarker combining TP53 loss‑of‑function and amplification of different combinations of nine genes in lung squamous cell carcinoma treated with chemotherapy

  • Authors:
    • Yuli Li
    • Ting Hou
    • Hongjie Liu
    • Haiwei Du
    • Li Qiu
    • Yajing Zhang
    • Guiping Zhang
    • Yuan Tang
  • View Affiliations / Copyright

    Affiliations: Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China, Department of Medical Affairs, Burning Rock Biotech, Guangzhou, Guangdong 510000, P.R. China
    Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 289
    |
    Published online on: May 11, 2026
       https://doi.org/10.3892/ol.2026.15644
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Abstract

Lung squamous cell carcinoma (LUSC) is a prevalent subtype of lung cancer, which is primarily characterized by poor prognosis due to the lack of targeted therapies, while a large proportion of patients show limited response to chemotherapy. The present study aimed to identify predictive chemotherapy biomarkers based on genomic alterations in LUSC. Non‑negative matrix factorization clustering was applied to classify patients with LUSC into distinct subgroups based on genomic alterations. Subsequently, chemotherapy efficacy was predicted via exploring gene signatures, and the results were validated using The Cancer Genome Atlas database (TCGA). A total of four distinct clusters were classified. Cluster 1 and TP53 loss‑of‑function (TP53 LOF) variations were each independently associated with poor prognosis, irrespective of clinical stage. Based on the molecular characteristics of the initial clusters, the classification was further refined by further incorporating TP53 LOF and gene amplification (amp). Patients without TP53 LOF, who harbored amplification of at least one of nine specified genes [PIK3 catalytic subunit, cyclin D1, fibroblast growth factor (FGF) 19, FGF3, FGF4, FGF receptor 1, kinase insert domain receptor, KIT proto‑oncogene and platelet derived growth factor receptor α] displayed the longest progression‑free survival (PFS). By contrast, patients with TP53 LOF but lacking amplification of at least one of nine genes [Amp(9G)] exhibited the worst overall survival compared with the other subgroups. Validation in the TCGA database confirmed the prognostic significance of this classification, with Amp(9G) without TP53 LOF predicting the most favorable PFS, and TP53 LOF without Amp(9G) indicating the least favorable PFS. Therefore, a composite biomarker integrating Amp(9G) and TP53 LOF was identified as a prognostic indicator for patients with LUSC treated with first‑line chemotherapy. Overall, the results of the present study suggest that the absence of TP53 LOF combined with the presence of Amp(9G) could be associated with improved response to first‑line chemotherapy in LUSC.
View Figures

Figure 1

NMF-based molecular clustering of 317
patients with LUSC. (A) NMF-based molecular clustering of patients
with LUSC, classified into four clusters (C1, C2, C3 and C4). (B)
Differences in the number of copy number variants among the four
molecular clusters (C1-4) were first assessed using the
Kruskal-Wallis test, followed by pairwise comparisons using the
Wilcoxon rank-sum test with Holm correction. *P<0.05,
****P<0.0001. NMF, non-negative matrix factorization; LUSC, lung
squamous cell carcinoma; C, cluster; Indel, insertion and deletion;
CN, copy number; CNV, copy number variation; LGR, large genomic
rearrangement; KSCC, keratinizing squamous cell carcinoma; NKSCC,
non-keratinizing squamous cell carcinoma; del, deletions; amp,
amplification.

Figure 2

Associations between NMF-based
molecular clustering and PFS in patients with lung squamous cell
carcinoma treated with first-line chemotherapy. (A) NMF-based
molecular clustering of patients who received first-line
chemotherapy, classified into C1, C2, C3 and C4. (B) PFS between
C1-C4 is presented. (C) PFS between C1 and C2/3/4 is presented.
NMF, non-negative matrix factorization; C, cluster; PFS,
progression-free survival; HR, hazard ratio.

Figure 3

Prognostic value of TP53 LOF
alterations alone or in combination with non-negative matrix
factorization-based molecular clustering or gene amp status in
patients with lung squamous cell carcinoma who received first-line
chemotherapy. (A) PFS stratified by TP53 LOF status. (B) PFS
comparison among four subgroups: C1 with TP53 LOF, C1
without TP53 LOF, C2/3/4 with TP53 LOF and C2/3/4
without TP53 LOF. (C) PFS comparison among patients
harboring Amp(9G) with TP53 LOF, Amp(9G) without TP53
LOF, TP53 LOF without Amp(9G) and those without TP53
LOF and Amp(9G). (D) PFS comparison among patients harboring
TP53 LOF without Amp(9G), Amp(9G) without TP53 LOF
and others [including those with Amp(9G) and TP53 LOF and
those without Amp(9G) and TP53 LOF]. LOF, loss-of-function;
PFS, progression-free survival; C, cluster; amp, amplification;
Amp(9G), amplification of at least one of nine genes.

Figure 4

Validation of the prognostic
potential of TP53 LOF alone or combined with Amp(9G) in the
TCGA LUSC cohort treated with chemotherapy. (A) PFS stratified by
TP53 LOF status in the TCGA LUSC cohort. (B) PFS comparison
among patients harboring TP53 LOF without Amp(9G), Amp(9G)
without TP53 LOF and others [including those with Amp(9G)
and TP53 LOF, and those without Amp(9G) and TP53
LOF]. LOF, loss-of-function; TCGA, The Cancer Genome Atlas; LUSC,
lung squamous cell carcinoma; PFS, progression-free survival; amp,
amplification; Amp(9G), amplification of at least one of nine
genes.
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Copy and paste a formatted citation
Spandidos Publications style
Li Y, Hou T, Liu H, Du H, Qiu L, Zhang Y, Zhang G and Tang Y: A novel prognostic biomarker combining <em>TP53</em> loss‑of‑function and amplification of different combinations of nine genes in lung squamous cell carcinoma treated with chemotherapy. Oncol Lett 32: 289, 2026.
APA
Li, Y., Hou, T., Liu, H., Du, H., Qiu, L., Zhang, Y. ... Tang, Y. (2026). A novel prognostic biomarker combining <em>TP53</em> loss‑of‑function and amplification of different combinations of nine genes in lung squamous cell carcinoma treated with chemotherapy. Oncology Letters, 32, 289. https://doi.org/10.3892/ol.2026.15644
MLA
Li, Y., Hou, T., Liu, H., Du, H., Qiu, L., Zhang, Y., Zhang, G., Tang, Y."A novel prognostic biomarker combining <em>TP53</em> loss‑of‑function and amplification of different combinations of nine genes in lung squamous cell carcinoma treated with chemotherapy". Oncology Letters 32.1 (2026): 289.
Chicago
Li, Y., Hou, T., Liu, H., Du, H., Qiu, L., Zhang, Y., Zhang, G., Tang, Y."A novel prognostic biomarker combining <em>TP53</em> loss‑of‑function and amplification of different combinations of nine genes in lung squamous cell carcinoma treated with chemotherapy". Oncology Letters 32, no. 1 (2026): 289. https://doi.org/10.3892/ol.2026.15644
Copy and paste a formatted citation
x
Spandidos Publications style
Li Y, Hou T, Liu H, Du H, Qiu L, Zhang Y, Zhang G and Tang Y: A novel prognostic biomarker combining <em>TP53</em> loss‑of‑function and amplification of different combinations of nine genes in lung squamous cell carcinoma treated with chemotherapy. Oncol Lett 32: 289, 2026.
APA
Li, Y., Hou, T., Liu, H., Du, H., Qiu, L., Zhang, Y. ... Tang, Y. (2026). A novel prognostic biomarker combining <em>TP53</em> loss‑of‑function and amplification of different combinations of nine genes in lung squamous cell carcinoma treated with chemotherapy. Oncology Letters, 32, 289. https://doi.org/10.3892/ol.2026.15644
MLA
Li, Y., Hou, T., Liu, H., Du, H., Qiu, L., Zhang, Y., Zhang, G., Tang, Y."A novel prognostic biomarker combining <em>TP53</em> loss‑of‑function and amplification of different combinations of nine genes in lung squamous cell carcinoma treated with chemotherapy". Oncology Letters 32.1 (2026): 289.
Chicago
Li, Y., Hou, T., Liu, H., Du, H., Qiu, L., Zhang, Y., Zhang, G., Tang, Y."A novel prognostic biomarker combining <em>TP53</em> loss‑of‑function and amplification of different combinations of nine genes in lung squamous cell carcinoma treated with chemotherapy". Oncology Letters 32, no. 1 (2026): 289. https://doi.org/10.3892/ol.2026.15644
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