A radiotherapy-related fibrosis gene signature-based risk model for predicting prognosis and immunological features in lung adenocarcinoma
In brief
Six-gene fibrosis signature accurately predicts survival and immune profile in lung adenocarcinoma
Researchers built a six-gene model based on radiotherapy-related fibrosis genes that reliably stratifies lung adenocarcinoma patients into high-risk and low-risk groups, with low-risk tumors showing a "hot" immune environment and better response to immunotherapy. High-risk cases have higher tumor mutational burden and distinct drug sensitivities, but the tool needs prospective validation before clinical use.
- Journal
- Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico (Q2)
- Published
- 2 August 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Yanyan Qiu, Cui Lv, Shubo Ding
- PMID
- 42542992
- DOI
- 10.1007/s12094-026-04525-z
Why clinicians should know about it
- Picked for Pulmonary and Respiratory Medicine (paper of the day, 3 August 2026).
Abstract
BACKGROUND: Lung adenocarcinoma (LUAD) is marked by significant tumor heterogeneity and immune interactions that influence therapeutic response, while radiation-induced fibrosis poses a critical clinical challenge by compromising pulmonary function and complicating post-treatment surveillance. METHODS: A prognostic risk signature for lung adenocarcinoma was established by integrating transcriptomic data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) repositories. The methodology involved initial screening for differentially expressed radiotherapy-related fibrosis genes, followed by least absolute shrinkage and selection operator (LASSO) regression coupled with multivariate Cox analysis to derive a compact risk model. Rigorous validation-encompassing survival analysis, receiver operating characteristic (ROS) evaluation, and external cohort testing-confirmed its predictive accuracy. Subsequent analyses delved into functional enrichment pathways, the tumor immune microenvironment, mutational characteristics, and potential chemotherapeutic responsiveness. RESULTS: Following construction and validation, a model based on six genes demonstrated high accuracy in predicting patient outcomes. Low-risk patients exhibited "hot" immune phenotypes with favorable immunotherapy responses, while high-risk patients showed elevated tumor mutational burden (TMB) and differential drug sensitivity. Three molecular subtypes were identified, with Group 3 representing a "cold" tumor phenotype associated with poorest prognosis. CONCLUSION: This study developed and validated a six-gene-fibrosis-based prognostic model for LUAD. The model stratifies survival risk and correlates with immune features and drug sensitivity, but provides a preliminary framework requiring prospective clinical validation.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.