Temporal characterization of serum metabolite signatures in lung cancer patients undergoing treatment

Lung cancer causes more deaths in men and women than any other cancer related disease. Currently, few effective strategies exist to predict how patients will respond to treatment. We evaluated the serum metabolomic profiles of 25 lung cancer patients undergoing chemotherapy +/- radiation to evaluate the feasibility of metabolites as temporal biomarkers of clinical outcomes. Serial serum specimens collected prospectively from lung cancer patients were analyzed using both nuclear magnetic resonance (H-1-NMR) spectroscopy and gas chromatography mass spectrometry (GC-MS). Multivariate statistical analysis consisted of unsupervised principal component analysis or orthogonal partial least squares discriminant analysis with significance assessed using a cross-validated ANOVA. The metabolite profiles were reflective of the temporal distinction between patient samples before during and after receiving therapy (H-1-NMR, p < 0.001: and GC-MS p < 0.01). Disease progression and survival were strongly correlative with the GC-MS metabolite data whereas stage and cancer type were associated with H-1-NMR data. Metabolites such as hydroxylamine, tridecan-1-ol, octadecan-1-ol, were indicative of survival (GC-MS p < 0.05) and metabolites such as tagatose, hydroxylamine, glucopyranose, and threonine that were reflective of progression (GC-MS p < 0.05). Metabolite profiles have the potential to act as prognostic markers of clinical outcomes for lung cancer patients. Serial H-1-NMR measurements appear to detect metabolites diagnostic of tumor pathology, while GC-MS provided data better related to prognostic clinical outcomes, possibility due to physio-chemical bias related to specific biochemical pathways. These results warrant further study in a larger cohort and with various treatment options.