A single-cell derived immune risk score predicts recurrence in NSCLC following neoadjuvant chemo-immunotherapy
4 affiliations
- 1Department of Medical Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China
- 2Criminal Science and Technology Office, Criminal Police Brigade of Pidu Branch of Chengdu Public Security Bureau
- 3Department of Neurology, The Affiliated Hospital, Southwest Medical University
- 4Department of Comprehensive Inpatient Ward, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China
Abstract
Background Neoadjuvant chemo-immunotherapy improves outcomes in resectable non-small cell lung cancer (NSCLC), but predicting postoperative recurrence remains challenging. While the precursor exhausted T cell (Texp) index offers prognostic value, the broader tumor immune microenvironment (TIME) contains untapped predictive potential. Methods A secondary analysis was conducted based on single-cell RNA and TCR sequencing data from 138 NSCLC patients treated with neoadjuvant chemo-immunotherapy. Following collinearity filtering of 51 immune cell subtypes and the Texp index, LASSO-Cox regression was applied to develop a prognostic Risk Score for recurrence-free survival (RFS). Results A four-feature Risk Score was identified, incorporating the Texp index, CXCL13+ Th1-like CD4+ T cells, KLRB1+ MAIT CD8+ T cells, and terminally exhausted T cells. This score robustly stratified patients into distinct RFS groups and demonstrated independent prognostic value in multivariate analysis (HR = 6.090, p = 0.004). Compared to the baseline Texp index alone, the expanded Risk Score model yielded significantly improved predictive discrimination (mean ΔC-index = 0.096) and demonstrated superior net clinical benefit in decision curve analysis at 12 and 24 months. Conclusion This integrated single-cell immune Risk Score provides enhanced prognostic accuracy over single-metric biomarkers, offering a refined tool for postoperative risk stratification and personalized adjuvant management in NSCLC.
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BibTeX
@article{ge2026singlecell,
title = {{A single-cell derived immune risk score predicts recurrence in NSCLC following neoadjuvant chemo-immunotherapy}},
author = {Jun Ge and Xuesong Tong and Xingxia Wang and Jian Wang},
journal = {BMC Cancer},
year = {2026},
month = jul,
doi = {10.1186/s12885-026-16565-3},
url = {https://doi.org/10.1186/s12885-026-16565-3},
note = {CC BY},
}
RIS
TY - JOUR
TI - A single-cell derived immune risk score predicts recurrence in NSCLC following neoadjuvant chemo-immunotherapy
AU - Jun Ge
AU - Xuesong Tong
AU - Xingxia Wang
AU - Jian Wang
PY - 2026
DA - 2026/07/01
JO - BMC Cancer
DO - 10.1186/s12885-026-16565-3
UR - https://doi.org/10.1186/s12885-026-16565-3
AB - Background Neoadjuvant chemo-immunotherapy improves outcomes in resectable non-small cell lung cancer (NSCLC), but predicting postoperative recurrence remains challenging. While the precursor exhausted T cell (Texp) index offers prognostic value, the broader tumor immune microenvironment (TIME) contains untapped predictive potential. Methods A secondary analysis was conducted based on single-cell RNA and TCR sequencing data from 138 NSCLC patients treated with neoadjuvant chemo-immunotherapy. Following collinearity filtering of 51 immune cell subtypes and the Texp index, LASSO-Cox regression was applied to develop a prognostic Risk Score for recurrence-free survival (RFS). Results A four-feature Risk Score was identified, incorporating the Texp index, CXCL13+ Th1-like CD4+ T cells, KLRB1+ MAIT CD8+ T cells, and terminally exhausted T cells. This score robustly stratified patients into distinct RFS groups and demonstrated independent prognostic value in multivariate analysis (HR = 6.090, p = 0.004). Compared to the baseline Texp index alone, the expanded Risk Score model yielded significantly improved predictive discrimination (mean ΔC-index = 0.096) and demonstrated superior net clinical benefit in decision curve analysis at 12 and 24 months. Conclusion This integrated single-cell immune Risk Score provides enhanced prognostic accuracy over single-metric biomarkers, offering a refined tool for postoperative risk stratification and personalized adjuvant management in NSCLC.
SN - 1471-2407
ER -