e23159 Background: Depression and inflammation are both associated with lung cancer. Tumor Mutation Burden (TMB) can be used to predict immunotherapy response which relies on tumor immunogenicity, a form of inflammation. This study evaluated whether higher TMB was associated with increased depression and various forms of inflammation. Methods: Patients with metastatic Non-small Cell Lung Cancer (NSCLC) and Small Cell Lung Cancer (SCLC) receiving anticancer treatments were evaluated for depression severity using the Hospital Anxiety and Depression Scale (HADS). TMB was measured using Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT). Inflammation was evaluated using C - reactive protein (CRP) and the Neutrophil to Lymphocyte Ratio (NLR). Results: Ninety-six out of 140 participants with adequate TMB testing were evaluated (68.6%). The average number of mutations was 10.8 (SD 10.8). Twenty-four percent met screening criteria for depression. TMB correlated with depression severity (r = .34, p = .001) and NLR (r = .37, p = .002) and absolute neutrophil count (r = .3, p = .006) but not CRP (r = .193, p = .06). TMB was higher in patients receiving chemotherapy (12.0) and immunotherapy (14.4) over targeted therapy (4.8). A multivariate model found that TMB (β = .25, p = .032) and CRP (β = .36, p = .003) predicted for depression severity. Conclusions: TMB is an independent predictor of depression. Inflammatory indices suggest a possible relationship but the exact mechanism should be further evaluated and the results warrant replication. Ultimately, these findings may help identify lung cancer patients at risk for depression. [Table: see text]
Tumor mutation burden as emerging biomarker in non-small cell lung cancer and beyond
