Abstract
OBJECTIVE: The objective of our study is to evaluate the predictive value of cytoplasmic Galectin-3 (Gal-3) expression in tumor cells (TCs) as well as in tumor-infiltrating immune cells (TIICs), including tumor-associated macrophages (TAM), tumor-associated neutrophils (TAN), and tumor-associated lymphocytes (TAL), in Moroccan patients with unresectable non-small cell lung cancer (NSCLC). METHODS: This is a prospective study conducted between 2019 and 2023 on 56 Moroccan patients diagnosed with unresectable NSCLC. These patients were treated with platinum-based doublet chemotherapy and followed at the Mohammed VI Center for Cancer Treatment at CHU Ibn Rochd in Casablanca. Immunohistochemistry (IHC) was used to assess Gal-3 (clone 9C4) expression in TCs and TIICs (TAM, TAN, and TAL). The characteristics of the patients were obtained from the patients' medical records. Statistical analysis, including Kaplan-Meier survival analysis and Cox regression, was performed using SPSS v.21. RESULTS: Survival analysis across different subgroups revealed that only patients with high Gal-3 expression in TCs, along with positive expression in TIICs or TAL, exhibited significantly improved overall survival (OS = 16.81 months, p = 0.007; OS = 15.95 months, p = 0.034) compared to other subgroups. Additionally, multivariate analysis showed that poor performance status (PS 1-2) and the presence of bone metastases were significantly associated with decreased progression-free survival (PFS) (p = 0.015 and p = 0.029, respectively). The histological type (squamous cell carcinoma) was significantly correlated with OS (p = 0.000). CONCLUSION: The concomitant expression of Gal-3 in TCs (high expression), TIICs, and TAL may serve as a predictive biomarker for chemotherapy response in patients with unresectable NSCLC.